Diindolylmethane

• Preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) of anticancer effects among people with prostate cancer or prostatic intraepithelial neoplasia (PIN) treated with DIM
• No evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on breast density among women with breast cancer prescribed tamoxifen treated with DIM

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• Preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) of favorable changes in sex hormones among people with hormone-sensitive cancers (breast and prostate), or at risk of these cancers, or with thyroid proliferative disease treated with DIM

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• Preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) of fewer and shorter bleeding episodes and less pelvic pain among women with endometriosis (not specific to cancer) treated with DIM

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• Preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) of regression of cervical lesions among women with grade 1–2 cervical intraepithelial neoplasia (CIN) treated with DIM as a vaginal suppository
• No evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on markers of cervical cancer among women treated with oral DIM
• Weak evidenceone or more case studies, supported by animal evidence OR small treatment effects of limited clinical significance OR studies with no controls OR weak trends of effects (this is the CancerChoices definition; other researchers and studies may define this differently) of less fibroglandular tissue but no evidence of an effect on a marker of cancer risk among female BRCA carriers treated with DIM
• Weak evidence of better BRCA1 mRNA expression in white blood cells (related to lower risk of breast cancer) among women BRCA mutation carriers treated with DIM

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• Not mentioned in integrative cancer clinical practice guidelines
• Used in several (at least 4) of our program sources and recommended weakly

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• Generally safe, with only minor side effects
• Some evidence of an interaction with tamoxifen
• A few possible drug interactions

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• Widely available without restriction
• Generally inexpensive (less than $500 US/year)

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