In nearly every case, the goal is better health, even though there is no firm evidence to support this hope. The absence of benefit is one thing, but the presence of harm is another: A 2007 report in the Journal of the National Cancer Institute concluded that there was an increased prostate cancer risk among men using multivitamins, reports the October 2007 issue of Harvard Men's Health Watch .

When scientists further explored this finding, they found no link between multivitamin use and the risk of developing localized prostate cancer. But they did find that men who take multivitamins more than once a day were 32% are more likely to develop advanced prostate cancer and 98% more likely to die from the disease.

However, the study had its limitations. For example, it was not designed to determine whether multivitamins actually caused cancer; it did not ascertain which multivitamins were taken; and the results failed to establish a relationship between dose and response. Moreover, other studies have shown no connection between prostate cancer and multivitamins. Faced with this contradictory information, scientists know they need more studies, and several are already under way.

Meanwhile, what should you do? Harvard Men's Health Watch suggests that a good diet and other lifestyle changes may help lower your prostate cancer risk. As for vitamins, the new study cautions against excessive multivitamin use, but it does not show harm from a daily supplement that sticks to the recommended daily amounts of the standard vitamins. Above all, the new study adds to the growing body of evidence that tells us not to count on supplements.

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Patients varied widely in how they ranked treatments and complications. Those who had experience with a specific medication or complication saw them as having less of an impact on quality of life than those without such direct experience.

But many patients found both complications and treatment onerous. Between 12 and 50 percent were willing to give up 8 of 10 years of life in perfect health to avoid life with complications. More surprising, between 10 and 18 percent of patients were willing to give up 8 of 10 years of healthy life to avoid life with treatments.

The existing burden of treatment may even increase when results from the ongoing ACCORD trial are announced in 2010, said Huang. "This trial may produce evidence for even greater use of medications to try to prevent complications," he said

"Our study results show that taking multiple medications on a routine basis represents a significant burden for many patients," the authors conclude. "Quality of life related to treatments will be likely to improve if we can simplify or modify current treatments through treatment innovations."

Until specialists find ways to do that, Philipson added, "physicians need to be able to spend more time with patients." This includes finding ways to bill appropriately for phone- and web-based interactions. "We also need more ancillary services like psychiatric social workers and diabetes educators to meet with patients," he added. "That could save the health care system a ton of money, even without developing new drugs or treatments. But we have to do that as well."

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