Remember when there used to be a slogan on television that stated, “Milk does the body good!” This slogan eventually evolved into a new slogan: “Got Milk!” Both slogans, and others like them, were not only aimed at selling more milk to consumers. They also had an underlying health message. That message was drink milk to acquire essential nutrients, such as vitamin D and calcium, in order to live a healthier life. That message, somehow, in some way, got lost in translation.
Deficiencies in both nutrients, which are endemic in the United States, have been associated with the development of a number of different disease states, including osteoporosis and cancer. The impact of vitamin D deficiency in the field of oncology has become more apparent for ChemotherapyAdvisor in the last 3 months. During which time, we have provided our readers will be healthy sampling of articles focused on this very topic.
The first study came though our news feed during the first week of June as output of the 2012 American Society of Clinical Oncology Annual Meeting. In that study, women with early-to-late-stage breast cancer were given 30,000IU/week of vitamin D3 while initiating adjuvant letrozole. Surprisingly, these women experienced fewer adverse quality of life events (i.e. pain, fatigue) during adjuvant therapy which could be attributed to supplemental vitamin D3. This observation led the authors to conclude that vitamin D deficiency, which has been linked to cancer development, progression, and poor outcomes, could be corrected through high-dose supplementation and actually improve cancer outcomes.
More evidence came a couple weeks later when another study was distilled from remote coverage of the American Association for Cancer Research’s Pancreatic Cancer: Progress and Challenges Conference. This study was somewhat different in that it reported on the association between genetic variation in the vitamin D receptor (VDR) and pancreatic cancer outcome. The function of the VDR protein is to bind vitamin D and then initiate a chain of biological events that lead to the absorption of calcium by the gastrointestinal tract. In this study, the investigators examined 2 genetic variants (alleles) of VDR. Germane to our oncology interests, patients with pancreatic cancer that carried both variants of VDR had higher rates of overall survival compared with patients that only carried 1 variant.
Following that story was a study that continued on the theme of linking vitamin D deficiency with cancer. In that study, a retrospective chart review, presented at the 2012 Endocrine Society Annual Meeting, found that vitamin D deficiency is highly prevalent in survivors of childhood cancer. However, when the investigators attempted to identify risk factors for the deficiency, no distinct factors emerged. However, the investigators did recommend that this patient population should be carefully monitored for vitamin D deficiency during remission.
In a study recently published in July issue of The Oncologist, the investigators found that recommended doses of vitamin D and calcium are inadequate to prevent bone loss in men with metastatic prostate cancer who had been treated with androgen deprivation therapy. However important these nutrients might be for men with early stage prostate cancer, the investigators argued that high levels of dietary calcium and calcium supplement use are associated with higher risks for cardiovascular disease and advanced prostate cancer, thus identifying an unmet medical need for careful monitoring of calcium and vitamin D supplementation in these men.
Finally, in an article published in the July issue of the American Journal of Respiratory and Critical Care Medicine, vitamin D deficiency was associated with poor lung function and more rapid lung function decline in current male smokers. With smoking being such a major risk factor in many cancers, including lung cancer, is it possible that researchers will eventually identify vitamin D deficiency as another risk factor for lung cancer development?
What cancer types have been associated with vitamin D and/or calcium deficiency in your patients?
How does supplementation affect cancer treatment outcomes in these patients?
Stay tuned for an upcoming case study that examines the benefits of calcium and vitamin D supplementation in breast cancer patients.