Clinical Trials Find Calcium Vitamin D May Reduce Colon Cancer Risk

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April 15, 2008

Clinical trials find calcium/vitamin D may reduce colon cancer risk

Clinical trials find calcium/vitamin D may reduce colon cancer risk

Research findings presented at the American Association for Cancer Research meeting, held this year in San Diego, suggest that supplementing with vitamin D and calcium may reduce colon cancer risk, while consuming too much iron might increase it.

Veronika Fedirko of Emory University presented her team’s discovery that supplementing colorectal adenoma (polyp) patients with 2 grams calcium, 800 international units of vitamin D, or a combination of the two for six months was associated with an increase of Bax, a protein that controls apoptosis (programmed cell death), compared with placebo group levels. By increasing Bax levels in the colon’s mucosa, a greater number of precancerous cells (such as those that are found in polyps) may self-destruct. The trial found that the greatest increase in the ratio of Bax to Bcl-2 (an apoptosis inhibitor) occurred in the group that received both calcium and vitamin D.

"We were pleased that the effects of calcium and vitamin D were visible enough in this small study to be significant and reportable," Dr Fedirko stated. "We will have to fully evaluate each marker's strength as we accumulate more data."

In another study presented at the AACR meeting, Emory University Rollins School of Public Health professor of epidemiology Robert Bostick, MD, MPH and colleagues found that individuals who consume high amounts of vitamin D and calcium had increased expression of E-cadherin, a calcium-dependent glycoprotein that moderates the movement and proliferation of colon cells. Loss of E-cadherin expression has been associated with the progression of cancer. The study involved the comparison of biopsy samples from individuals with and without sporadic colorectal adenoma, and is part of a larger effort to identify biomarkers for the development of colon cancer. "We want to have the equivalent of measuring cholesterol or high blood pressure, but for colon cancer instead of heart disease," Dr Bostick remarked. "These measurements will describe the climate of risk in the colon rather than spotting individual tumors or cells that may become tumors."

An additional abstract coauthored by Dr Bostick reported the finding in the same study population that high levels of iron are associated with a reduction in a protein known as APC needed to control cell growth. “Clinical implications of these findings, if confirmed, could include lowering iron intakes in adenoma patients to prevent adenoma recurrence or colorectal cancer,” the authors conclude.

The current studies contribute more evidence for a protective role for calcium and vitamin D in colorectal cancer. Dr Bostick’s team is involved in a ten year study at several centers which will evaluate the effects of increased calcium and vitamin D as well as biomarker-guided treatment on the recurrence of colon cancer.

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Health Concern Life Extension Highlight

Colorectal cancer

Interventions that can prevent the development of colorectal cancer include screening for adenomas, removal of polyps by endoscopic polypectomy, excision of the large bowel (in FAP) (Munkholm P 2003; Watson P et al 1998), and regular NSAID use (Reeves MJ et al 1996; Giardiello FM et al 1993), in addition to the following dietary interventions:

Fiber from bran and cellulose is effective in reducing the risk of colorectal cancer development (Gonzalez CA 2006b); Greenwald P et al 1986). In those with low intake of dietary fiber, doubling of total fiber intake could reduce the risk of colorectal cancer by 40 percent (Bingham S 2006). Fruit fiber consumption, as opposed to vegetable fiber, reduces the risk of colorectal adenomas (Platz EA et al 1997). High-fiber foods include legumes, beans, seeds, nuts, wild rice, and oatmeal.

Calcium reduces the growth rate of rectal and colon epithelial cells both directly and by binding bile acids and fatty acids in the stool, resulting in compounds that are less likely to adversely affect the colon (Rozen P et al 1989). Calcium’s beneficial effects may occur only in individuals who have a low level of fat intake (Cats A et al 1995). Oral calcium supplementation reduces benign tumor (adenoma) formation by 19 percent (Baron JA et al 1999) and slightly reduces cell proliferation in the rectum (Cats A et al 1995). Foods such as broccoli, kale, Chinese cabbage, milk, cheese, and yogurt are good sources of calcium.

Curcumin is currently being investigated in human clinical trials for the prevention and treatment of colorectal cancer (Jiao Y et al. 2006a). Curcumin may be effective in preventing the development of colon cancer related to APC mutations (Corpet DE et al 2003; Pierre F 2003; Reddy BS et al 1994, 2002). The suggested daily dose is 1.6 grams (Perkins S et al 2002). Curcumin is extracted from turmeric root and is used as a spice in cooking.

Multivitamin use reduces the risk of benign tumor (adenoma) formation in high-risk individuals (Whelan RL et al 1999). Vitamins C, E, and A reduce the risk of developing colorectal cancer (Howe GR et al 1992; Newberne PM et al 1990).

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