Higher folate levels associated with improved survival in postmenopausal breast cancer patients

Higher folate levels associated with improved survival in postmenopausal breast cancer patients

Life Extension Update

Tuesday, February 17, 2015. In an article published online on February 3, 2015 in the journal Nutrition and Cancer, researchers from California State University, the University of California, and the CDC in Atlanta report better survival among postmenopausal breast cancer patients with higher plasma levels of the B vitamin folate.

The study included 471 postmenopausal women diagnosed with breast cancer between 1994 and 1995. Stored plasma samples collected after diagnosis were analyzed for total folate (which is the sum of all folate vitamers), and the vitamers folic acid, tetrahydrofolic acid (THF), 5-methyl tetrahydrofolic acid, and 5-formylTHF/MeFox. Dietary questionnaires provided information on food intake and supplement use. The women were followed for an average of 6.7 years, during which 85 deaths occurred.

Among women whose plasma total folate levels were among the top 25% of all subjects, there was a 59% lower risk of mortality over follow-up in comparison with those whose levels were among the lowest 25%. Supplemental folic acid and total folate intakes were strongly, positively associated with circulating total folate and all vitamer levels.

"Several studies have shown increased bioavailability of folate from folic acid supplements compared with folate from food," Archana Jaiswal McEligot, of Cal State Fullerton, and colleagues noted.

"Folic acid supplementation compared to dietary folate alone, was not only significantly associated, but also much more highly correlated with circulating total folate concentrations, suggesting that in the absence of folic acid fortification and/or consuming a low folate diet, folic acid supplementation may improve survival after breast cancer diagnosis," they conclude. "However, more studies are needed to elucidate the role of the relationship between dietary folate intakes and folate supplementation with circulating folate vitamers, and their influence on survival after breast cancer diagnosis."

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Greater vitamin C intake linked with reduced risk of breast cancer mortality
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The results of a meta-analysis conducted by researchers at Sweden's Karolinska Institutet indicate improved survival among women with breast cancer who had a higher intake of vitamin C from supplements or food sources. The findings were reported online on March 7, 2014 in the European Journal of Cancer.

For their analysis, Holly R. Harris and her colleagues selected nine reports describing ten observational studies that included a total of 17,696 women diagnosed with breast cancer, among whom there were 1,558 deaths attributable to the disease and 2,791 total deaths. Studies examined the effect of supplementing with vitamin C following breast cancer diagnosis and/or the effect of vitamin C obtained in the diet.

When the studies that reported the effects of vitamin C supplements were evaluated, their use was associated with a 19% lower risk of total mortality and a 15% lower risk of dying from breast cancer in comparison with no use. Analysis of vitamin C from food sources uncovered a 27% lower risk of mortality and a 22% lower risk of breast cancer death in association with each 100 milligram per day increase. Comparison of high versus low dietary intake resulted in a 20% lower risk of dying and a 23% reduction in the risk of breast cancer mortality among women whose intake was categorized as high.

"To our knowledge this is the first meta-analysis to combine the limited number of published studies available on vitamin C supplement intake and dietary vitamin C intake and survival following breast cancer diagnosis," the authors announce. "More studies of post-diagnosis supplement use, including vitamin C, are warranted to further our understanding of how their intake during chemotherapy or radiation therapy may influence breast cancer outcomes."

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Health Concern

Breast Cancer

Vitamin A and vitamin D3 inhibit breast cancer cell division and can induce cancer cells to differentiate into mature, noncancerous cells. Vitamin D3 works synergistically with tamoxifen (and melatonin) to inhibit breast cancer cell proliferation. The vitamin D3 receptor as a target for breast cancer prevention was examined. Pre-clinical studies demonstrated that vitamin D compounds could reduce breast cancer development in animals. Furthermore, human studies indicate that both vitamin D status and genetic variations in the vitamin D3 receptor (VDR) may affect breast cancer risk. Findings from cellular, molecular and population studies suggest that the VDR is a nutritionally modulated growth-regulatory gene that may represent a molecular target for chemoprevention of breast cancer (Welsh et al. 2003).

Daily doses of vitamin A, 350,000 to 500,000 IU were given to 100 patients with metastatic breast carcinoma treated by chemotherapy. A significant increase in the complete response was observed; however, response rates, duration of response and projected survival were only significantly increased in postmenopausal women with breast cancer (Israel et al. 1985).

Breast cancer patients may take between 4000 to 6000 IU, of vitamin D3 every day. Water-soluble vitamin A can be taken in doses of 100,000-300,000 IU every day. Monthly blood tests are needed to make sure toxicity does not occur in response to these high daily doses of vitamin A and vitamin D3. After 4-6 months, the doses of vitamin D3 and vitamin A can be reduced.

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1. Myerburg RJ, Junttila MJ. Sudden cardiac death caused by coronary heart disease. Circulation. 2012;125:1043-1052.
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