Higher vitamin D levels linked with improved prostate cancer survival

Tuesday, February 9, 2016

In an article published online on January 25, 2016 in Cancer Epidemiology, Biomarkers & Prevention, researchers at the National Cancer Institute in Bethesda, Maryland document an association between higher serum vitamin D levels and an increased chance of surviving prostate cancer.

The current investigation included 1,000 participants in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study who were diagnosed with prostate cancer following enrollment. Three hundred sixty-three of the subjects died from their disease over 23 years of follow-up from the time of diagnosis. Serum 25-hydroxyvitamin D levels and other factors were measured upon enrollment and questionnaires concerning diet and medical history were completed by all participants.

Among men whose vitamin D levels were among the top 20% of subjects, there was a 28% lower average adjusted risk of dying from prostate cancer compared to those whose levels were among the lowest 20%. The effect was stronger among those who survived more than 3.3 years.  

Authors Alison Mondul and colleagues point out that previous studies that failed to find an association between vitamin D levels and prostate cancer mortality had small sample sizes, leading to uncertainty concerning whether the results were truly null. Other studies have examined vitamin D levels at the time of diagnosis or included only men with stage 4 disease, which ignores the fact that primary tumors and metastases can influence vitamin D status.

"Our findings that higher 25(OH)D reduces the most clinically relevant prostate cancer outcome, disease-specific mortality, if true, could have important public health implications, including whether vitamin D supplementation should be considered for men diagnosed with prostate cancer," the authors conclude.

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Vitamin D supplementation slows progression of low-grade prostate cancer
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A presentation at the 249th National Meeting & Exposition of the American Chemical Society revealed the outcome of a randomized trial which found a benefit for vitamin D supplementation among men with low-grade prostate cancer.

Acting on the results of a previous study published in the Journal of Clinical Endocrinology and Metabolism, which found a reduction in Gleason scores (which are used to grade tumor aggressiveness) in prostate cancer patients supplemented with vitamin D over one year, Bruce Hollis, PhD, and colleagues set out to determine whether the vitamin could decrease tumor aggressiveness during the 60-day required waiting period between prostate biopsy and surgery to remove the gland. The trial randomized 37 men scheduled for elective prostatectomy to receive 4,000 international units (IU) vitamin D or a placebo for 60 days. Examination of the excised glands revealed improvement among a number of men in the vitamin D-supplemented group, in contrast with no improvement or worsening of disease in those who received a placebo. The vitamin D group also exhibited changes in cell lipids and proteins, including those involved in inflammation. "Cancer is associated with inflammation, especially in the prostate gland," stated Dr Hollis, of the Medical University of South Carolina. "Vitamin D is really fighting this inflammation within the gland."

Dr Hollis observed that the vitamin D dose used in the trial is significantly lower than the amount made in the body from daily sun exposure. "We're treating these guys with normal body levels of vitamin D," he noted. "We haven't even moved into the pharmacological levels yet."

"We don't know yet whether vitamin D treats or prevents prostate cancer," he commented. "At the minimum, what it may do is keep lower-grade prostate cancers from going ballistic."


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Health Concern

Prostate cancer prevention

As the New England Journal of Medicine clarified, "Cancer results from the accumulation of mutations in genes that regulate cellular proliferation" (Haber 2000). In other words, cancer is essentially caused by the genetic mutations that occur over the lifespan. The fascinating impact of vitamin D is that it protects against cancer by enabling us to regain control over the genes that regulate cell proliferation. Vitamin D affects at least 200 human genes (Holick 2007). These genes are responsible for regulating crucially important aspects of cells: their proliferation, differentiation, and apoptosis.

In recent years, a multitude of studies have shown cancer risk reductions of 50% and greater based on higher vitamin D status (Garland 1989; Garland 1991; Garland 2007; Gorham 2005). People with higher vitamin D levels have lower risks of lethal prostate cancer, as well as reduced risks of other cancers (Holick 2007; Garland 1989; Yousef 2013; Skinner 2006; Polesel 2006; Shui 2012). Individual blood testing is needed to determine individual-appropriate dosages, which typically range from 2,000 to 10,000 international units (IU) daily for prevention. Life Extension suggests an optimal vitamin D blood level of 50-80 nanograms per milliliter (ng/mL).

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