vitamin d cancerWe have known for quite a while that Vitamin D is a potent pro-hormone in the body, responsible for many beneficial effects. One of these effects is cancer prevention. Furthermore, the developing science is that it can prevent RECURRENCE also! The best plan is to maintain Vitamin D levels before any cancer is evident, but new research shows that higher levels achieved as soon as possible in the disease process can improve prognosis in the fight against cancer.

Here is a backgrounder video which you should pay very careful attention to. It covers soup to nuts about Vitamin D in terms of disease prevention as well as cancer per se. Following this, we will get into the newer research studies which demonstrate that higher Vitamin D in the blood and tissues improve cancer prognosis.

Vitamin D and Cancer-New Information!

Get our free email newsletter at: http://www.ihealthtube.com/content/newsletter Recent studies are showing the benefit of vitamin D levels and a couple of the most common cancers. Learn more about the connection! Also, learn about a food that's been found to dramatically lower blood glucose levels!

 

We now know that the original Institute of Medicine and RDA recommendations of Vitamin D supplementation were kind of low. The concept was that “you can get this from the sun”. The problem is that up to one third of individuals living in the sun belt are still deficient. Why? Well, to some extent the prudent use of sunscreen, to avoid skin cancer and mainly the deadly melanoma, cuts out about 95% of skin production of Vitamin D. Imagine what this is in the “non-sun belt” regions of the world. Supplementation appears critical.

What level is ideal? This is not clear but if one can get to a blood level of 35-40ng/mL (90-100nmol/L) the cancer prevention is about 35%. So, to some extent more is better and some advocate getting to 50ng/mL or more. For the short term, especially when fighting cancer, this may be OK. However, there is also some scientific evidence that very high levels over a prolonged time period can actually CAUSE cancer. So, some caution is warranted.

New research from the Institutes of Natural Sciences at the Shanghai Institutes for Biological Sciences in China showed that every 10 nmol/L increase in blood concentration of Vitamin D were linked to a 4% improvement in cancer survival. In a second study in prostate cancer patients, lower Vitamin D levels at diagnosis were associated with a much more aggressive variant of disease. In fact it is felt that lower Vitamin D in prostate cancer can be a biomarker in that disease. This finding was real was after adjusting the statistics for other risk factors like smoking, family history, diet and calcium intake. In other words, it was a very real association and likely a cause effect mediator in some way. This could be the case for other cancers as well, but not clear yet.

The very best plan is prevention. Second best plan is pump those Vitamin D levels up if you have been diagnosed with cancer. The association with prognosis is not totally clear, but it appears very positive and the risks are very low. The best approach is to get your blood tested for Vitamin D. After that it becomes obvious how much is required to increase your circulating levels of Vitamin D.

Here is a rough estimate of what would be required to raise a level over a few months:
200 IU (5 mcg) per day increases vitamin D blood levels 2 ng/ml (5 nmol/L).
400 IU (10 mcg) per day increases vitamin D blood levels 4 ng/ml (10 nmol/L).
500 IU (12.5 mcg) per day increases vitamin D blood levels 5 ng/ml (12.5 nmol/L).
800 IU (20 mcg) per day increases vitamin D blood levels 8 ng/ml (20 nmol/L).
1000 IU (25 mcg) per day increases vitamin D blood levels 10 ng/ml (25 nmol/L).
2000 IU (50 mcg) per day increases vitamin D blood levels 20 ng/ml (50 nmol/L).

On average I tell patients they should be consuming about 1000-2000IU per day unless they were severely deficient to start.  However, the main point is that the dose should be adjusted based on the lab levels.  Vitamin D can be metabolized differently and consumed variably in any given individual, so it takes careful adjustment rather than randomly adjusting the dose too high or too quickly.

Li M et al Reivew: The impacts of Circulating 25-hydroxyvitmain D levels in cancer patient outcomes: a systematic review and meta-analysis J Clin Endocrinol Metab doi:1012 10/jc.2013-4320
Murphy AB et al Vitamin D deficiency predicts prostate biopsy outcomes Clin Cancer Res. 2104;20(9):2289-2299

Studies gone bad have alerted us to the fact that some supplements, especially in higher doses, can have no effect or even CAUSE cancer rather than help fight or prevent it.  The thought was simple and noble and is the reason we do clinical research studies rather than rely totally on animal studies or laboratory research in test tubes and Petri dishes.  What SHOULD work well might be disastrous.

Do your own research before choosing supplements

By research I mean look at what was published with a very critical eye. If you don’t know how research is structured, ask for help. Not all research is the same, not all research is done well and some is very early in development. Something that is early in development, like in a lab or animal study, does not prove or disprove much. Similarly epidemiologic studies, although in some ways “better” because they are based on human data, can only show “associations” and not causation. Results from ANY of these can only SUGGEST that it has to be studied in human clinical trials. Why? Because of this very issue with supplements causing cancer. The idea was great and plausible, but fell apart badly when tested in humans.

Anti-oxidants theoretically fight cancer. When consumed in food, in almost all cases this is true and the synergies that are in food between micro-nutrients were put there and refined over eons. However, when you split something out, like a single anti-oxidant, especially synthetic versions, and then use them as a pill supplement the result can be quite different. The following are a few cases in point.

Consistent epidemiologic evidence suggested that high intake of fruit and vegetables are associated with a reduced risk of lung cancer. So, which micro-nutrients are the most likely in this mix? Among many candidates, several top picks surfaced based on biochemistry, lab and animal studies. Retinoids are natural and synthetic derivatives of vitamin A (retinol). Related to these are carotenoids, which are a family of conjugated polyene molecules, found largely in fruit and vegetables. Certain carotenoids are converted to retinol. In addition, there are several variants of Vitamin E or Tocopherol. α-Tocopherol (alpha) is a potent antioxidant, scavenging reactive oxygen species and free radicals, and protecting against oxidative damage. These seemed like top picks and that was exactly what was done. Three phase III studies were completed involving primary cancer prevention: the α-Tocopherol, β-Carotene (ATBC) Study, the β-Carotene and Retinol Efficacy Trial (CARET), and the Physicians Health Study. The data from these studies were VERY disturbing. Smokers(current and ex-smokers analyzed together as a high risk group) who received high-dose β-carotene supplementation had an INCREASED risk for lung cancer. Regarding Vitamin E or α-Tocopherol the only published, controlled randomized trial was the ATBC study which showed no effect on lung cancer incidence. But hold on, the problem with this study was that in food the main Vitamin E is GAMMA Tocopherol, whereas in this study it was ALPHA Tocopherol that was tested. Based on whole food epidemiologic studies where gamma-tocopherol is a major contributor to anti-oxidant potential, the goof may have been in which biochemical variant of Vitamin E was used. The lesson? We tried to outsmart Mother Nature in splitting out what we thought was the best and it failed.

Another famous example is the use of Selenium. Epidemiological studies suggest that Selenium (Se) has anticarcinogenic capacity and plays a role in cellular defense against oxidative stress. When split out from food and tested in the Selenium and Vitamin E Cancer Prevention Trial (SELECT) clinical trial, selenium had no effect on prostate cancer risk, but alpha tocopherol significantly increased prostate cancer risk by 17{e1e3d526fd36fc01ebced66f8743c136750b0fc895f2fe665098c818ee436a7e}. Again, this is not the GAMMA tocopherol that is the predominant form of Vitamin E in whole food. Perhaps the results would have been different but this will always remain the worry. Which forms and doses of micro-nutrients are safe and effective when compared to an anti-oxidant whole food diet which is chock full of beneficial synergies between nutrients?

Whole Food Diet to Prevent Cancer and Heart Disease

There are many other supplements that are highly touted with no data (or poor data) to back that up. We know even less about a multitude of isolated supplements packaged up and marketed as effective and safe. But instead of risking taking a supplement than can be a best draining your pocket book with no beneficial effect or at worst causing your cancer or cancer recurrence, think about what the world’s experts are saying. This video covers the gamut of what you need to know. Please note that I am not a big fan of the few areas of “conspiracy stuff” in this video, but overall it imparts a GREAT message.

Here is the take home message about supplements. Some may help and some may harm you. We do not have all the information required to tell you which is which, especially when you consider taking high doses of anything like that. Here is the good news, especially for couch potatoes with poor dietary habits. In the process of studying prevention of cancer, often unfortunately called “chemo-prevention” even when natural substances are used, we are at least getting to understand the biochemical pathways and the epigenetic effects of all of these substances and nutrients. This opens the door to exciting research in the prevention of cancer but we are still well away from outsmarting whole food approaches WHEN they are applied appropriately. In other words, we may well find “miracle supplement pills” that allow someone to poison themselves daily with fast food, cigarettes, sedentary lifestyle and still reduce their risk of cancer. However, it will be a LONG time before we are able to find something better than an integrative solid whole food and exercise cancer prevention program. So, rather than focusing on seeking the “magic” chemo-prevention agent, synthetic or natural, take a very long hard look at the benefits of whole food disease prevention.

My patients ask me in person and my followers ask on line, what are the very best cancer fighting supplements out there? Which supplements really fight cancer? How much should I take of what? Some even bring a bag full of various mixes of supplements and botanicals for me to review with them, hoping to leave with “THE” answer.

Well, the truth behind the best supplements is very far from visiting the local vitamin shop in most situations. There was a gentleman, an ancient Greek physician who is said to be the father of Western medicine. He lived over 2,000 years ago and, among other things, said “Let food be thy medicine and medicine be thy food”. His name was Hippocrates and the best modern research in the world still rings true to that comment. To this day, even though we can study things to the sub-molecular level, whole food contains wondrous healing synergies that we are only beginning to understand. It is going to be while before we become smarter than Mother Nature by artificially splitting out vitamins and other micro-nutrients and reassembling them with human concoctions.

Unfortunately, the very thing that ails us as a society addicted to pharmacologic prescription pill popping spills over into “natural health”. Only, there is nothing natural about it. You do not have to be a conspiracy theorist to see that Big Pharma is a multi-trillion dollar industry that is focused on the image of wellness through pill popping for everything. Standard mainstream medicine has embraced this way too much. However, it is an integrative medicine truth that in some cases, at least for a while, such medications can be lifesavers. Nevertheless, this is not something you want to depend upon for true health as you will never achieve it that way. So what makes you think that popping fistfuls of various “natural” supplements is any better? The Big Nutra, or supplements biz, is alive and well and is a multi multi billion dollar industry in its own right. The problem is that this industry, in contradistinction to Big Pharma, Big Nutra is hardly regulated at all and marketing glitz VERY often trumps science. Enough said on the “politics” of taking human-made substances, drugs or supplements, but lets move on.

You don’t want to take synthetic drugs when you can avoid them, at least in the long run. By the same token you don’t really want to take synthetic mixes of supplements either. In some cases this pharmaco-nutrient therapy can be very harmful and is grounded in the general belief that more of something is better. We know this not to be the case, with cancer CAUSATION as an extreme example. But what about “natural” supplements? Some manufacturers sell what are coined “whole food vitamins”, which are way more expensive and offer little proof that they are any better. Theoretically they may be better because they are concentrated nutrients from whole foods rather than synthetics. However the process of stripping the nutrients out and concentrating them always uses some proprietary methods which might be heating or enzymes or some other degradation. It is a black box of questions and at the very least separates out micro-nutrients from fiber and may be breaking the synergies required between nutrients to be maximally effective, according to Mother Nature’s plan. We simply do not know and guessing, glitzy marketing and testimonials are just not the answer.

With respect to cancer specifically, all of the best data in the world points to whole foods FIRST as being the answer to this question. If you want to go in-depth, download and read the World Cancer Research Foundation’s report. Rather than trying to outsmart Mother Nature with pseudo-science, rat studies that may not apply to humans, and theoretical benefits, the leading minds around the world agree on this principle. Cancer prevention, both primary and secondary (i.e. prevention of recurrence) is best accomplished through solid dietary management of macro-nutrients (i.e. best mix and sources of carbs, proteins and fats) and micro-nutrients (i.e. supplements, vitamins, minerals and some healing botanicals). Furthermore, there is a whole body of evidence which is related to how food is prepared (i.e. raw vs steamed vs broiled). The bottom line is that creating, honing and optimizing a cancer fighting kitchen is a far better use of time than finding out what stores carry the best vitamin pills. This is a topic for many upcoming reviews and posts.

Here is a great short and to the point video from Dana Farber Cancer Institute regarding “Food First” as an integrative anti-cancer strategy.

Having said all of the above, there may be a few exceptions. First of all, if it is just IMPOSSIBLE for you to follow a solid anti-cancer diet plan, work with a nutritionist of dietitian to ensure you have the basics covered with supplements. This is VERY inferior, but will keep you out of more trouble. Second, there are a few supplements that are notoriously lacking even in a good diet. If you are following a primarily plant based whole food diet, make sure you are getting enough B vitamins. Calcium is also sometimes hard to manage with a combined goal being 1500 to 2000mg per day from diet and supplementary sources. Finally, and most importantly, Vitamin D. This last one is crucial to your anti-cancer battle and is deficient even in sun belt areas. Ask your doctor to measure your blood level and focus on attaining a level above 35-40ng/mL (90-100nmol/L).

All of the above is meant to cover why whole food is a better source of micro-nutrients than concocting supplement packs. However, if you need specific help there is certainly a need for targeted supplementation. For example, rather than taking potentially addicting and side-effect prone prescription sleeping pills, you may benefit from melatonin supplementation. This is highly individualized and is part of a good patient centric integrative oncology program.