Prevalence of vitamin D insufficiency among breast cancer survivors

The objective of this study was to determine if vitamin D deficiency is a prevalent problem for female breast cancer survivors (BCS) who have completed treatment for breast cancer. Ninetynine breast cancer survivors and a control population of fifty-five women with no history of breast cancer participated in this study. Serum 25-hydroxy vitamin D concentrations were measured throughout 2007. Dietary and supplement intake of vitamin D was assessed by a food frequency questionnaire. Zip code of residence was used to evaluate potential for skin production of vitamin D. Vitamin D deficiency (\u3c32ng/mL) was observed in 76 of 99 (77%) of BCS, and 51 of 55 (93%) of controls. Women taking vitamin D supplements were less likely to exhibit vitamin D deficiency, but supplementation did not guarantee sufficiency. Vitamin D deficiency appears to be prevalent among both groups. Vitamin D status should be routinely evaluated for all women as part of regular preventive care

Impact of oral vitamin D supplementation on serum 25-hydroxyvitamin D levels in oncology

<p>Abstract</p> <p>Background</p> <p>Serum 25-hydroxyvitamin D [25(OH)D] is the major circulating form of vitamin D and a standard indicator of vitamin D status. Emerging evidence in the literature suggests a high prevalence of suboptimal vitamin D (as defined by serum 25(OH)D levels of <32 ng/ml) as well as an association between lower serum levels and higher mortality in cancer. We investigated the effect of oral vitamin D supplementation as a means for restoring suboptimal levels to optimal levels in cancer.</p> <p>Methods</p> <p>This is a retrospective observational study of 2198 cancer patients who had a baseline test prior to initiation of cancer therapy at our hospital to evaluate serum 25(OH)D levels between Jan 08 and Dec 09 as part of their initial nutritional evaluation. Patients with baseline levels of < = 32 ng/ml (n = 1651) were considered to have suboptimal serum 25(OH)D levels and were supplemented with 8000 IU of Vitamin D3 (four 2000 IU D3 capsules) daily as part of their nutritional care plan. The patients were retested at their first follow-up visit. Of 1651 patients, 799 were available for follow up assessment. The mean serum 25(OH)D levels were compared in these 799 patients across the 2 time points (baseline and first follow-up) using paired sample t-test. We also investigated the factors associated with response to vitamin D supplementation.</p> <p>Results</p> <p>Of 2198 patients, 814 were males and 1384 females. 1051 were newly diagnosed and treated at our hospital while 1147 were diagnosed and treated elsewhere. The mean age at presentation was 55.4 years. The most common cancer types were breast (500, 22.7%), lung (328, 14.9%), pancreas (214, 9.7%), colorectal (204, 9.3%) and prostate (185, 8.4%). The mean time duration between baseline and first follow-up assessment was 14.7 weeks (median 10.9 weeks and range 4 weeks to 97.1 weeks). The mean serum 25(OH)D levels were 19.1 ng/ml (SD = 7.5) and 36.2 ng/ml (SD = 17.1) at baseline and first follow-up respectively; p < 0.001. Patients with prostate and lung cancer had the highest percentage of responders (70% and 69.2% respectively) while those with colorectal and pancreas had the lowest (46.7% each). Similarly, patients with serum levels 20-32 ng/ml at baseline were most likely to attain levels > 32 ng/ml compared to patients with baseline levels < 20 ng/ml.</p> <p>Conclusions</p> <p>The response to supplementation from suboptimal to optimal levels was greatest in patients with prostate and lung cancer as well as those with baseline levels between 20-32 ng/ml. Characteristics of non-responders as well as those who take longer to respond to supplementation need to be further studied and defined. Additionally, the impact of improved serum 25(OH)D levels on patient survival and quality of life needs to be investigated.</p

The association between pre-treatment serum 25-hydroxyvitamin D and survival in newly diagnosed stage IV prostate cancer.

Emerging evidence in the literature suggests a positive association between serum 25-hydroxyvitamin D [25(OH)D], a standard indicator of vitamin D status, and survival in certain types of cancer. We investigated this relationship in newly diagnosed stage IV prostate cancer patients.A consecutive cohort of 125 newly diagnosed stage IV prostate cancer patients underwent a baseline serum 25(OH)D evaluation prior to receiving any treatment at our institution between January 2008 and December 2011. We used the vitamin D categories of "deficient (<20 ng/ml)", "insufficient (20 to 32 ng/ml)", and "sufficient (>32 ng/ml)". Cox regression was used to evaluate the prognostic significance of serum 25(OH)D after adjusting for relevant confounders.Mean age at diagnosis was 60 years. Of the 125 patients, 32 (25.6%) were deficient, 49 (39.2%) were insufficient and 44 (35.2%) were sufficient in vitamin D at the time of diagnosis. The median survival in deficient, insufficient and sufficient cohorts was 47.8, 44.0 and 52.6 months respectively (p = 0.60). On univariate analysis, four variables demonstrated a statistically significant association with survival: nutritional status, bone metastasis, corrected serum calcium and serum albumin (p<0.05 for all). On multivariate analysis, five variables demonstrated statistically significant associations with survival: hospital location, age, bone metastasis, serum albumin and corrected serum calcium (p<0.05 for all). Serum vitamin D status was not significant on either univariate or multivariate analysis.Contrary to previously published research, we found no significant association between pre-treatment serum 25(OH)D and survival in newly diagnosed stage IV prostate cancer patients. The lack of a significant association between serum vitamin D and survival in our study could perhaps be due to the fact that the disease was far too advanced in our patients for vitamin D levels to have any impact on prognosis

Overall survival stratified by baseline serum 25(OH)D categories.

<p>There was no statistically significant difference in the median survival times across the 3 categories of serum vitamin D.</p

Median survival as a function of patient characteristics.

<p>(SGA = Subjective Global Assessment, ECOG = Eastern Cooperative Oncology Group, CTCA = Cancer Treatment Centers of America, PA = Pennsylvania, IL = Illinois, OK = Oklahoma, AZ = Arizona, PSA = Prostate Specific Antigen, ng/ml = nanograms per milliliter)</p><p>*P < = 0.05</p><p>Median survival as a function of patient characteristics.</p

Univariate and multivariate Cox regression analyses of the relationship between serum vitamin D and survival.

<p>(SGA = Subjective Global Assessment, ECOG = Eastern Cooperative Oncology Group, CTCA = Cancer Treatment Centers of America, PA = Pennsylvania, IL = Illinois, OK = Oklahoma, AZ = Arizona, PSA = Prostate Specific Antigen, BMI = Body Mass Index, ng/ml = nanograms per milliliter, HR = Hazard Ratio, CI = Confidence Interval)</p><p>*P < = 0.05</p><p>Univariate and multivariate Cox regression analyses of the relationship between serum vitamin D and survival.</p