Vitamin D May Help Some Cancer Therapies Work

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While important questions remain about vitamin D for cancer prevention, there is no question that this vitamin is important in many ways. Researchers recently found that vitamin D status seemed to impact cancer treatment in elderly individuals with the most common type of non-Hodgkin lymphoma, diffuse large B cell lymphoma, or DLBCL.

Could You Have a Vitamin D Deficiency?

Today there is greater appreciation for the importance of vitamin D, aside from strong bones.

Vitamin D deficiency has been linked to muscle aches, poor strength, and even symptoms of depression.

How does a person get vitamin D naturally? Unfortunately, very few foods commonly consumed in Western diets contain vitamin D, and many people are deficient. Fatty fish and cod liver oil are good natural sources. The sun is another natural source, but there’s a catch. All the cautions about UV exposure and the risk of skin cancer apply. What is more, sunbathing to get adequate vitamin D may not be practical for many people. If in doubt about your vitamin D status, talk to your doctor about any symptoms and ask about getting a blood test to see where you stand.

Does Vitamin D Prevent Cancer?

There’s reason to be hopeful, but many questions remain unanswered. According to laboratory studies, vitamin D deficiency seems to help certain malignancies develop, but experts say more research is needed before routine vitamin D for cancer prevention could be recommended.

Studies on vitamin D for prevention of breast, prostate, and colorectal cancers have yielded inconsistent results. In some cases, researchers couldn’t tell whether low vitamin D levels were the result of having cancer or a possible cause of the cancer.

What’s the Link Between Vitamin D and Blood Cancers?

In the case of blood cancers like leukemia and lymphoma, evidence supports the idea that vitamin D actually seems to help certain cancer therapies do their job.

Studies have shown a link between vitamin D deficiency and a worse prognosis in various types of blood cancer, including chronic lymphocytic leukemia (CLL), and diffuse large B cell lymphoma (DLBCL), the most common type of non-Hodgkin lymphoma. But these studies look backwards, so it can be hard to tell cause from effect. Might vitamin D be used to increase the power of certain cancer therapies? This remains an open question, but data are encouraging.

There is also the fact that many cancer therapies -- and cancers themeselves -- have the tendency to lead to low bone mass, increasing the risk of osteoporosis, so maintaiing adequate levels of calcium and vitamin D can be a part of managing this risk.

Vitamin D and Rituximab (Rituxan)

Investigators recently reported in the Journal of Clinical Oncology that insufficient vitamin D appears to affect how well the anti-cancer therapy rituximab, a monoclonal antibody, does its job. “Vitamin D deficiency is a risk factor for elderly patients with DLBCL treated with R-CHOP,” said investigators.

They found evidence that vitamin D deficiency impairs the cancer-cell killing action of rituximab.

They called for specially designed trials to study the use vitamin D in DLBCL and other cancers currently treated with antibodies, such as trastuzumab in breast cancer and cetuximab in colorectal cancer.

Sources and Background on Vitamin D and ADCC

Vitamin D. Fact Sheet for Health Professionals. Accessed August 2014.

Welsh J. Vitamin D and breast cancer: insights from animal models. American Journal of Clinical Nutrition. 2004;80(6);1721S-1724S.

Byers SW, Rowlands T, Beildeck M, Bong YS. Mechanism of action of vitamin D and the vitamin D receptor in colorectal cancer prevention and treatment. Reviews in Endocrine & Metabolic Disorders. 2012;13(1):31-38.

Min D, Lv XB, Wang X, et al. Downregulation of miR-302c and miR-520c by 1,25(OH)2D3 treatment enhances the susceptibility of tumour cells to natural killer cell-mediated cytotoxicity. British Journal of Cancer. 2013;109(3):723-730.

Bittenbring JT, Neumann F, Altmann B, et al. Vitamin D deficiency impairs rituximab-mediated cellular cytotoxicity and outcome of patients with diffuse large B-cell lymphoma treated with but not without rituximab. Journal of Clinical Oncology. JCO.2013.53.4537. Published online August 18, 2014.

Shanafelt TD, Drake MT, Maurer MJ, et al. Vitamin D insufficiency and prognosis in chronic lymphocytic leukemia. Blood. Feb 3 2011;117(5):1492-1498.

Drake MT, Maurer MJ, Link BK, et al. Vitamin D insufficiency and prognosis in non-Hodgkin's lymphoma. Journal of Clinical Oncology. 2010;28(27):4191-4198.

Ottanelli S. Prevention and treatment of bone fragility in cancer patient. Clinical Cases in Mineral and Bone Metabolism. 2015;12(2):116-129.

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