Five Years Plus

{August 14, 2010}   The D-bate

Prior to my first thermography appointment (in less than a week) I have done a lot of research on imaging and early detection. While learning some fascinating facts on cancer screening and diagnosis, I have begun to question whether the emphasis on detection and diagnosis might completely miss the point. What about preventing cancer in the first place?

I despair at attempting a comprehensive answer which would include proper nutrition, suitable physical exercise, stress and inflammation reduction, avoidance of toxins (e.g. industrial chemicals, pollutants, pesticides, drugs, tobacco smoke, alcohol, and ionizing radiation), a healthy mental attitude, nourishing family and social relationships and beliefs (religious or spiritual) that connect us to something larger than ourselves. The prospect of trying to comprehend and apply all of this is almost enough to send me scampering back to the straightforward recommendations of my doctors and the seeming certainty of the Standard of Care.

This week I want to focus attention on the debate on vitamin D. There is promising evidence that it has a role in the prevention and treatment of breast cancer and other diseases, but the American Cancer Society and the National Cancer Institute do not currently recommend vitamin D supplements. Beyond a basic multivitamin, many people do not regularly take supplements. There is a common belief that “if we eat properly we will get everything we need” and the conventional medical system has downplayed the importance of supplements. So what is the evidence for and against taking vitamin D supplements?

The case for vitamin D supplementation

Vitamin D is a pro-hormone that influences many genes. Proper levels of vitamin D have been linked to improved muscle strength, proper immune function, reduced inflammation and absorption of calcium and phosphate required for bone health. Our skin produces Vitamin D when exposed to sunlight. Today about half the adults in developed countries have deficient levels of vitamin D probably due to lower exposure to unscreened sunlight. The role of Vitamin D in cancer prevention first became apparent in the 1990s through geographic correlation studies showing that individuals living in southern latitudes have lower incidence and death rates from cancer. In the laboratory Vitamin D slows the growth and increases the differentiation and death of cancer cells. In a four year randomized clinical trial of 1200 healthy post-menopausal women found that women taking calcium (1400-1500 mg) and Vitamin D (1100IU) together had a 60 percent lower incidence of cancer overall than the women taking a placebo. A 2009 article published in the Annals of Epidemiology concluded that if the population at large raised levels of Vitamin D to optimum levels, 58,000 new cases of breast cancer and 49,000 new cases of colorectal cancer could be prevented annually and ¾ of all deaths from these two diseases could be avoided. Grassroots Heath (a organization of scientists promoting public health) published a Vitamin D call to action statement and posted a video calling for increased research and stating that delays in encouraging daily supplementation of Vitamin D3 of 2000 IU per day is leading to a great deal of unnecessary loss of life.

The case against vitamin D supplementation

Much of the evidence sited above comes from observational studies (based on questionnaires) that are inherently inaccurate. The one randomized clinical trial sited above was focused on bone health, not cancer prevention, and did not test the effect of vitamin D without calcium. The National Cancer Institute’s summary of the direction of Vitamin D research in the last 20 years concludes that evidence for Vitamin D’s benefits is “limited and inconsistent”. Vitamin D for breast cancer prevention is not in the American Cancer Society summary of current and proposed research on breast cancer. The Vitamin D Council suggests that the lack of research may be because Vitamin D is simply too cheap. “Therefore, the idea that [vitamin D] could help breast cancer offered no financial incentive to drug companies or researchers hoping to discover a drug they could patent.”

So what do I think?

I have my doubts about any magic bullet for tricky diseases like cancer and the compelling figures given are undermined by the deficiencies of the current research. But given that there is no harm caused by testing vitamin D levels and supplementing at 2000 IU per day, it seems like a no-brainer to do it.

I have my vitamin D levels tested regularly via the 25 hydroxy vitamin D blood test and have taken vitamin D3 supplements since I was first diagnosed. My results have never been dangerously low, but they have regularly been below the recommended 40-80 ng/ml. When doubling my daily supplement didn’t significantly raise my blood serum levels of vitamin D, my nutritionist recommended that I use a form that includes isoflavones to help the absorption. She told me that some people are genetically predisposed to have lower vitamin D levels. It’s shocking to think that insufficient levels of vitamin D might be related to both my mother’s and my own breast cancer.

I believe that taking dietary supplements (vitamins, minerals, probiotics, enzymes, herbs and other compounds that detoxify and support the immune system and certain organs) is one of the easiest things we can do to improve our health and help prevent disease, yes, even cancer. I consult a nutritionist 3 to 4 times each year to help me refine my eating and modify my supplement and dosage schedule to suit my changing needs. Currently I take 16 different supplements every day. I think it’s very helpful to have professional help in deciding on what to take. Our local health food store Natur-tyme offers free mini-consultations that can help people start on a supplement program.

In the nearly six years I have regularly taken supplements I have rarely been sick, my moods have continued to stabilize and I have less muscular and joint pain in my body. My massage therapist noticed that over time my body tissue has become more pliable and hydrated. Granted, supplements are not the only healing modality I have used and thus I cannot say how much is one thing and how much another. As the D-bate goes on, I take the tiny pill each morning, test my blood levels each year, and gently expose my skin to the sun whenever our upstate New York weather allows.

et cetera