Prostate cancer and vitamin D

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" The Vitamin D Council " <vitamindcouncil

 

Prostate cancer and vitamin D

Sun, 21 Nov 2004 16:56:23 -0800

 

Press Release

For Immediate Release

The Vitamin D Council

9100 San Gregorio Road

11/21/04

 

Vitamin D may help treat prostate cancer

 

Oliver Wendell Holmes, Sr, the eminent 19th-century physician and

poet, once admonished doctors saying, " Beware how you take away hope

from another human being. " Thanks to a discovery announced last week,

millions of hopeless men around the world suffering from advancing

prostate cancer now have reason for hope. A presentation at the

conference on vitamin D and cancer, sponsored by the National

Institutes of Health and the National Cancer Institute, gave them

reason to hope. A group from . . .

 

Vitamin D may help treat prostate cancer

 

 

 

Oliver Wendell Holmes, Sr, the eminent 19th-century physician and

poet, once admonished doctors saying, " Beware how you take away hope

from another human being. " Thanks to a discovery announced last week,

millions of hopeless men around the world suffering from advancing

prostate cancer now have reason for hope. A presentation at the

conference on vitamin D and cancer, sponsored by the National

Institutes of Health and the National Cancer Institute, gave them

reason to hope. A group from the University of Toronto reported the

first human trials of a deltanoid (vitamin D compound) that appear to

both help fight prostate cancer and to fight that cancer without

causing any side effects.

 

This year, about 400,000 American men will learn they have prostate

cancer, making it the leading cancer among men. Early diagnosis is

important as surgery or radiation can be curative. Early diagnosis is

helped by measuring PSA, a blood marker for possible prostate cancer.

If a biopsy is positive, then surgery or radiation leads to falling

PSA levels and hope for a cure. After such treatment, urologists then

use PSA as a marker for tumor reoccurrence and progressive disease.

If the treatment is not curative and the cancer continues to grow, the

PSA often goes up again leading to castration, either surgical or

chemical. Then the PSA often falls again indicating a remission.

Castration can delay the cancer from spreading for several years, but

then, if the cancer grows again, the PSA again marches steadily

upwards and treatment options become quite limited, leading to

hopelessness. Throughout the battle with prostate cancer, PSA is the

standard clinical marker for progressive disease. This year,

thousands of American men go down the hopeless road marked by

progressive rises in PSA. About 40,000 will die, making prostate

cancer the second leading cancer killer of American men.

 

Dr. Woo and his colleagues in Toronto have finally given these men and

their families reason to hope. The senior investigator of the study,

Dr. Reinhold Vieth, presented the first human trial of cholecalciferol

ever reported in any cancer, as well as the best clinical results of

any vitamin D compound ever tested in any human cancer. Woo, Vieth

and colleagues studied 15 men with biopsy proven prostate cancer who

had undergone surgery or radiation but who had started down that

hopeless road marked by three progressive increases in PSA levels.

The researchers gave all the patients 2,000 units of cholecalciferol

(the plain, cheap, simple, natural, available at any health food

store, form of vitamin D) every day for up to 21 months. In the

majority of men, their PSA either went down or stopped going up,

suggesting their prostate cancer either started to regress or remained

quiescent!

 

The Toronto researchers found evidence of a clinical response in 14 of

the 15 men as confirmed by a prolongation of their PSA doubling time.

What's more, none of the men had any side effects, of any kind.

Again, this is the best result yet obtained for any vitamin D compound

in any human cancer trial. For example, let's compare Vieth's result

to any earlier trial of a vitamin D compound reported by a Stanford

University Group in 1998. The Stanford group gave a very different

form of vitamin D [activated vitamin D (calcitriol), a dangerous form

of vitamin D known to cause high blood and urine calcium] to seven men

in the same stage of prostate cancer. They also used PSA as a marker

of tumor responsiveness. After getting the calcitriol, the PSA of the

men continued to increase, although more slowly. One of the patients

showed a transient decrease in PSA but he had to be withdrawn from the

study due to side effects from calcitriol. Unlike the Toronto study,

none of the Stanford patients showed a prolonged flattening or a

prolonged decrease in their PSA. All of the Stanford patients

developed side effects such as high urine calcium, and one developed a

kidney stone.

 

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=pubmed & dopt=Abstra\

ct & list_uids=9598513

 

Therefore, the University of Toronto beat Stanford University,

hands-down. Moreover, they did so with much lower comparable doses of

deltanoids (deltanoids are a generic term for vitamin D compounds).

The Stanford group gave increasing doses of the most potent and most

dangerous deltanoid (the steroid hormone, calcitriol). They gave as

much as the patients could tolerate until their urine calcium got too

high. The Toronto group gave a fixed low dose (2,000 units) of the

prehormone, cholecalciferol, a very safe compound that never causes

high calcium in the doses used. In fact, the lowest dose of

cholecalciferol known to cause high blood calcium is more than 20,000

units. Therefore, the Toronto group got better results with one-tenth

the comparable dose of deltanoids! Vieth wanted to use more

cholecalciferol but widespread ignorance about the physiology and

pharmacology of vitamin D remains and he could not get adequate dosing

past the various review committees.

 

 

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=pubmed & dopt=Abstra\

ct & list_uids=10232622

 

In fact, 2,000 units of cholecalciferol a day will raise the " average "

calcidiol [25(OH)D] level to about 40 ng/mls, now considered by most

authorities to be the lower limit of adequate vitamin D nutrition.

" Average " means half above and half below, which also means 50 % of

the Toronto men were still below 40 ng/mls; that is, one-half of the

Toronto men with prostate cancer may still have been vitamin D

deficient after treatment. Robert Heaney proved that adequate

treatment of vitamin D deficiency requires about 4,000 units of

vitamin D every day. Said another way, it takes 4,000 units of

cholecalciferol to assure that 97.5 % of healthy subjects will become

vitamin D replete.

 

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=pubmed & dopt=Abstra\

ct & list_uids=12499343

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=pubmed & dopt=Abstra\

ct & list_uids=11157326

 

Given these results, what would evidence based medicine have us do?

(Evidence based medicine is a new mantra which decries doctors from

any treatment that is not rigorously scientifically proven). The

evidence based medicine folks say one open study of 15 patients is

hardly rigorous proof (the Vitamin D Council agrees); more trials are

needed (the Vitamin D Council agrees); falling PSA does not prove the

tumor is regressing (the Vitamin D Council agrees) and Vieth's study

has only been presented, not published and should be viewed with

skepticism (the Vitamin D Council agrees). Finally, the evidence

based medicine folks say that doctors should not give cholecalciferol

to prostate cancer patient until rigorously conducted scientific

trials prove vitamin D helps cure prostate cancer. That is, the

evidence based medicine folks say urologists should allow prostate

cancer patients to die before treating them with cholecalciferol. The

Vitamin D Council disagrees and we know some plaintiff attorneys who

disagree as well.

 

You see, the question is not " Should men with prostate cancer be

treated with vitamin D? " The question is, " Should men with prostate

cancer be allowed to die vitamin D deficient? " The evidence based

medicine folks say they should. We say they shouldn't. All patients

with prostate cancer should have their vitamin D deficiency

aggressively and immediately corrected and that requires up to 4,000

units of cholecalciferol every day. Physicians, researchers, or

scientists who say 4,000 units may be toxic are simply admitting their

ignorance of current scientific literature.

 

Physicians who have read the recent scientific literature and who

understand the physiology and pharmacology of cholecalciferol would be

comfortable using up to 10,000 units of cholecalciferol a day while

following the patient's PSA, urine and serum calcium, and 25(OH)D.

Thanks to the Toronto group, scientific evidence now exists that

suggests such an approach may help prostate cancer patients; only time

will tell.

 

Many patients with prostate cancer are on the long hopeless road

towards death. Not only may plain old vitamin D help men with

prostate cancer, it is likely to give them back their hope.

Physicians have many rights, but the right to take away hope is not

among them.

 

John Cannell, MD

 

The Vitamin D Council

 

9100 San Gregorio Road

 

Atascadero, CA 93422

 

 

 

Contact:

 

Reinhold Vieth, PhD

 

Mount Sinai Hospital

 

Pathology and Laboratory Medicine

 

600 University Ave.

 

Department of Medicine

 

Toronto, Ontario, Canada

 

M5G 1X5

 

Phone (416) 586-5920

 

Fax (416) 586-8628

 

Email: rvieth