Prostate cancer patients may have low vitamin D levels

Vitamin D deficiency and low calcium intakes may be highly prevalent in patients with prostate cancer, says a new Spanish study.

In the cross-sectional study, serum vitamin D levels, calcium intake and bone mineral density (BMD) of
91 prostate cancer patients were determined (1). The study results showed that about 30% of patients were vitamin D deficient (defined as 25(OH)D level <15 ng/ml) and 48% had insufficient blood concentrations
(15-30 ng/ml). According to current guidelines, calcium intake was low in 98% of patients (less than 1000 mg/day). There was no correlation between vitamin D level, BMD, calcium intake and androgen-deprivation therapy.

The researchers concluded that vitamin D deficiency and low calcium intake may be highly prevalent in prostate cancer patients. Although this would be a common condition in other populations, in this group of patients especially prone to osteoporosis it could have more relevance. Additional research would be needed to establish the consequences of low calcium intake and vitamin D deficiency in prostate cancer patients.

Serum vitamin D concentrations have been described not only as a predictor of bone health but also as an independent predictor of risk for cancer (2) and other chronic diseases (3). There are several data supporting the relationship between vitamin D deficiency and cancer prognosis (4, 5) and numerous studies suggest that vitamin D deficiency is associated with an increased risk of medical complications to which patients with cancer are predisposed, i.e. infection, falls and immune dysfunction (6, 7). The effect of vitamin D in cancer processes has been demonstrated in experimental studies and may influence cancer incidence through mechanisms affecting cancer development and progression (4). Moreover, vitamin D deficiency has been proposed to be a risk factor for prostate cancer (8) although increased risk of aggressive disease with higher circulating 25 OH vitamin D concentrations (9, 10) or no association had also been reported.

1. Varsavsky M. et al. Serum 25 OH vitamin D concentrations and calcium intake are low in patients with prostate cancer. Endocrinol Nutr. Published online November 2011.
2. Garland C. F. et al. Serum 25-hydroxyvitamin D and colon cancer: eight-year prospective study. Lancet. 2000; 2:1176–11768.
3. Holick M. Vitamin D deficiency. N Engl J Med. 2007; 357:266–281.
4. Giovannucci E. et al. Prospective study of predictors of vitamin D status and cancer incidence and mortality in men. J Natl Cancer Inst. 2006; 98:451–459.
5. Zhou W. et al. Circulating 25-hydroxyvitamin D levels predict survival in early-stage non-small-cell lung cancer patients. J Clin Oncol. 2007; 25:479–485.
6. Adams J. S. and Hewison M. Unexpected actions of vitamin D: new perspectives on the regulation of innate and adaptive immunity. Nat Clin Pract Endocrinol Metab. 2008; 4:80–90.
7. Beer T. M. et al. Double-blinded randomized study of high-dose calcitriol plus docetaxel compared with placebo plus docetaxel in androgen-independent prostate cancer: a report from the ASCENT Investigators. J Clin Oncol. 2007; 25:669–674.
8. Luscombe C. L. et al. Exposure to ultraviolet radiation: association with susceptibility and age at presentation with prostate cancer. Lancet. 2001; 358:641–642.
9. Ahn J. et al. Serum vitamin D concentration and prostate cancer risk: a nested case-control study. J Natl Cancer Inst. 2008; 100:796–804.
10. Tuohimaa P. et al. Both high and low levels of blood vitamin D are associated with a higher prostate cancer risk: a longitudinal, nested case-control study in the Nordic countries. Int J Cancer. 2004; 108:104–108.