- Question from Jo-Ann: You read so much about the effect of vitamin D to prevent further breast cancer. Do you have an opinion on this?
- Answers - Nicholas Robert, M.D. As someone who's originally from Canada, there was some pride when an observation was made from some Canadians in Toronto that there was a relationship between low vitamin D levels and breast cancer recurrence. However, with more people looking at this relationship, it is less clear that there is a relationship between low vitamin D and breast cancer. In these observations, there is an impression that having a normal amount of vitamin D is good for general health, and has an impact in terms of bone health. So in my practice, I do check vitamin D levels. If they are very low, I encourage patients to increase the amount of vitamin D, but one has to be cautious not to give too much. One also has to be careful that we at this point don't know that replacing vitamin D will have an impact on how someone will do with their breast cancer diagnosis.
- Beth Baughman DuPree, M.D., F.A.C.S. In July 2007, in the New England Journal of Medicine, a review article seemed to spur a very large push for evaluation and treatment of patients' vitamin D levels. Many studies had been looked at prior to that and felt that possibly the cancer was the cause of the low vitamin D, as opposed to the low vitamin D levels being linked to an increased risk of developing breast cancer, colon cancer, and other medical disorders. Patients who live far north of the Equator and who have less sun exposure may have lower levels of vitamin D and the exact relationship is still something that we don't understand completely. We have begun testing all our patients at diagnosis and have found a significant number of patients who are deficient in their level of 25-hydroxy vitamin D. Since vitamin D-3 cannot be obtained through drinking milk, we recommend either sun exposure, which can create Vitamin D through the skin, or more importantly supplementation just to get the vitamin D level back into the normal range of somewhere between 35 and 55 nanograms/ml. I do not believe that vitamin D is the magic bullet that some people believe it can be in the prevention of breast cancer, but I think that having our levels within a normal range can certainly help with normal cellular functions. Vitamin D deficiencies have been associated with the ability to have ingrowth of blood vessels into tumors, and since some of our targeted therapies such as Avastin work to stop the ingrowth of blood vessels, an association can certainly be present but I believe still needs further investigation.
The Ask-the-Expert Online Conference called Updates From the 2009 ASCO Annual Meeting featured Nick Robert, M.D. and Beth Baughman Dupree, M.D., F.A.C.S. answering your questions about the newest findings on risk, screening, treatment, and more.
Editor's Note: This conference took place in June 2009.
The materials presented in these conferences do not necessarily reflect the views of Breastcancer.org. A qualified healthcare professional should be consulted before using any therapeutic product or regimen discussed. All readers should verify all information and data before employing any therapies described here.
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