Research presented at the annual American Society of Clinical Oncology meeting reports that high dose vitamin D3 combats joint pain, a common side effect of breast cancer therapy.
Musculoskeletal pain is one of the most pronounced side effects of aromatase inhibitor (AI) therapy, a common treatment for breast cancer. The pain associated with the treatment is one of the main causes of treatment discontinuation.
A pilot study published in 2009 by Dr Qamar J Khan and colleagues presented results from a small scale study that suggested beneficial effects from vitamin D3 supplementation on AI treatment side effects. Dr. Khan’s present study strengthens the validity of the past research.
Dr Khan, Dr Bruce Kimler, and colleagues recruited 160 women with stage I-III breast cancers who were starting adjuvant AI therapy and had a vitamin D level ≤40 ng/mL. All participants received the AI treatment (letrozole), as well as 600 IU vitamin D3 and 1200 mg calcium daily. The participants were randomly assigned to the vitamin D arm (30,000 IU D3/weekly) or the placebo arm for 24 weeks. Vitamin D status, symptoms (pain, fatigue, and quality of life), and hand grip strength were all assessed at baseline, 12, and 24 weeks.
The results are as follows:
- Median 25(OH)D (ng/mL) for the placebo arm was 25 at baseline, 32 at 12 weeks, and 31 at 24 weeks. In the Vitamin D3 arm 25(OH)D was 22, 53, and 57 respectively.
- At week 24 51% of participants in the placebo arm reported musculoskeletal symptoms (worsening of joint pain, disability from joint pain) while only 37% in the vitamin D arm reported symptoms (p=0.069).
- Seventy-two percent of women in the placebo arm experienced an adverse quality of life event (worsening of pain, disability or fatigue) while only 42% reported this in the vitamin D arm (p<0.001).
Researchers not involved in the study were impressed by the publication. Dr Karen Michelle Mustian, PhD, MPH, assistant professor of radiation oncology at the University of Rochester Medical Center told Pain Medicine News,
“This was a very well-done study. Vitamin D3 may be a promising intervention for musculoskeletal symptoms and possibly cancer-related fatigue.”
Khan QJ, Kimler BF, Reddy PS, Sharma P, Klemp JR, et al. Randomized trial of vitamin D3 to prevent worsening of musculoskeletal symptoms and fatigue in women with breast cancer starting adjuvant letrozole: The VITAL trial. J Clin Oncol 30: 2012. suppl; abstr 9000