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Link between latitude and lymphoma risk

Posted on: March 7, 2013   by  John Cannell, MD

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Most readers have heard the terms non-Hodgkin’s lymphoma (NHL) and Hodgkin’s lymphoma (HL). Lymphoma is a cancer of the lymphocytes, which may grow faster than normal cells or live longer than normal cells, thus accumulating into masses, often in the lymph nodes.

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14 Responses to Link between latitude and lymphoma risk

  1. D-fiant

    Hi all,
    I read this story with interest as our son has NHL. His battle has seen him in hospital for most of the year since diagnosed on the 7th Feb 2012.
    He has had 3 bowel operations, spleen removed, a heart condition and various reactions and infections while being neutropenic. During this time he has lost over 30 Kgs of weight and his hair, but this is starting to grow back, which we have taken as a sign that the chemo is slowly leaving his body. (most of the ops etc was not caused by the NHL, but as a consequence)

    Last week he was classified as being in remission….yeah!!!!!!!!!!!!!

    Anyway …..back to the story at hand, because he had NHL I did a fair amount of reading and I came across this article from the Mayo clinic. It says that “Patients with deficient vitamin D levels had a 1.5-fold greater risk of disease progression and a twofold greater risk of dying, compared to patients with optimal vitamin D levels after accounting for other patient factors associated with worse outcome.”

    Link = http://newsblog.mayoclinic.org/2009/12/02/vitamin-d-associated-with-survival-in-lymphoma-patients/

    So as I read their research, Vit D does not stop everyone from getting NHL but if you do and your Vit D level is at a certain level, then your odds of survival are increased.

    Needless to say we have tried to keep his Vit D levels up, but chemo will sometimes smash the Vit D levels way down.

    PS… We now have concerns that our son’s liver is damaged due to the chemo, but we will find out more on that next week after we visit the doctor and find out the results of his latest tests. All prayers welcome.

  2. pidkb@comcast.net

    To D-fiant
    If I may ask (you do not have to give answer) when you say “Needless to say we have tried to keep his Vit D levels up, but chemo will sometimes smash the Vit D levels way down.” What ng/ml levels are you trying for and how much Vitamin D does he take per day? Even though he has lost weight does this make him underweight, normal or overweight? Can I also assume he is getting co-factors for Vitamin D? Is he young or an adult?

  3. Rita and Misty

    Dear D-fiant,

    My thoughts are with your son, and with you, your family and friends, during his recovery process. I am certain others here in the Vitamin D community are also sending you their supportive thoughts and prayers.

    Here are several links pertaining to Vitamin D deficiency and Chemotherapy.

    http://www.rushoffools.info/chemotherapy-drugs-are-linked-to-severe-vitamin-d-deficiency-latest/html
    http://www.naturalnews.com/037663_chemotherapy_drugs_vitamin_D_deficiency.html
    http://www.vitamindwiki.com/Chemotherapy+might+be+amplified+by+vitamin+D
    http://jco.ascopubs.org/content/29/4/e81.full.pdf

    Sincerely,
    Rita Celone Umile

  4. D-fiant

    Thanks for showing interest.
    Answer to your questions.
    He is now 26
    Weight went from 103 kgs to mid 70’s kg (looking trim but not skinny, but a big change from where he was)
    We have him on 10,000 iu per day with co-factors
    Our target was 150 (Aust) 60 (USA) but we never got there, best was about 120 (Aust) 48 (USA)

    While taking 10,000/ day he fell back to about 65 (Aust) 26 (USA)
    He is now off chemo, and is very slowly increasing.

    Currently in hospital recovering from his last bowel op, but he may have picked up another infection last night, waiting on blood tests. He is feeling a bit sick but happy to be seperated from his Ileostomy bag.

    You might like to read this http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2715947/
    Quote
    “Conclusions – Chemotherapy is associated with a significant increase in the risk of severe vitamin D deficiency. Patients with colorectal cancer, especially those receiving chemotherapy, should be considered for aggressive vitamin D replacement strategies.”

    Ask more questions if you wish I learn things through the process.

  5. IAW

    To D-Fiant
    This is from the same person as above but it will now show it coming from “IAW”.

    Sorry more questions before I put my foot in my mouth so to speak. Just trying to help!

    You said “Our target was 150 (Aust) 60 (USA)”. Why not a higher target? (Dr. Cannell would say to aim for a high normal range of 80ng/ml if you are battling something like a disease.) I realize you then said “but we never got there, best was about 120 (Aust) 48 (USA)”. Why did you not go above 10,000 iu? If he is off chemo and “slowly increasing” why not increase his 10,000 iu to a minimum of 20,000 iu for a while?

    I am not being critical just asking. He is so lucky that he has you and that he is getting the amount he is taking. There are many that are not so lucky!

  6. D-fiant

    Hi IWA
    Thanks once again for your concern.
    Your questions are very valid.
    The reason that I have been doing what I have been doing is due to one of timidness on my part.

    I am NOT getting any advice from a local advisor such as a Doctor or Naturopath so I have been concerned that I might do my son some harm.
    If anything, apart from what I read on the internet, nearly everyone around me here is negative about Vitamin D, and I am referring to most doctors and my other adult children.

    So I try to stay within boundaries that have been well trodden before, The rate of 10,000 iu /day is mentioned lots of times on the net as being safe and no known side effects, so I was happy with this amount. I have read where other people have taken very large amounts, something like 50,000/day for a month or so. This bothered me.
    But you mentioned 20,000 iu/day for a while, this is not beyond my view of what can be taken – and actually my son did take that much for a week or so when he misunderstood the amount I said for him to take. This did not overly worry me.

    As a further area of concern, I have learned through this site that in some cases of Lymphoma that Vit D can trigger a high calcium reaction. This has not happened in our son’s case as we have been getting his blood results and checking these almost daily. Also in the last few months I have added Vit K2 to assist in calcium regulation. But from now on we hope not to be getting daily blood results, but with this comes the uncertainty of what the calcium is actually doing.

    The next thing you mentioned is why don’t we aim for much higher Vit D levels, i.e. 200.?
    I am in somewhat agreement with you on this one, but for the reasons above, especially the doctors, who we have to work with I thought that 150 would be an ideal spot to reach as an interim goal. But this is somewhat academic, because as stated, we could not reach there. But now he is off chemo this should achievable.

    This afternoon our son was discharged from hospital, which we are very happy about. The infection reported in my last post seemed to just go away and the doctors were not worried about it. He is walking around like a half opened pocket knife and 50 foot is a long walk for him, but he will improve quickly. And he is very happy not to have his bag anymore after having this for nearly ¾ of a year.

    The point is, now that he does not have the bag on him he will not be embarrassed to take his shirt off and get some sun. So if he is taking 10,000 IU / day and getting sun from time to time we may actually see him go above 150 heading towards 200. I always thought somewhere between these, say 175 would be an ideal level.
    It’s a pity that we are starting to go into our winter months.

    So ticking down the targets from the last 13 month ordeal.
    • Obtain remission ….Tick
    • Remove bag….Tick
    • Fix liver….still to do (doctor appointment in 2 days to find out test results)
    • Live a low risk cancer lifestyle…..still to learn… this is a “biggy” (advisor / coach meeting next week and a seminar with a different advisor next Tuesday night as well.)
    • Stem cell collection … approx 6 to 8 weeks time when he is stronger.

    To top things off I may have to start prostate treatment, so when it comes to Vit D with this one I am very confused. Currently I am taking 5,000 iu/day. Believe it or not my levels did the same reductions as my sons in the same time and I was not on chemo I was 120 and went to about 70 (from memory) Is this stress??

    Thanks very much for your words of encouragement.
    But today has been a great day.
    Any more questions please feel free to ask.

  7. D-fiant

    To Rita Celone Umile
    Thanks ever so much for your kind words, I must say we have been blessed greatly throughout this process by being surrounded with beautiful people who are wishing us well and covering us with prayer.

    I looked at your links that you sent but I was stopped in my tracks when I came to this one http://www.vitamindwiki.com/Chemotherapy+might+be+amplified+by+vitamin+D

    This one bothered me. It said that either Vit D or Chemo should be reduced if taken together. This was not done…….. was there harm done, and now I am thinking of his liver?

    We only have one patient to be aware of and that is our son. But he did not suffer from any of the chemo reactions that the nurses and doctors tell you about except for a very mild amount of diarrhoea from time to time. He remained upbeat nearly all the time and I think the ipad that I bought him one day one was a big contributor to that as he has a wide range of friends that he kept in touch with via Facebook.

    If we consider the idea that chemo works stronger when supplemented with Vit D then maybe it contributed to his longer neutropenia stages at the end of every cycle, but then the nurses said that this can happen. But were they extended due to the combination of Vit D and Chemo……there is no way of knowing as they were still within the range of normal.

    I liked your link on the prostate – I will go and read that a few more times.
    Once again, thanks for your concern, may you be blessed greatly.

    If I can help with any other information , just ask.

  8. Rita and Misty

    @Di-fiant,

    I think it is very important to also include a knowledgeable Vitamin D physician in the team of doctors working with your son’s oncologist.

    I am not a healthcare professional, simply someone like yourself who takes responsibility for my personal health.

    That being said, I do think that if your son can achieve and maintain 25(OH)D of 100 ng/ml (or perhaps higher…150 ng/ml), then perhaps chemo might be able to be reduced.

    Again, a partnership between a knowledgeable Vitamin D doctor and your son’s oncologist is of primary importance.

    From personal health issues with my liver, I can tell you that research indicates Vitamin D has healing properties for the liver….

    I’m glad you found the prostate link helpful… Knowledge is the key to better health!

    If I can help with any further research, please email or call me:
    umileritac@aol.com; 203-785-6269

    What is life without hope.

    Warmly,
    Rita

  9. Rita and Misty

    @Di-fiant,

    May I ask your concerns with prostate cancer? More and more research are indicating that many types of prostate cancer can be slow growing and not requiring treatment..

    So, if you’ve been diagnosed with this cancer, please take a deep breathe, relax and do a bit of research on your own.

    My husband has had success treating his prostate cancer with daily doses of Vitamin D…He was using 50,000 iu daily…I wish I could provide you with greater detail, but he and I are estranged and not on speaking terms regarding this matter (among others).

    Be well…and do contact me if you’d like help researching your health concerns.

    Rita

  10. IAW

    To D-Fiant
    I agree with Rita when she says “if your son can achieve and maintain 25(OH)D of 100 ng/ml (or perhaps higher…150 ng/ml), then perhaps chemo might be able to be reduced.” I also think you will have to have a much higher level in order to have to worry about this. So no you did not cause liver damage from the Vitamin D. If anything you probably prevented or lessened any damage. Another question I would have was when, in this mess did he start taking the Vitamin D?
    On your list was “• Live a low risk cancer lifestyle…..still to learn… this is a “biggy” (advisor / coach meeting next week and a seminar with a different advisor next Tuesday night as well.” Let me know if Vitamin D is on their “list”!
    Rita also said “I think it is very important to also include a knowledgeable Vitamin D physician in the team of doctors working with your son’s oncologist.” That would be nice but I gathered from your writing that you are on your own. I encourage you to keep up the good work! You are doing fine!
    Sorry you have to deal with health problems yourself. I agree with Rita and would listen to what she says above!
    Maybe reading the below will help alleviate your fears on “amounts”. Thank “hlahore” for pointing this out again in the blog not too long ago. (It made me feel better.)
    Vitamin D Supplement Doses and Serum 25-Hydroxyvitamin
    D in the Range Associated with Cancer Prevention
    CEDRIC F. GARLAND1, CHRISTINE B. FRENCH2, LEO L. BAGGERLY2 and ROBERT P. HEANEY3
    “Although this data set provides no information with respect to serum or urine calcium values in these individuals, at the same time it is clear that there were no clinical evidences of toxicity. Indeed, since virtually all of the values, at whatever dose, were associated with 25(OH)D values below 200 ng/ml [and no doses below 50,000 IU/d produced serum 25(OH) D values above 200 ng/ml], the absence of apparent toxicity is not surprising. The very slow rise in serum 25(OH)D concentration for each 1,000 IU increment at serum values above 80-100 ng/ml (Figure 3) is firm expression of the general safety of even relatively high doses.”

    Could stress make your Vitamin D levels go down? I would say most definitely! Everything has to work harder. Could be the prostate thing making it go down. At a 120 level (48 USA and I did not double check any of your conversions) think of it this way. Taking 5000 iu or a level of 120 would, in my opinion, be for a normal person with absolutely no physical problems to contend with. If you also read between the lines the Vitamin D Council says 5000 iu plus get some sunshine.

  11. D-fiant

    OOPS
    please disregard previous post. I was seeing if the post would hold the formating and the part message was sent.

  12. D-fiant

    To Rita and IAW,
    Thanks for your continued support and recommendations I am excited by your input.
    We have changed accommodation and hospitals since the last post, and we have great news on the liver!

    But first I need to make it clear, as obviously I have not, and I apologize, my words on my son’s chemo and simultaneous Vit D intake were me thinking retrospectively. By this I mean he has finished his chemo some weeks ago.

    I will try and answer your questions.

    Rita –“important to also include a knowledgeable Vitamin D physician in the team of doctors working with your son’s oncologist.” ……..I wish that I could but I don’t know of any doctors who are Vit D advocates and over here the specialists (son’s oncologists) would not take advice from a GP, nor would one give it. We feel lucky with our oncologist that he assists with suppling us with Vit D tests, but he never discusses them.

    Rita – Thanks for conveying the information about your liver and the beneficial effect of Vit D. The doctor had played down the bad liver test numbers for the last 6 months or so and said it was just chemo. Well, the chemo has stopped but the bad numbers were still there on the last test on the 5/3/2013, but today’s test 14/3/2013 (we are a day ahead of you in USA) showed a great improvement, the doctor actually jumped in his chair when he saw the results.
    Look at these last 4 tests
    ……………….25/2/13………..4/3/13……….5/3/13………14/3/13
    ALP ………..177………………160 …………163 …………….to 84, ………(35 – 110)
    AST ………….76……………….66…………… 55 …………….to 21, ………(10 – 40)
    ALT ………..182………………115……………106 …………….to 30………,(5 – 40)
    GGT ……….415…………………425………….. 432 ……………to 151……… (5 – 50)
    LDH ………..361………………..351…………..334 ……………to 232. ……(120 – 250)
    The only difference is that he has just started taking some over the counter liver tablets (Milk Thistle 17,000 Plus) and his Church did a special prayer for his tests to be right. WOW!! A big change in just 9 days. The GGT is the only one that is still high.

    IAW – “I agree with Rita when she says “if your son can achieve and maintain 25(OH)D of 100 ng/ml (or perhaps higher…150 ng/ml),”……..These numbers would equate to 250 and 375 in Australia these seem high to my understanding . The reading I have done seems to say that 100ng/ml should be the max and anything over this does not achieve anything. But that is probably 4 times what my son and I are now so I have plenty of time to read up on this. Your extract that you provided seemed to say that daily intake of up to 50,000iu / day and blood serum amounts up to 200 ng/ml (500 nmol/L) are safe. Please forgive me but my mind can’t expand to that at the moment. Rita you said your husband took 50,000/day, I think this could be possible, but I would suspect that it was for a defined time and watched closely with regular blood tests. But I will do more reading on this.

    IAW – “Another question I would have was when, in this mess did he start taking the Vitamin D?”…….This is difficult to answer, he was first diagnosed and emergency op 8th Feb 2012, they did not start chemo for about 3 weeks to allow healing, so considering I had to read about vit D and then do something I imagine somewhere in April last year. I then only started off with light doses of 1,000iu/day as that was all you can get in oz, and I might add, they were about $35 for about 60 tabs at the chemist. I did more reading and started increasing the dose, so probably by about a month later he was on 5,000iu a day and I quickly got some from the USA. ( I was having some heated discussions with other family members on these issues at that time) So most of the time he was on 5,000/day without cofactors. But then I would feel if it is not enough ask him to take 10,000. I wish I could say that it was a real planned approach, but it was not. Then he had a PET scan and it showed some calcification of the prostate and I got worried again, so I cut him back. But it just so happened that I was talking to a doctor at church who is a personal friend, and she thought that it would be a chemo issue not Vit D, so I went back to the normal dose. The tablets with cofactors have been taken for about 4 – 5 months. In truth, it was a mess for the most part, but lately 10,000iu/day has been the norm. My mind was in a similar mess , no wonder I did not do it well.

    IAW – “You want to know what the health advisors say about Vit D” I will have to contact you next week on this one.

    I can also give more accurate numbers of his Vit D levels and how they fell away.
    24/7/2012 =121, 4/12/2012 = 55, 20/1/2013 = 61, 5/3/2013 = 72 nmol/L

    The second thing I wish to apologize for is that maybe I should not have mentioned my prostate issue as it is still early days, I go to see a specialist next week. I included the bit about the prostate but as soon as I hit the “Post” button, I thought that it was the wrong thing, as this post is about my son, not me! But having said that I really appreciate your thoughts on this issue. Based on your suggestions I will increase my intake to 10,000 iu. And try and get some more sun. I mentioned the bit about being confused with Vit D and Prostate because there have been some results of population studies that seemed to link high Vit D with worst prostate cancer outcomes. Thus the confusion. I appreciate that there is an argument that these results may be inaccurate and the negative association was more to do with Vit A that was consumed at the same time as the Vit D. When you read about these things it is all of great interest, but when it comes back to you on a personal level and you realise that you now have to sort this out and make a decision because it is you with the prostate issue, then it becomes difficult and as I say…… confusing. I will study your links as I am sure they will make things clearer. Maybe 50,000iu for a while????

    But let’s talk about stress, and this is me now.
    I am a “stressy” sort of a person, The first week my son was diagnosed I think I cried every morning and night. I would come home to the unit and just collapse in bed and I was asleep in seconds, then wake in the morning and be shocked by where I was and why I was here. I improved but I was still not handling things, so I go my doctor to give me some nice little white pills that fixed my life. My wife started yelling at me for no reason and I said you need some white pills. So she got the same as me and my darling wife returned to me, we are still on them.

    But there is something that you are not aware of. In late October, my 92 YO father who I loved dearly was also put in the same hospital as my son and they had the same oncologist. On the 4 th November at 2.30 AM he died. I saw his last breath leave his body and I got an understanding of the words “he is at peace now” He was a special man, he received many state awards and has two buildings named after him. On the day of his funeral his beloved high school stopped their senior exams to stand on the footpath as the hearse drove by. I worked in the business he created for 36 years and therefore I saw him nearly every day. When the business that had about 850 employees was sold 5 years ago I would ring him several times a week. I miss him greatly. And when my son went into remission I felt that there was still someone to tell, then I realized it was dad. So yes, maybe stress can affect Vitamin D levels it has certainly lost me a lot of hair in the last few months since his passing.

    This post is probably long enough, I will end now. I hope I did not miss one of your questions, but feel free to ask more.

  13. Rita and Misty

    @Di-fiant,

    I am estranged from my husband, and therefore I’m unable to completely answer your questions regarding his protocol pertaining to prostate cancer and Vitamin D. To the best of my knowledge, he is still taking 50,000 iu daily..but, as I said, I have no way to confirm this…nor his subsequent tests…. I do know that at one time he said D was helping…I am sorry I can’t be of more help to you on this item.

    I think that maintaining a 25(OH)D level of between 100 ng/ml to 150 ng/ml is helpful when one has cancer. I know that Dr. Mercola states a level of between 70 ng/ml–100 ng/ml as helpful. I know that Dr. Prendergast looks to 150 ng/ml for heath benefits.

    Dr. Cannell has written a helpful section on toxicity of D…and I’ve attached the link for your benefit: http://www.vitamindcouncil.org/about-vitamin-d/what-is-vitamin-d/vitamin-d-toxicity/

    Regarding your comments on stress…Yes, stress is a killer… we all have to find our own particular stress relief..running is mine…whether thru the woods or on the beach, running is when I’m at my happiest.

    My thoughts are still with you!

    Rita

  14. IAW

    To D-Fiant

    First “We feel lucky with our oncologist that he assists with supplying us with Vit D tests, but he never discusses them.” Kudos (praise) to your oncologist for doing what he did! He could have refused.

    Very happy for you and your son on the liver results .When you stated “the doctor actually jumped in his chair when he saw the results” you can thank the Vitamin D and the doctors fighting to bring it to our attention. Maybe even the doctor will be a convert.

    You and yours will have to decide what amount to stay on in the long run when things are more normal. I have impressed upon my three children that no matter what to never ever ever let anyone/doctor talk them into doing any less than 10,000 iu a day. (Some of us in the family take more.) I said this because I would make sure that your son absolutely understands to take it for life not just in this moment. I would also state again to try and work on a higher level for him 80 ng/ml (USA).

    Sorry about your Dad! By your description he was a wonderful person who did great things! No wonder you are stressed! (Being a “stressy” person though, may actually come from a Vitamin D deficiency.)

    If you had not added the “prostate” thing in with your son’s blog then you would have missed information on that. Vitamin D is still the answer. Maybe see what the doctor has to say, get those D-levels up to the “higher” end of the range, then go back for a recheck after some reasonable time has passed. You said “maybe 50,000iu for a while????” but sounds like you at least went from 5000 iu to 10,000 iu. That, I think, was definitely a step in the right direction!

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