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Vitamin D monitoring linked to bladder cancer survival?

Posted on: February 21, 2013   by  John Cannell, MD

Vitamin D monitoring linked to bladder cancer survival?

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In the United States, bladder cancer is the fourth most common type of cancer in men and the ninth most common cancer in women. More than 50,000 men and 16,000 women are diagnosed with bladder cancer each year. Bladder cancer is usually treated successfully if it is found and treated early. Moreover, most bladder cancer is found early because the main symptom, blood in the urine, is hard to miss.

Researchers point to several components that could lead to bladder cancer, including cigarette smoking and chemical exposure. More recently, however, a more alarming trend has surfaced. The type 2 diabetes drug Actos has been linked to a 40 percent increased risk of bladder cancer for patients taking the drug for longer than a year.

We know that both latitude and 25(OH)D levels are associated with the risk of getting bladder cancer but what about people who already have it? Is there any evidence of a treatment effect by having higher 25(OH)D levels?

Dr Alan Peiris and colleagues of the East Tennessee State University recently studied more than 4,100 veterans with established bladder cancer. They wanted to see if vitamin D testing was associated with better survival. If patients were getting tested, then presumably they were getting treated to various degrees.

Peiris AN, Bailey BA, Manning T. Relationship of vitamin d monitoring and status to bladder cancer survival in veterans. South Med J. 2013 Feb;106(2):126-30.

They found the following:

  • The veterans who had vitamin D testing were 67% more likely to survive than those who did not have such testing (P < 0.001).
  • Among those who did not survive, those who had vitamin D testing survived more than 2 years longer than those who had no testing ( P< 0.001).
  • The number of 25(OH)D tests was significantly correlated with days until death (P < 0.001), indicating that the more 25(OH)D  tests that a patient underwent, the longer he was likely to survive.
  • Those who were initially vitamin D deficient were significantly less likely to survive than those who were not initially deficient (P = 0.001).

The authors concluded,

“Findings from the present study suggest that vitamin D deficiency may contribute to adverse outcomes in veterans with bladder cancer. Moreover, achieving higher vitamin D values early in the course of the disease may be better than trying to achieve replete status after diagnosis. In addition, vitamin D emerged as a significant risk factor independent of more traditional risk factors such as age, seasonality, latitude, and tobacco use.”

Furthermore, they recommend,

“Pending prospective studies to confirm these findings, we believe that all veterans with bladder cancer should have a 25(OH)D level checked with appropriate replacement as needed. In addition, efforts should focus on preventive measures to bring patient vitamin D to replete levels before serious health problems emerge.”

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