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Vitamin D And Bladder Cancer

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Study Links Low Vitamin D Levels To Greater Bladder Cancer Risk

Patient Testimonial, IV Therapy Bladder Cancer, Bino Rucker, M.D.

Research presented at the Society for Endocrinology Conference, held November 7-9 in Brighton, UK, found a connection between low levels of vitamin D and higher risk of bladder cancer.

Investigators from the University of Warwick in Coventry, UK, performed a systematic review of 7 studies, with the goal of evaluating the link between vitamin D and bladder cancer. The number of participants in each of these studies ranged from 112 to 1125, according to the authors, who point out that some of the studies measured vitamin D levels before diagnosis, while others measured vitamin D levels during diagnosis, and others did so at the follow-up stage.

Ultimately, 5 of the 7 studies the authors reviewed determined that the risk of bladder cancer increases when vitamin D levels are low. In addition, the researchers saw a correlation between higher vitamin D levels and better survival and outcomes in individuals with bladder cancer.

The investigators also examined transitional epithelial cells, which line the bladder, and found that these cells can activate and respond to vitamin D. According to the authors, these cells can also synthesize enough vitamin D to activate a local immune response. In turn, the immune system could use this information to prevent cancer by recognizing abnormal cells before they have a chance to further develop.

Mark McGraw

Vitamin D May Benefit Immune Response

They carried out a systematic review of seven studies to investigate the link between vitamin D and bladder cancer. The number of participants per study ranged from 112 to 1,125. Some of the studies measured vitamin D levels before diagnosis, some during, and some at the follow-up stage.

Five out of the seven studies found that the risk of bladder cancer goes up when vitamin D levels are low. Higher vitamin D levels also correlated with better survival and outcomes in people with bladder cancer.

The team also examined the cells that line the bladder, known as transitional epithelial cells. They found that these cells can activate and respond to vitamin D, and that they can synthesize enough vitamin D to trigger a local immune response. By recognizing abnormal cells before they develop further, the immune system may be able to use this information to prevent cancer.

The researchers conclude that âbladder cancer risk correlates with low serum levels.â Dr. Bland suggests that if this is confirmed, administering supplementary vitamin D could be a safe and economical means of prevention.

âMore clinical studies are required to test this association, but our work suggests that low levels of vitamin D in the blood may prevent the cells within the bladder from stimulating an adequate response to abnormal cells. As vitamin D is cheap and safe, its potential use in cancer prevention is exciting and could potentially impact on the lives of many people.â

Dr. Rosemary Bland

Low Vitamin D Levels Linked To Increased Risk Of Bladder Cancer

Date:
University of Warwick
Summary:
Vitamin D deficiency is associated with an increased risk of developing bladder cancer, according to a systematic review of seven studies. Though further clinical studies are needed to confirm the findings, the study adds to a growing body of evidence on the importance of maintaining adequate vitamin D levels.

Vitamin D deficiency is associated with an increased risk of developing bladder cancer, according to a systematic review of seven studies presented at the Society for Endocrinology annual conference in Brighton. Though further clinical studies are needed to confirm the findings, the study adds to a growing body of evidence on the importance of maintaining adequate vitamin D levels.

Vitamin D, which is produced by the body through exposure to sunshine, helps the body control calcium and phosphate levels. Vitamin D can also be obtained from food sources such as fatty fish and egg yolks. Previous studies have linked vitamin D deficiency with a host of health problems including cardiovascular disease, cognitive impairment, autoimmune conditions, and cancer.

“More clinical studies are required to test this association, but our work suggests that low levels of vitamin D in the blood may prevent the cells within the bladder from stimulating an adequate response to abnormal cells,” said Dr Bland. “As vitamin D is cheap and safe, its potential use in cancer prevention is exciting and could potentially impact on the lives of many people.”

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Patients And Pathological Morphological Assessment

The study was approved by the Committee of Ethics of Scientific Research of Collegium Medicum of Nicolaus Copernicus University in Toru, Poland . All patients who underwent cystectomy or cystoprostatectomy in the Oncology CentreProf. Franciszek ukaszczyk Memorial Hospital, Bydgoszcz, Poland, from 2007 to 2010 were included into this study. In the next step of qualification, patients without tumor in resected urinary bladder or with insufficient tumor presence in blocks after diagnostic procedures were excluded. Finally seventy-one patients were included in this study. The characteristic of the patients recruited to this study are presented in Table 4. The clinicalpathomorphological data were obtained from the electronic database of the Oncology Center, Bydgoszcz, Poland. The dates of deaths were obtained from the Department of Registry Office in Bydgoszcz, Poland, and from the Polish National Cancer Registry. Information concerning the age, gender, date of diagnosis, survival or the date of death were available for each patient included into this study. The survival time was calculated based on date of pathomorphological diagnosis of bladder cancer and the date of death or the end of observation. The patients who did not die were censored. The mean follow up time was 46.7 months, and the mean survival time was 35.5 months.

Isolating The Effects Of Vitamin D

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The body produces vitamin D when the skin is exposed to sunlight. The vitamin is also found naturally in some foods, such as fatty fish and mushrooms, and is often added to others, including milk and some cereals.

For people with known vitamin D deficiencies, supplementation is recommended to maintain bone health and prevent fractures. The main goal of VITAL was to see if theres benefit to getting above the recommended dietary allowance, more than what is considered necessary for bone health, explained JoAnn Manson, M.D., of Brigham and Womens Hospital and Harvard Medical School, who led the study.

Observational studies have suggested that people who take vitamin D supplements may have a lower risk of many diseases. But people who take vitamins may be very different in important ways from people who dont take vitamins, explained Dr. Kramer. They often have a higher income and are less likely to smoke, less likely to be overweight, and more likely to have health insurance, he addedall of which are strongly linked with a lower risk of a variety of chronic health conditions, including heart disease and many cancers.

Large randomized clinical trials with thousands of participants can avoid these biases by randomly assigning study participants to receive or not receive the treatment.

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Primary Sources And Forms Of Vitamin D

There are two main forms of vitamin D supplements: D2 and D3. Your body naturally produces both from sun rays. Vitamin D2 is also produced in plants and fungi, and vitamin D3 is produced in animals.3

Some sources of vitamin D in food are:3

  • Fatty fish and fish liver oils
  • Foods fortified with vitamin D, like cereal or milk

Lack Of Vitamin D Linked To Greater Risk Of Bladder Cancer

Low levels of vitamin D have been linked to a greater risk of bladder cancer, according to a new study, adding to the body of evidence suggesting that a lack of vitamin D is detrimental to health.

Researchers from the University of Warwick, led by Dr Rosemary Bland, set out to find out more about how synthesis of vitamin D might affect immune responses in specific tissues.

They carried out a systematic review of seven studies to investigate the link between vitamin D and bladdercancer. The number of participants per study ranged from 112 to 1,125. Some of the studies measured vitamin D levels before diagnosis, some during, and some at the follow-up stage.

Five out of the seven studies found that the risk of bladder cancer goes up when vitamin D levels are low. Higher vitamin D levels also correlated with better survival and outcomes in people with bladder cancer.

The team also examined the cells that line the bladder, known as transitional epithelial cells. They found that these cells can activate and respond to vitamin D, and that they can synthesise enough vitamin D to trigger a local immune response. By recognising abnormal cells before they develop further, the immune system may be able to use this information to prevent cancer.

The researchers conclude that bladder cancer risk correlates with low vitamin D levels. Dr Bland suggests that if this is confirmed, administering supplementary vitamin D could be a safe and economical means of prevention.

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Future Paths For Vitamin D Research

The VITAL trial was well designed, said Dr. Kramer. And when its important to get the answer right that is, when youre potentially making recommendations to hundreds of thousands, or even millions, you want to make sure that your recommendations are based on very strong evidence, he added.

Other research into vitamin D and cancer prevention is ongoing, such as studying whether some types of cancer may be more sensitive than others to the effects of supplementation.

For example, an NCI-sponsored clinical trial is currently looking at whether supplementation with vitamin D, calcium, or both can prevent the development of new colorectal adenomas in people who have already had one or more such precancerous growths removed. VITAL will also examine effects of the supplements on the risk of new colorectal adenomas.

Dr. Manson and her colleagues plan to follow the participants for at least 2 more years and hope to secure grant funding to follow them for a longer period, she said. They would also like to study the potential influence of genetics on the effects of vitamin D supplementation.

This is something we really want to look atwhether there are gene variants related to vitamin D metabolism, the vitamin D receptor, binding proteins, or even completely separate mechanisms, that could have influenced the effects of supplementation and could help identify those most likely to benefit, Dr. Manson said.

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Evaluation Of The Nds

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In routine hematoxylin and eosin-stained sections, the presence of a non-classic differentiations was identified according to the histological classification of urinary tumors of the World Health Organization . The percentage tissue displaying the nonclassic differentiation pattern, which was defined as the average percentage of the surface of the whole neoplastic tissue displaying that pattern, was recorded for the sections of the tumors examined .

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How Is Vitamin D Being Studied Now In Clinical Cancer Research

Taken together, the available data are not comprehensive enough to establish whether taking vitamin D can prevent cancer . To fully understand the effects of vitamin D on cancer and other health outcomes, new randomized trials need to be conducted . However, the appropriate dose of vitamin D to use in such trials is still not clear . Other remaining questions include when to start taking vitamin D, and for how long, to potentially see a benefit.

To begin addressing these issues, researchers are conducting two phase I trials to determine what dose of vitamin D may be useful for chemoprevention of prostate, colorectal, and lung cancers . In addition, larger randomized trials have been initiated to examine the potential role of vitamin D in the prevention of cancer. The Vitamin D/Calcium Polyp Prevention Study, which has finished recruiting approximately 2,200 participants, is testing whether vitamin D supplements, given alone or with calcium, can prevent the development of colorectal adenomas in patients who previously had an adenoma removed. The studyâs estimated completion date is December 2017. The Vitamin D and Omega-3 Trial will examine whether vitamin D supplements can prevent the development of a variety of cancer types in healthy older men and women . The organizers of VITAL expect to recruit 20,000 participants and complete the trial by June 2016.

Selected References

How Does Vitamin D Relate To Cancer

Higher pre-cancer levels of vitamin D have been linked to lower colorectal and bladder cancer risk. Some of vitamin D’s effects on the body are great for slowing tumor growth, including:1,2

  • Reducing inflammation
  • Slowing the production of new blood vessels
  • Causing unhealthy cells to die
  • As of right now, though, there is no specific support from a health institution for vitamin D as cancer prevention. This is because more research needs to be done on its effects and how it works to see if vitamin D is safe and effective for everyone. Future research topics include:1

    • The types of tumors vitamin D could help
    • How it interacts with other factors, like genetics
    • How it affects cancer risk in people of color

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    Literature Search And Study Characteristics

    A total of 156 individual abstracts for potential studies were identified through literature search. 147 abstracts were excluded because they were irrelevant to the current meta-analysis, and 9 studies were left and were assessed by reading full-text . One study was excluded for lack of usable data , and one was excluded for containing overlapping data . Thus, seven studies met the inclusion criteria and were finally included into the meta-analysis . Those 7 studies contained with a total of 62,141 participants, and were published from 2006 to 2013 . Among those 7 studies, two were prospective cohort studies , two were nested case-control studies , and the other 3 studies were case-control studies . All studies reported adjusted risk estimates, but the confounding factors were different among those studies . Five studies assessed the relationship between serum vitamin D levels and bladder carcinoma risk , and the other two studies assessed the relationship between dietary vitamin D intake and bladder carcinoma risk . According to NOS criteria, four studies had high quality , while the other 3 studies didn’t have high quality .

    Study Strengths And Limitations

    A closer look at bladder cancer

    A major strength of the large sample set of more than 2300 incident BC cases. Also, the use of individual PIN for linkages between multiple data sources to establish a virtually complete study file, with exception of data on histopathology, is a strength. The data sources are high-quality population-based registries, with high degree of completeness. The bladder cancer diagnoses are coded according to ICD-O. To get information on staging and control the data quality, all histopathological information will be reviewed and characterised by tumour . Another strength of this study is that the public health data has been quality assured, structured and harmonised. The use of prediagnostic samples assures the proper temporality of the relationship between exposure and BC, limiting the possibility of reverse causality.

    Treatment data are of importance when evaluating the survival analyses. These data are missing and will be a limitation of this study

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    Literature Search And Selection

    We performed a literature search up to September 2014 using the databases of Pubmed and Embase, using the following search terms AND OR vitamin C) OR Vitamin E) OR Tocopherol) OR vitamin D) OR 1,25-dihydroxyvitamin D) OR 25-hydroxyvitamin D) OR 25-hydroxyvitamin D3) OR 25-hydroxyvitamin D2) without restrictions. We also reviewed the reference lists from retrieved articles to search for further relevant studies.

    For inclusion, studies must fulfill the following criteria: exposure of interest was Vitamin C, vitamin D or vitamin E outcome of interest was bladder cancer relative risk or odds ratio with 95% confidence interval was provided , or data available to calculate them conducted in humans for doseresponse analysis, the number of cases and participants or person-years for each category of vitamins must also be provided . The most recent study was included for duplicate publications.

    Low Vitamin D May Raise The Risk Of Bladder Cancer

    Nicola Jones, University of Warwick

    A review of seven research studies suggests a vitamin D deficiency might increase the risk of bladder cancer.

    The review was presented at the Society for Endocrinology annual conference. Though further clinical studies are needed to confirm the findings, the study adds to a growing body of evidence on the importance of maintaining adequate vitamin D levels.

    Vitamin D, which the body produces through exposure to sunshine, helps the body control calcium and phosphate levels. Vitamin D can also come from from food sources such as fatty fish and egg yolks.

    Previous studies have linked vitamin D deficiency with a host of health problems including cardiovascular disease, cognitive impairment, autoimmune conditions, and cancer. In countries with low levels of sunlight, it is difficult to obtain enough vitamin D from food alone.

    In this work, researchers from the University of Warwick and University Hospital Coventry and Warwickshire investigated the link between vitamin D and bladder cancer risk. They reviewed seven studies on the topic, which ranged from having 112 to 1,125 participants each.

    Five out of the seven studies linked low vitamin D levels to an increased risk of bladder cancer.

    In a separate experiment, the researchers then looked at the cells that line the bladder, known as transitional epithelial cells, and found that these cells are able to activate and respond to vitamin D, which in turn can stimulate an immune response.

    Also Check: Bladder Infection In Elderly Man

    Linking Low Levels Of Vitamin D And Bladder Cancer

    Many people know that they get vitamin D from milk and being outside in the sun, but what many people do not know is the potential health hazards of low levels of vitamin D in your body. At our natural medicine clinic in Milwaukee, we are proponents of nutritional health, so we were very interested in a recent study* that linked low vitamin D and bladder cancer.

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