The Vitamin D Newsletter December, 2007 Does vitamin D prevent cancer? 

If it does, will doctors who ignore the research end up with blood on their hands?  The press makes it easy for doctors to believe what they want to believe.  Below are six stories about the same scientific study; read the six different headlines.  According to your a priori beliefs, you can choose the story you want to believe and read that one.  Don't feel bad, we all do it.  As Walter Lippman once said, "We do not see and then believe, we believe and then we see."

 Vitamin D cuts colon cancer death risk

 Study Finds No Connection Between Vitamin D And Overall Cancer Deaths

 Vitamin D protects against colorectal cancer

 Vitamin D May Not Cut Cancer Deaths

 Vitamin D protects against colorectal cancer

 Scientists advise a vitamin D downgrade as there is no real proof ...

Another option is to read the study yourself.

Freedman DM, et al.  Prospective Study of Serum Vitamin D and Cancer Mortality in the United States. J Natl Cancer Inst. 2007 Oct 30; [Epub ahead of print] 

What Dr. Freedman actually discovered is that when you take a very large group of people (16,818), some as young as seventeen, measure their vitamin D levels, and then wait about ten years to see who dies from cancer, you find 536 die and that a vitamin D level from ten years earlier is not a good predictor of who will die from cancer.  However, even a level drawn ten years earlier predicted that those with the lowest level were four times more likely to die from colon cancer, suggesting, as Ed Giovannucci has, that colon cancer may be exquisitely sensitive to vitamin D.  Furthermore, 28 women got breast cancer, 20 in the group with the lowest vitamin D level but only 8 in the highest.  The breast cancer findings were not statistically significant - even during a very long breast cancer awareness month - but can you imagine what critics at the American Cancer Society would be telling women if the numbers were reversed, if the 20 women who got breast cancer were in the high vitamin D group?

 Another large epidemiological study appeared about breast cancer the very next day.  This time, the press passed on the story and the American Cancer Society was mum, no editorials by Dr. Lichtenfeld, their spokesman, in spite of breast cancer awareness month.

 Abbas S, et al. Serum 25-hydroxyvitamin D and risk of postmenopausal breast cancer - results of a large case-control study. Carcinogenesis. 2007 Oct 31; [Epub ahead of print]

 In the above study, 1,394 women with breast cancer were case-controlled with a similar number of women without breast cancer.  The women with breast cancer were three times more likely to have low vitamin D levels.  That is a lot of women who may be dying during next year's breast cancer awareness month.

 Both of the above studies were epidemiological, not randomized controlled trials.  Of course a randomized controlled trial has already shown a 60% reduction in internal cancers in women taking even a modest 1,100 IU per day of vitamin D.

 Lappe JM, et al. Vitamin D and calcium supplementation reduces cancer risk: results of a randomized trial. Am J Clin Nutr. 2007 Jun;85(6):1586-91.

 What is interesting is the difference in the response of the Canadian Cancer Society and the American Cancer Society.  The Canadian Cancer Society has advised all Canadians to take 1,000 IU per day - not enough but a good first step - and for immediate additional large scale clinical trials.  The Canadians simply performed a risk/benefit analysis.  What is the risk of treating vitamin D deficiency versus what are the potential benefits?  They quote the American Food and Nutrition Board, which says 2,000 IU/day is safe for anyone over the age on one to take, on their own, without being under the care of a physician.  If there is little or no risk, then the next question is what are the potential benefits of treating vitamin D deficiency?  This is not quantum mechanics. 

 Cancer society calls for major vitamin D trial 

 The Canadians acted because the Canadian government knows it could save billions of dollars by treating vitamin D deficiency.

 Vitamin D Deficiency Drains $9 billion From Canadian Health Care ... 

If wide spread treatment of vitamin D deficiency became the rule, ask yourself, "Who would be helped and who would be hurt."  First ask yourself that question about Canada and then about the USA.  Remember, in Canada, the government directly pays for its citizen's health insurance; in the USA, private insurance is the norm.  In Canada, the government is realizing they could save billions if vitamin D deficiencies were treated.  In the USA, a large segment of the medical industry would be hurt, some anti-cancer drug manufacturers would have to close their doors, thousands of patents would become worthless, lucrative consulting contracts between industry and cancer researchers would dry up.
Both Canadians and Americans are shocked to think their doctors care about money, are in the illness business.  In some ways people think of their doctors like they do their local public schools.  They know medicine is a business and know doctors do things for money but they don't think their own doctors do.  Likewise they think public schools are in bad shape but think their local schools are above average. They think their doctor is above average, like their "Lake Woebegone" kids.
Lake Woebegone Effect

The fact is that doctors, hospitals, regional cancer centers, and the cancer drug manufacturers are all in business to make money and all of these businesses make money off the sick, not off the well.  Just a fact, but, as Aldous Huxley once observed, "Facts do not cease to exist because they are ignored."

 Vitamin D will save the Canadian government enormous amounts of money but will cause widespread economic disruption in the USA.  Do the physicians leading the American Cancer Society have strong economic ties to the cancer industry in the form of patents, stock options, and consulting fees?  If so, what do you expect them to do?  What would you do?  It's simple.  You would believe what you have to believe, what you need to believe, that is, anything with the word "vitamin" in it is simply the latest Laetrile.  Look to Canada, not the USA, to lead the way.

 Vitamin D may fight cancer

What about American physicians?  They are apparently waiting for the American trial lawyers to smell a tort.  After all, the case is quite simple.  Doctor, did you advise Mrs. Jones to avoid the sun?  Doctor, did you tell her the sun is the source of 90% of circulating stores of vitamin D?  Doctor, did you prescribe vitamin D to make up for what the sun would not be making?  Doctor, did you measure her vitamin D levels?   So you had no way of knowing if your sun-avoidance advice resulted in vitamin D deficiency?  Doctor, do you know our expert tested her vitamin D level and it was less than 20?  Doctor, did you tell her about any of the studies indicating vitamin D deficiency causes cancer?  Doctor, did you know Mrs. Jones has terminal breast cancer and will be leaving behind a loving husband and two young children?
And what about the American Cancer Society?  Dr. Lichtenfeld, their spokesman, quickly gave his opinion; from what I can tell the first time he ever commented on a vitamin D study.  That is, he has ignored the hundreds of positive epidemiological studies, ignored the incredible randomized controlled trial, but he jumped on this one:
Maybe Vitamin D Isn't The Answer After All
Dr. Lichtenfeld, implied the Canadian Cancer Society has acted precipitously in recommending that all Canadians take 1,000 IU of vitamin D daily.  He implied that Americans should placidly wait until more randomized controlled trials, such as Lappe JM, et al (above), accumulate before they address their vitamin D deficiency. That is, nothing should be done until more randomized controlled trials prove vitamin D prevents cancer, one randomized controlled trial is not enough; epidemiological studies are not enough, animal studies are not enough, multiple anti-cancer mechanisms of action are not enough?  If that is his position, I challenge him to point to one human randomized controlled trial that proves smoking is dangerous? 
If he cannot, then he must admit that the American Cancer Society's position on smoking is entirely derived from epidemiological studies, animal studies, and a demonstrable mechanism of action, not on human randomized controlled trials?  Vitamin D not only has hundreds of epidemiological studies, thousand of animal studies, and at least four anti-cancer mechanisms of action, vitamin D deficiency has something smoking does not have, it has a high quality randomized controlled trial.  If future randomized controlled trials fail to show vitamin D prevents cancer - and Dr. Lichtenfeld better hope they do - he can have the satisfaction of saying "I told you so."  If future randomized controlled trials confirm vitamin D prevents cancer, then he needs to look at his hands, the red he sees is the blood of needless cancer deaths.
John Cannell, MD
The Vitamin D Council

9100 San Gregorio Road

Atascadero, CA 93422


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