Vitamin D and Cancer Information

Does vitamin D prevent cancer? If it does, will doctors who ignore the research end up in court, or worse, with blood on their hands? The press makes it easy for doctors to believe what they want to believe. Below are five stories about the same scientific study; read the five 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."

What Dr. Freedman actually discovered is that when you take a very large group of people (16,818), some as young as 17, 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 10 years earlier predicted that those with the lowest level were 4 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; that is, breast cancer was 2 1/2 times more frequent in the low vitamin D group. The breast cancer findings were not statistically significant - even during a very long breast cancer awareness month -but can you imagine what the American Cancer Society would be telling women if the numbers were reversed, that is, if breast cancer was 2 1/2 times more frequent in the high vitamin D group?

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.

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 called 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 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 benefits? This is not quantum mechanics. Cancer society calls for major vitamin D trial. Globe and Mail, 2007.10.25.

If 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, that is, in the illness business. In some ways people think of their doctors like they think about their public schools. They know medicine is a business and know doctors do things for money but they don't think their own doctor does. Likewise they think public schools are in bad shape but think their own local schools are above average. They think their doctor is above average, like their Lake Woebegone kids.

The fact is 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 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 such as drug 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 want 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. Terri Coles At the Moment, Vitamin D may fight cancer.Reuters, 2007.11.01.

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, doctor, 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 Mrs. Jones about any of the several hundred 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.

Dr. Lichtenfeld, implied the Canadian Cancer Society acted precipitously in recommending that all Canadians take 1,000 IU of vitamin D daily. He implied Americans should placidly wait for more randomized controlled trials, such as Lappe et al (above), to accumulate before they correct 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 just one human randomized controlled trial that proves cigarette smoking is dangerous to human health?

If he cannot, then he must admit that the American Cancer Society's position on cirarette smoking is entirely dependent on epidemiological studies, animal studies, and a demonstrable mechanism of action, not on even one human randomized controlled trial? 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.

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