Tuesday, March 31, 2015

Vitamin D and Follicular Lymphoma

MedicalXpress reports on new research on Vitamin D levels and survival in Follicular Lymphoma patients. It reports on a study from The Journal of Clinical Oncology. I think it's worth discussing both of them. Or, more importantly, my reaction to both of them.

I read the MedicalXpress article last night. Nice headline: "Low vitamin D linked to worse prognosis in type of non-Hodgkin lymphoma." Certainly caught my attention. I've been interested in Vitamin D for a while, and its affect not only on Lymphoma, but on health in general. A few years ago, my doctor (my regular ol' doctor, not my oncologist) recommended I take some every day. It's a controversial supplement, with some studies saying it has a whole lot of health benefits, and others saying those benefits aren't real, or that too much Vitamin D might even be bad for you (the latest in this controversy came out just a few days ago).

So anything about Vitamin D and cancer catches my attention.

The opening sentence was as interesting as the headline: "A new study found that people with lower vitamin D levels prior to treatment for follicular lymphoma succumb to the disease or face relapse earlier than patients with sufficient vitamin D levels in their blood."

At this point, I'm thinking, "Woo hoo! I take my Vitamin D every day! I'm covered!"

I scanned the rest of the article, saw that the original research was published in JOC, and made a note to look at it today when I got a chance.

This morning, I read the JOC abstract. My excitement went down a little bit.

The researchers looked at two groups from two separate Follicular Lymphoma trials. Both groups involved patients who had been untreated, and then received CHOP + Rituxan or Zevalin, or just CHOP + Rituxan. They found that the patients who had low levels of Vitamin D had lower Progression Free Survival and Overall Survival.

Reading a little more closely, I could see that the comparison wasn't perfect. Although the researchers tested Vitamin D levels from two different groups, in two different countries, they had slightly different treatments and, if I'm reading correctly, had different levels that were considered "deficient."

The study's conclusion says "Although statistical significance was not reached in the LYSA cohort, the consistent estimates of association between low vitamin D levels and FL outcomes in two independent cohorts suggests that serum vitamin D might be the first potentially modifiable factor to be associated with FL survival. Further investigation is needed to determine the effects of vitamin D supplementation in this clinical setting."

Basically, this study doesn't say anything for sure, but it says enough that this should be looked into more deeply by someone else.

I looked back again at the MedicalXpress article,  and it said basically the same thing, though without as much emphasis on the lack of statistical significance. So why was I so much happier about reading the MedicalXpress article?

I think part of it is because I read it quickly, but also because of the way it is set up. The good news always comes first in this kind of article. And then it gives some helpful context, talking about the other studies that have shown that Vitamin D is related to better outcomes. When I read a medical journal, that good news (or bad news) usually comes at the end, especially when it's just an abstract. And I always read a little more slowly with a medical journal, because there's so much I don't understand on the first reading.

But mostly, I think I was seeing what I wanted to see in the MedicalXpress piece -- that Vitamin D was going to be a big help, and I was doing the right thing.

So for me, the big take-away doesn't have to do with Vitamin D (though I'm going to keep taking my supplements anyway). It has to do with reading, and remembering that it's easy to see things that aren't there when we read.

I do hope someone does more research on Vitamin D and Follicular Lymphoma. It would nice to have one solid answer about this disease, wouldn't it?

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