The Journal of the American Medical Association published an article that this week that disappointed a lot of people. It's called "Addition of High-Dose Vitamin D3 to Standard Treatment in Patients With Metastatic Colorectal Cancer: The SOLARIS Randomized Clinical Trial (Alliance A021703)." The hope was that taking high-dose vitamin D along with standard chemotherapy would improve outcomes in this specific group of colorectal cancer patients. Unfortunately, it did not improve Progression-Free Survival.
The study looked at high-dose (8000 IU for two weeks, followed by 4000 IU daily) versus standard-dose (400 IU daily). There was a small PFS benefit for the high-dose group, but it wasn't statistically significant.
This isn't a study about Follicular Lymphoma, or any other kind of blood cancer, so it doesn't say anything directly about how vitamin D would affect those of us with FL. But studies of cancer and vitamin D always catch my eye because it's one of those interventions that people have asked me about fairly frequently over the years. There have been some tantalizing studies that get our hopes up. For example, in 2022, a study of Diffuse Large B Cell Lymphoma patients found that those with low Vitamin D levels had a lower response rate to CAR-T and a lower Overall Survival after 2 years than patients with normal vitamin D levels. But that's not the same thing as saying vitamin D will improve outcomes if you already ave normal levels. Another study from 2019 found that Lymphoma patients who had higher sun exposure (and thus more opportunity for the body to naturally develop vitamin D) had a smaller risk of developing some kinds of Lymphoma, including FL. But they also found that getting vitamin D through food or supplements didn't have any effect. And then in 2018, there was a presentation at ASCO on a phase 3 clinical trial comparing FL patients who received Rituxan + vitamin D versus just Rituxan. I never saw results from the trial, which typically means it wasn't successful.
There are more. You can put "vitamin D" in the search box at the top of the blog to see more. But it's more of the same -- studies that show there might be some benefit maybe to some small population in some particular circumstance. I get these reminders every now and then that I need to step back and ask why I'm doing things and consider what I believe.
To be very clear -- I'm not saying you shouldn't take vitamin D. It has all kinds of health benefits. The National Institutes of Health have a nice comprehensive sheet that describes some of those benefits.
But keep reading -- it also describes some of the problems that come from excessive vitamin D intake.
The point here is that it's worth knowing what your vitamin D levels are, and working with a doctor to figure out what that means for your own overall health. But I wouldn't expect it to cure your cancer.
This is also a good time to remind you that I am not a medical doctor or a cancer biologist, and you shouldn't take medical advice from me. The best person to take medical advice from is your own doctor. They know you best, and they have the expertise to help you.
All of that said, I do take vitamin D every day. I tested low a few years ago, and my doctor recommended supplements. My vitamin D levels are normal now. I still take a fairly high dose every day, and that keeps me within normal range. In fact, it's at kind of the lower end of normal range, which suggests that my high dose is what I need. There's something happening in my body that keeps my levels low without the supplement.
What is that thing that keeps my levels low? I have no idea, and I'm not going to worry about it. The very easy and fairly inexpensive intervention that my doctor recommended is doing its job.
As I said, I like to have a reminder every now and then -- even a negative one -- that there are no easy answers, as much as we'd like there to be. The best we can do is stay informed, work with our doctors, and trust the excellent research that is being done.
No comments:
Post a Comment