Should Cancer Patients Die Vitamin D Deficient?
More than half a million Americans will die this year from cancer. Most of them will die vitamin D deficient. Some of them will die while under the care of Dr. Jay Brooks, chairperson of hematology and oncology at Ochsner Clinic Foundation Hospital in New Orleans. Like most physicians, Dr. Brooks looks to the venerable Institute of Medicine (IOM) for guidelines concerning the appropriate use of vitamin D, both for the dose that prevents deficiency and the dose that is toxic. The web site of the IOM states it “strives to provide advice that is unbiased, based on evidence, and grounded in science.” What happens when the IOM violates the public trust with guidelines that are neither based on current evidence nor grounded in current science?
An impressive science now connects vitamin D deficiency with increased risk of developing cancer. Dozens of studies also suggest, but do not prove, vitamin D may be helpful in cancer treatment as well. For a review of the several hundred most important studies, see: http://vitamindcouncil.com/
However, in the last several months, two studies indicate vitamin D may be remarkably effective in cancer treatment. The first was Dr. Reinhold Vieth’s landmark study showing vitamin D reduced or stabilized PSA (a cancer marker) in the majority of men with prostate cancer.
A group from Harvard, led by Dr. David Christiani, announced that vitamin D (in sunshine, diet, and supplements) almost tripled the five year survival of patients with lung cancer. The five year survival was 72 percent in the group with the highest vitamin D intake compared to 29 percent with the lowest. Hundreds of newspapers and television stations in this country and abroad ran the story.
But the Harvard study is epidemiological, not interventional. It does not prove that vitamin D is useful in treating cancer; only that the highest vitamin D intake is associated with longer life in lung cancer patients. Vieth’s study was interventional (that is, he gave vitamin D to cancer patients). His was the first and, to date, the only such study ever done. But Vieth’s study was small, when he couldn’t get a grant he did the study on his own, his coauthors didn’t want to exceed IOM guidelines, and he could not get approval from research committees to exceed IOM guidelines.
The IOM’s Food and Nutrition Board issued their guidelines in 1997. Although eight years-old, the guidelines still have powerful effects on both practicing physicians and clinical researchers. The guidelines not only recommend absurdly inadequate daily intake levels, they erroneously state that 2,000 units of vitamin D are potentially toxic. Research in the last five years shows just the opposite. If fact, healthy humans utilize about 4,000 units of vitamin D a day. Some of us get it from the sun, but many of us avoid the sun and get less than 1,000 units a day.
No one knows how much vitamin D cancer patients need to optimally help fight their cancer. It may not help at all. Small amounts may be as effective as larger amounts. It may have increasing effects with increasing dose. There may be an optimal dose. No one knows because the research has not been done. Most American physicians just assume that the IOM guidelines are optimal doses for every patient, no matter what disease they may have. The IOM has done little to correct this misimpression.
But it doesn’t stop there. The 2,000 units a day that the IOM lists as the Upper Limit, or dose which toxicity may occur, has the practical effect of preventing many researchers from using even physiological doses of vitamin D (not to mention pharmaceutical ones) in clinical trials. The IOM’s eight year old guidelines are no longer based on evidence nor grounded in science. Instead, it is embarrassingly outdated and factually incorrect. Don’t bother contacting your attorney. Federal law protects the IOM from malpractice lawsuits. (Dr. Brooks is not so protected). However, does IOM’s legal protection apply to consumer fraud complaints? After all, American taxpayers foot the bills of the IOM and Americans are the consumers of their advice. IOM’s vitamin D guidelines may qualify as “constructive fraud,” defined in the law as “conduct that is considered fraud under the law despite the absence of an intent to deceive because it has the same consequences as an actual fraud would have and it is against public interests as in the violation of a public trust or confidence”. Every day the IOM refuses to update its archaic guidelines, it is against the public interest and violating the public trust. Getting back to the Harvard study, did it convince any American physicians to treat vitamin D deficiency in their cancer patients? Dr. Jay Brooks, chairperson of hematology and oncology at Ochsner Clinic Foundation Hospital in New Orleans said, “This is an interesting observation, but it won’t influence the way I would practice today.” Brooks explained he won’t do anything different because studies with other vitamins “didn’t pan out.”
Plenty of chemotherapy drugs haven’t panned out but we hope that doesn’t stop Dr. Brooks from using chemotherapy in his oncology practice. Apparently, Dr. Brooks, like most American physicians, will ignore current research. To him, vitamin D is just another vitamin. Will he let his cancer patients die vitamin D deficient because other vitamins “didn’t pan out?” If he does, he will turn to the Institute of Medicine, with their fraudulent guidelines, to back him up.