Yet another major study proves no cau... - Advanced Prostate...

Advanced Prostate Cancer
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Yet another major study proves no causal connection between Vitamin D and prostate cancer

Jiang et al. report the results of a Mandelian randomization study of the causal connection between serum Vitamin D levels and prostate cancer. They identified 6 genetic mutations associated with low serum levels and looked for them in 79,148 men who were diagnosed with prostate cancer. They found no greater incidence of those genetic mutations in men with prostate cancer or advanced prostate cancer. Nor was there any association in women with breast cancer. The incidence of the genetic mutations were also not statistically different in 73,699 people who did not have breast or prostate cancer. This proves (once again) that there is no causal connection between low Vitamin D and prostate cancer.

academic.oup.com/ije/advanc...

pcnrv.blogspot.com/2018/07/...

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oldestnewest

Hmmm I think I am still going to keep taking vitamin D with the goal of keeping my Vitamin D levels between 50 and 80.

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Moi aussi

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I think that is a smart move, I intend doing the same.

Its funny how trials debunking supplements and minerals which MAY HELP without any major side effects involve 80 thousand plus participants. The SELECT trial involved 40 thousand participants. I call BS on these large trials for MY Treatment.

If they are interested do a trial with 100 men.

In specific clinical trials it is the free Vitamin D that MAY help not the serum.

Stampede trials involve 900 men and its a game changer.

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Why would a sample of 100 be inherently better than a sample of 80,000?

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If they did a clinical trial of 100 men with Vitamin D3 and 100 men without.

It would cost less that is all. No Pharma company is going to pay for this, it will have to come from a charity or government source. It will still cost millions if done properly.

Monitor them as with Stampede type trial we would get a specific outcome.

We need to know How, Why and Where it helps. The percentage of men where their PSA rose less than the control etc.. Does it help with maintaining Bone health?

I do not think that Vitamin D will give a 30% improvement over Standard of care that a Zytiga type drug can give, or that the FDA would require for it to be considered a NEW treatment addition.

BUT it may be of some benefit, if it helped by 10% for SOME men. How bad is that.

The next trial I would like to see in Stampede (after Metformin) is a supplement /mineral trial. Involve supplement/minerals that men on this site use, BUT do them all in one trial.

Vitamin D3 (4000IU), K2 and Calcium... for bones (My MO has me on D3 and Calcium)

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Lycopene, Selenium (from brewers yeast, Not only one type of Selenium Like Select) and Vitamin E (Plant based not produced form Gasoline like the SELECT trial, what a joke that trial was. 114 million dollars wasted)

I asked myself WHY they went so BIG with SELECT? Why not 900 men done properly?

They must have had excellent reason to believe that Selenium and Vitamin E was going to be a game changer, what was that reason?

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Essential Fish oils,

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POMI-T, broccoli, turmeric, green tea, and pomegranate

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etc....etc... That is 11 supplements/minerals. There are smart guys on here who could put a better list together!

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IF they each produced a small % benefit on their own, they MAY produce a better outcome when used together. I know the purist RCT guys will not like this. They would only be interested in WHICH component was Most effective , BUT I don't care which one, I am willing to take them all.

Just my opinion,

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I guess you didn't read the links. Confirmation bias.

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Allen, this is the internet age. Surely you don't expect anyone to actually read source material LOL

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I think it's part of the human condition that we don't let facts get in the way of our opinions. He just showed a perfect example.

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I read the source material LOL LOL LOL. Its out of date. Since that trial started we have learned that the serum D3 is not what we should be monitoring, it is the free D3. They should have stopped that trial 2 years ago. Those guys need to move away from their computer and get back into the lab and report on something of value. Its all over the place. What are they recommending? What conclusions do they come to regarding treatment for men with prostrate cancer? Has this trial any clinical benefit? What are they trying to achieve? Where they attempting to find something useful for men like us on this site or was it a total waste of time? Inconclusive as to any benefit? Confirmation bias and mirror spring to mind. Thanks to Tall-Allen for putting up the link all the same.

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I'll simplify it for you. If you read my article, there are 2 randomized clinical trials discussed there. The one by Manson et al randomized about 12,936 men to receive Vitamin D supplements or a placebo (just like in your imaginary trial, only 130 times bigger). They found there was no difference in incidence of prostate cancers between Vitamin D3 and Placebo.

The one by Scragg et al. included about 2,555 men (25 times bigger than the trial you imagined) - half got Vitamin D, half got a placebo. There was no significant difference between the Vitamin D cohort and the placebo cohort in the number of new prostate cancers or in prostate cancer deaths.

The Jiang study (on 73,699 men with prostate cancer) found that alterations in the genes that control serum Vitamin D levels did not cause any difference in incidence and virulence of prostate cancer.

How can it be more clear?

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I will simplify it for you. It says that higher Serum vitamin D levels will not give you prostate cancer. Who cares? We have Prostate cancer. What we need is ....

Does taking Vitamin D help lower PSA or reduse PSADT or make recurrent cancer less aggressive. Simple.

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If Vitamin D has no value in preventing PCa or aggressive PCa, why would it have any value after PCa is already discovered (when stronger measures are required)? If anything, I'd argue that introducing high doses of a steroid in men who are trying to maintain castration levels of androgens might be dangerous:

ncbi.nlm.nih.gov/pmc/articl...

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I repeat, we need relevant trials in men with prostate cancer that take Vitamin D and then monitor their PSA, PSADT and if possible see if their recurrent cancer is less aggressive. Also monitor their bone health while hormone treatment is lowering their T levels. There have been trials where free vitamin D in the blood has shown PSA benefit and important gene inflammation markers were affected. We need more of these BUT through stampede type multi arm controls to accelerate results. I can provide links to these trials but I am sure you have them. Thank you for response.

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Why would you care if it reduces PSA or inflammation markers if it doesn't increase survival?

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The Jiang paper is interesting and further shows the complexity of the disease. I will have to re-review the Vitamin D papers in greater depth. In any case, for those members who are on ADT taking Vitamin D (and K2) is a necessity to help mitigate bone mass loss. I have also come across papers indicating that Vitamin D may reduce the severity of muscle pains caused by statins, which I believe I can confirm - I used to have significant muscle pain when I took Crestor (a statin less prone to cause muscle pain) some time prior to being diagnosed with PCa and was forced to discontinue taking it. I can now tolerate Crestor with 4000 IU of Vitamin D. One caveat - metformin (which I also take) may also reduce muscle pain caused by statins. Cheers, Phil

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"for those members who are on ADT taking Vitamin D (and K2) is a necessity to help mitigate bone mass loss. "

if you read the article, it also addresses the non-effectiveness of Vitamin D on bone mass loss. It should only be taken if serum levels are inadequate.

Be careful about taking Vitamin K. The following study suggests that long-term use of a Vitamin K ANTAGONIST may DECREASE the risk of prostate cancer by 17%:

journals.lww.com/md-journal...

Based on that, I would be wary of increasing Vitamin K intake.

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Yes, I was deficient in Vitamin D and titrated the dosage accordingly to achieve a blood concentration of 25-Hydroxy/VitD is the lower third of the "normal" range. I have noticed the potential benefit of vitamin K antagonists with respect to decreasing the risk of prostate cancer and know that I have to investigate this potential conflict. Here is another paper: ncbi.nlm.nih.gov/pubmed/302... about VK antagonists. On the other hand, some papers indicate a potential benefit of VK in PCa which I have yet to review (various). One paper states the following:"...Although warfarin is unfit for use as a chemopreventative due to its anticoagulatory effects, our data suggest that its ability to reduce prostate cancer risk is independent of its anticoagulation properties. Furthermore, our data show that warfarin inhibits PPARγ and AR signaling, which suggests that inhibition of these pathways could be used to reduce the risk of developing prostate cancer." (https://www.ncbi.nlm.nih.gov/pubmed/28099154). I appreciate the warning and will work on the issue. Cheers, Phil

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Question: "Does taking Vitamin D help... make recurrent cancer less aggressive."

Answer: "There was no significant difference between the Vitamin D cohort and the placebo cohort in the number of new prostate cancers or in prostate cancer deaths."

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Good point - deaths would be lower if there were any benefit in men who already had PCa.

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A really terrible point. It is not just about deaths. It is PFS and time to first skeletal incident. I think ye are over reaching on this one. Let us just call it for what it is. An irrelevant and out of date trial.

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PFS is only a surrogate endpoint for overall survival. When we have data on overall survival, we can ignore surrogate endpoints. Vitamin D has proven to be of no benefit in reducing skeletal events. If bone-protective agents (e.g., Zometa, Xgeva) are used, it's a good idea to monitor serum levels of both Vitamin D and calcium to make sure they are adequate.

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Large studies are paid for by people with a vested interest in the outcome. Believing this was a legitimate study is like believing trump has even been honest in his life.

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These were government-sponsored studies. The only bias is in patients like yourself who refuse to believe them.

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D3 definitely has PROVEN wide health benefits other than for PC with no side effects --- whereas ADT has been PROVEN to NOT extend overall survival -- ADT causes heart problems, causes bone problems, causes weight gain, muscle wasting, hot flashes, depression -- but TA is all in for taking ADT

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Perhaps you can show me this proof you claim for Vitamin D and ADT? Keep in mind that a large RCT is the only way to show proof.

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Consider the time and manpower required to support a clinical trial of that magnitude. Then the amount of time to collect, dissect and analyze the data and draw any conclusions.

That would be my guess, the manageability of the sample size.

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The two randomized clinical trials were national projects funded by NIH and NZ.

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well over a hundred well over a hundred years ago a doctor wrote a paper on breast cancer cure. Called we chop the breast off,give it a name and forget the patient. That's the cure today. Now they are castrating men and for get the patient. Reason money.

If they find a cure the money won't stop. Their will always patients just like funeral homes they will never go out of business.

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The reason they castrate men is because it extends life.

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Stone age medicine with money as the gold end.

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Shoot.... I get all my vitamin D from a daily double scoop of chocolate chip ice cream.

Good Luck, Good Health and Good Humor.

j-o-h-n Wednesday 01/02/2019 4:49 PM EST

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and who works for NIH and NZ- big pharma employees on loan. Their return salary depends on the outcome of these studies. Too bad Vegas doesn't post and cover odds on these "studies".

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So your intuitions are always better than major clinical trials? That kind of cynicism can kill you.

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That's what a urologist told me 17 years ago when i dumped him. He wanted to do an RP. I found a better way.

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Great post..

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Maybe I've misunderstood something. In my case vitamin D3 and calcium were recommended by oncologists to slow down osteopenia. As far as preventing prostate cancer I don't know, but if a patient is getting hormone therapy doesn't it have some validity?

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Vitamin D and calcium are only warranted if serum levels are low. Read the section titled "No Effect on Bone Mineral Density"

pcnrv.blogspot.com/2018/07/...

It is especially important to monitor if one is taking bone preserving agents like Xgeva or Zometa.

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Thanks for the information.

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Vitamin D helps with many other things.

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Like what, If you are not deficient?

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Here are 8 signs and symptoms of vitamin D deficiency.

Getting Sick or Infected Often.

Fatigue and Tiredness. Feeling tired can have many causes, and vitamin D deficiency may be one of them. ...

Bone and Back Pain. ...

Depression. ...

Impaired Wound Healing. ...

Bone Loss. ...

Hair Loss. ...

Muscle Pain.

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You didn't mention rickets. Very few people in the US are deficient in Vitamin D. There is no known benefit to supplementing Vitamin D in people who are not deficient. you can have your blood checked for deficiency.

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I was deficient and my doctor gave me a supplement. It helps a lot.

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See also: fearlessparent.org/suppleme... - which explains beautifully that levels of the active HORMONE, calcitriol ARE also (likely to be) important in assessing "vitamin D" status.

Greg Blaney (RIP !) et al. paper from refs. list also worth considering for those with chronic conditions.

. . . . and my comments on this thread: healthunlocked.com/advanced...

Sid ;~)

3 Feb 2019

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