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Vitamin D reduces breast cancer risk
Dr. Susan E. Brown

How much vitamin D do you need to reduce breast cancer risk?

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It has been recognized for over a decade that vitamin D has a protective effect against a variety of cancers, including breast cancer (Garland et al., 2006; Krishnan et al., 2010). But new research from our friends at GrassrootsHealth on vitamin D and breast cancer has me really excited. The group has found that maintaining a higher vitamin D level can reduce breast cancer risk by — are you ready for it? — a whopping 80 percent.

Higher vitamin D levels reduce breast cancer risk AND reduce bone loss

GrassrootsHealth recently combined two randomized clinical trials from Dr. Joan Lappe (Lappe et al., 2007; McDonnell et al, 2016) looking at women over four years. What they found was that was that those women who had vitamin D blood levels equal or greater then 60 ng/mL — the same levels helpful in preventing bone loss — had an 80% lower risk of breast cancer than women with concentrations less than 20 ng/mL (a very deficient level indeed).

Meanwhile, a similar study conducted recently showed that women with a vitamin D level above 38 ng/mL (about the level conventionally regarded as “adequate) had a 21% lower risk of breast cancer than women with levels at or below 24.6 (O’Brien et al., 2017).

You can’t help but notice the difference in risk reduction at 60 ng/mL versus 38 ng/mL is rather large. It reinforces what I’ve maintained all along — that current serum vitamin D recommendations are too low for women to get the best protective effects. But it also strongly supports the need for everyone to keep tabs on their vitamin D levels to ensure they don’t fall below the minimum level for bone health (and overall health).

Watch my interview with Carol Baggerly, the founder of GrassrootsHealth, to learn more about this groundbreaking research and Grassroots Heath’s new D-Action Cancer Prevention Society!

Test Your Vitamin D at Home!

References

Garland CF, Garland FC, Gorham ED, Lipkin M, Newmark H, Mohr SB, Holick MF. The role of vitamin D in cancer prevention. Am J Public Health. 2006 February; 96(2): 252–261.

Krishnan AV, Trump DL, Johnson CS, Feldman D. The role of vitamin D in cancer prevention and treatment. Endocrinol Metab Clin North Am. 2010 Jun;39(2):401–418.

Lappe JM, Travers-Gustafson D, Davies KM, Recker RR, Heaney RP. Vitamin D and calcium supplementation reduces cancer risk: results of a randomized trial. Am J Clin Nutr. 2007 Jun;85(6):1586–1691.

McDonnell SL, Baggerly C, French CB, Baggerly LL, Garland CF, Gorham ED, Lappe JM, Heaney RP. Serum 25-hydroxyvitamin D concentrations ≥40 ng/ml are associated with >65% lower cancer risk: pooled analysis of randomized trial and prospective cohort study. PLoS One. 2016; 11(4): e0152441.

O’Brien KM, Sandler DP, Taylor JA, Weinberg CR. Serum vitamin D and risk of breast cancer within five years. Environ Health Perspect. 2017; DOI:10.1289/EHP943.

Cancer and fosamax
Dr. Susan E. Brown

Fosamax and breast cancer

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Last December, many news outlets were reporting the latest finding to come from the 2002 Women’s Health Initiative in articles that trumpeted the finding that women who were taking Fosamax and other bisphosphonates for their bones had 32% fewer breast cancers than women who weren’t. At first blush, the idea that you could prevent two of the most frightening conditions that affect post-menopausal women — osteoporosis and breast cancer — with a single medication would seem to be a breakthrough of tremendous importance. I wanted to know more. So I looked at what little information is available about the study — there’s not very much, just an abstract from the meeting where the study was presented and various news reports — and consulted with Dr. Dixie Mills, Medical Director of the Dr. Susan Love Research Foundation, to make sure I understood clearly what the findings meant.

My findings only confirmed my initial suspicions that popular media outlets were blowing the significance of this study out of proportion. I’d like to caution women not to take the headlines at face value. Why? For four reasons:

1. First, bisphosphonates like Fosamax, Actonel, and Boniva stop the activity of bone-building osteoblasts, which I feel (and science supports) could, over time, make bone brittle and more prone to fracture. Unless you’re at very high risk for breast cancer, trading lower risk of breast cancer for the risk of hip fracture would just not be helpful.

2. The information in the study wasn’t part of a clinical trial — it was drawn from the Women’s Health Initiative, which was never intended to study whether osteoporosis drugs affect breast cancer rates. “Observational” data like this is never as meaningful as data from a well-designed double-blind, randomized clinical trial because there is no way to make sure you’re comparing people and circumstances that are fundamentally alike. It’s as though you’re talking about “citrus fruit” without being able to say whether you’re looking at oranges, grapefruits, lemons, or limes!

3. Even if it’s true that these drugs have the happy side effect of limiting breast cancer it doesn’t change the fact that they also have many other unhappy side effects that make them very difficult, if not impossible, for women to tolerate. These side effects include serious digestive disorders and the increased risk of esophageal cancer.

4. The finding reported in the news consisted of “relative risk” data — that is, they compared the risk statistic of women on the drugs who got cancer to the risk of women not taking drugs who got cancer. This approach obscures the fact that in absolute terms, if you treated 100 women for 10 years with these drugs, you’d prevent only 1 incidence of breast cancer — and statistically speaking, that’s a lot of cost to women’s health, both physical AND financial, for a very small benefit!

5. Finally, as Dr. Mills pointed out, along with the decrease in invasive cancer that was so broadly discussed in the media was a less widely reported increase in the incidence of ductal carcinoma in situ (DCIS), a non-invasive, milder form of cancer that is nevertheless an important health concern for women.

All of these factors mean that this study’s findings really are very weak, so until someone undertakes a large, well-designed clinical trial that shows the same results, I think the hoopla is a bit premature.

I know there are better ways — natural ways — that women can both improve bone health and lower their risk of cancer of any kind (not just breast cancer) than using bisphosphonates. Here are four areas you can explore if you want to know more:

• Look into getting your Vitamin D status checked. Vitamin D plays a multitude of roles in our health, including helping us maintain strong bones and cancer prevention.

• Learn more about chronic inflammation, which has been implicated in a wide range of health problems — including some forms of cancer.

• Eat an alkaline diet rich in vegetables and fruits, which offer a range of cancer-fighting and –preventing antioxidants.

• Obtain all the 20 key bone building nutrients in adequate doses. All of these nutrients also help build and maintain immune strength.

 

References:

Bankhead C. SABCS: More evidence that bisphosphonates prevent breast cancer. Medpage Today, December 10, 2009.

Chlebowski RT, Chen Z, Cauley JA, et al. 2009. Oral bisphosphonate and breast cancer: Prospective results from the Women’s Health Initiative (WHI) (abstract). Paper presented at the San Antonio Breast Cancer Symposium, December 10, 2009, San Antonio, TX.