Although vitamin D can be obtained from many natural dietary sources, such as fish liver oil, eggs, and dairy products, for the majority of men, this dietary source fails to meet the daily required levels.
In addition psa levels and vitamin d its well-known role in regulating calcium homeostasis in the body via its actions in the kidney, bone, intestine, and parathyroid glands, 2 vitamin D also exhibits antitumorigenic properties, as demonstrated in in-vivo studies.
Accordingly, Schwartz and Hulka 4 were the first to propose that low levels of vitamin D increase the risk of prostate cancer. These observations were based on prostate cancer mortality rates in the United States, which are inversely related to ultraviolet light exposure, psa levels and vitamin d.
This, in turn, has led to numerous studies investigating the antiproliferative properties of vitamin D on the prostate. This hypothesis is based on the ability of vitamin D to reduce invasion and adhesion of androgen-independent prostate cancer cells lines in vitro, 10 as well as in a xenograft model of rat prostate cancer. Two recently published papers report on these subjects. Previously, Gross and colleagues 12 investigated the impact of daily oral calcitriol in 7 men with prostate-specific antigen PSA recurrence after previous definitive therapy surgery or psa levels and vitamin d. Although a reduction in serum PSA was noted in 6 of 7 subjects, there was predictable development of hypercalcemia and hypercalciuria.
In an attempt to avoid these complications, Beer and colleagues investigated the long-term toxicity of weekly oral administration of calcitriol and the impact of this regimen on serum PSA levels in 22 men with biochemical recurrence median serum PSA, 5. Calcitriol administration was continued until a maximum of a 4-fold rise in serum PSA level was reached or clinical evidence of disease progression. The study cohort received calcitriol for a median duration of 10 months range, 2—25 months.
In addition, although no grade 3 or higher toxicity was detected and no patient experienced hypercalcemia or renal calculi, 2 men discontinued therapy because of toxicity 1 due to worsening of preexisting atrial fibrillation and 1 due to elevation in creatinine. Even with the small study population and the lack of randomization comparing calcitriol with placebo, the results of this study are disappointing.
Although moderately well tolerated, calcitriol failed to demonstrate an impact on disease progression. Therefore, it is possible that serum calcitriol levels become subtherapeutic well before the time for repeat dosing, making this treatment less efficacious. In an effort to address the hypercalcemic toxicity associated with vitamin D, there has been a recent growth of interest in vitamin D analogs that are less toxic but retain efficacy as a modality for cancer intervention.
Study results revealed that, in the presence of androgen, 1, OH 2 D 2 significantly inhibited the growth of LNCaP cells in a manner that was comparable to vitamin D. The authors concluded that, with its lower calcemic toxicity compared with vitamin D, 1, OH 2 D 2 may provide a promising vitamin D-based therapeutic modality for prostate cancer, psa levels and vitamin d.
However, orwells animal farm lesson plans this can be confirmed, the antiproliferative properties of 1, OH 2 D 2 need to be demonstrated in an animal model of prostate cancer in vivo studies and subsequently in clinical trials. In summary, although daily oral administration of vitamin D can inhibit prostate cancer growth, the resultant hypercalcemia precludes regular use of this regimen.
Weekly administration vitamin b5 and vitamin c been considered but does not appear to be efficacious. Vitamin D analogs that have less hypercalcemic toxicity may prove to be of benefit in the treatment of prostate cancer. However, it is too early to confirm this.
National Center for Biotechnology InformationU. Journal List Rev Urol v. Chapuy M, Meunier PJ. Vitamin D insufficiency in adults and the elderly.
The photobiology psa levels and vitamin d vitamin D3 in man. Basic and Clinical Aspects. Kluwer Academic Publishers; Suppression of in vivo growth of human cancer solid tumor xenografts by 1,dihydroxyvitamin D3. Is vitamin D deficiency a risk factor for prostate cancer? Vitamin D and prostate cancer. Proc Soc Exp Biol Med.
Vitamin D in the prevention and treatment of prostate cancer. Sung V, Feldman D, psa levels and vitamin d. Inhibition of prostate cancer metastasis in vivo: Cancer Epidemiol Biomarkers Prev. Treatment of early recurrent prostate cancer with 1,dihydroxyvitamin D3 calcitriol J Urol. Natural history of progression after PSA venlafaxine and alcohol following radical prostatectomy.
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