Risk Factors of Prostate Cancer

Written by Dr. Steve Chaney on . Posted in current health articles, Nutritiion, Vitamins and Health

Vitamin D Deficiency?

Author: Dr. Stephen Chaney

Vitamin D

Is vitamin D deficiency one of the risk factors of prostate cancer? What if something as simple as maintaining optimal vitamin D status could decrease your risk of prostate cancer? There is a lot of indirect evidence suggesting that vitamin D deficiency might affect your risk of developing prostate cancer. For example:

  • Prostate cancer incidence and vitamin D deficiency parallel each other. Both are highest in northern latitudes, in African American men, and in older men.
  • Prostate cancer mortality rates are highest for patients diagnosed in the winter and at Northern latitudes.

However, clinical studies looking at the correlation between 25-hydroxy vitamin D (the biologically active form of vitamin D in the blood) and prostate cancer incidence have been inconsistent. Because of this there has been considerable controversy in the scientific community as to whether or not there was any correlation between vitamin D deficiency and prostate cancer.

Vitamin D Deficiency and Cancer

That’s what makes the recent headlines suggesting that vitamin D is associated with decreased risk of aggressive prostate cancer so interesting. Does this study show low vitamin D to be one of the risk factors of prostate cancer? Have the conflicting data on vitamin D deficiency and prostate cancer finally been resolved or is this just another case of dueling headlines? Let’s start by looking at the study itself.

This study (Murphy et al, Clinical Cancer Research, 20: 2289-2299, 2014) enrolled 667 men, aged 40-79 (average age = 62), from five urology clinics in Chicago over a four year period. These were all men who were undergoing their first prostate biopsy because of elevated serum PSA levels or an abnormal DRE (that’s doctor talk for digital rectal exam – the least favorite part of every guy’s physical exam). The clinics also drew blood and measured each patient’s 25-hydroxy vitamin D level at the time of the prostate biopsy.

This study had a number of important strengths:

  • It was conducted at a northern latitude. Because of that 41.2% of the men in this study were vitamin D deficient (<20 ng/ml) and 15.7% were severely vitamin D deficient (<12 ng/ml). That’s important because you need a significant percentage of patients with vitamin D deficiency to have any chance of seeing an effect of vitamin D status on prostate cancer risk.
  • The study had equal numbers of African American and European American men. That’s important because African American men have significantly lower 25-hydroxy vitamin D status and significantly higher risk of prostate cancer than European American men.
  • All of the men enrolled in the study had elevated PSA levels or abnormal DREs. That’s important because it meant that all of the men enrolled in the study were at high risk of having prostate cancer. That made the correlation between vitamin D status and prostate cancer easier to detect.
  • This was the first study to correlate 25-hydroxyvitamin D levels with prostate biopsies at the time of biopsy. That’s important because it allowed the investigators to distinguish between aggressive tumors (which require immediate treatment and have a higher probability of mortality) and slow growing tumors (which may simply need to be monitored).

The results were pretty dramatic:

  • In African American men vitamin D deficiency (<20 ng/ml) was associated with an increased risk of prostate cancer diagnosis at time of biopsy.
  • In both European American and African American men severe vitamin D deficiency (<12 ng/ml) was associated with increased risk of aggressive prostate cancer diagnosis at time of biopsy.

The authors concluded: “Our work supports the hypothesis that 25-hydroxy vitamin D is a potential biomarker that plays a clinically significant role in prostate cancer, and it may be a useful modifiable risk factor in the disease”.

That’s “science speak” for “adequate vitamin D status may help prevent prostate cancer” or “low vitamin D may indeed be one of the risk factors of prostate cancer.”

VitaminD-smashes-cancer

Why Have Some Studies Failed To Find A Correlation Between Vitamin D Deficiency and Prostate Cancer?

The authors of the current study had an interesting hypothesis for why some previous studies have not seen an association between vitamin D status and prostate cancer risk. When you compare all of the previous studies, the strongest correlations between vitamin D deficiency and prostate cancer were the studies conducted at northern latitudes, in African American men, or focusing on aggressive prostate cancer as an end point.

That offers a few clues as to why other studies may have failed to find a link between vitamin D status and prostate cancer risk. For example:

  • The clue that the correlation between vitamin D deficiency and prostate cancer risk was strongest at northern latitudes and with African American men suggests that you need to have a significant percentage of subjects with deficient or very deficient levels of 25-hydroxy vitamin D before you can see a correlation. Other studies may have failed to show a correlation simply because most of the men in the study had normal vitamin D status.
  • The clue that the correlation is strongest for aggressive prostate cancer is more subtle. The authors hypothesized that prostate cancer develops over a lifetime. If that is the case, measuring vitamin D deficiency at the time of diagnosis may not represent the lifetime vitamin D status. The vitamin D status could have decreased because the men were older or had become overweight, or the vitamin D status could have changed simply because they moved from one geographical location to another.

In contrast, the progression from benign to aggressive prostate cancer is generally short term, so it would be affected by the most recent vitamin D status. If that is the case, then the vitamin D status measured at the time of diagnosis may more accurately reflect the vitamin D deficiency that affected the aggressiveness of the cancer.

 

The Bottom Line

1)     The latest study suggests that vitamin D deficiency (<20 ng/ml serum 25-hydroxy vitamin D) may significantly increase the risk of prostate cancer. The correlation between low vitamin D status and prostate cancer risk is strongest for African American men.

2)     The study also suggests that severe vitamin D deficiency (<12 ng/ml serum 25-hydroxyvitamin D) may significantly increase the risk of aggressive prostate cancer in both African American and European American men.

3)     This is a very well done study, and it is consistent with many, but not all, of the previous studies. Clearly more research needs to be done. Future research should be focused on high risk subjects and subjects with low vitamin D status so that the correlation between vitamin D status and prostate cancer risk can be adequately tested.

4)     This is another example of why I recommend that you have your serum 25-hydroxy vitamin D level measured on a regular basis and that you aim to keep it in the normal range (20-80 ng/ml). Some experts believe that 30-80 ng/ml is optimal.

5)     If you are African American, overweight, live in northern latitudes or it is winter, you may need supplemental vitamin D3. 1,000 – 4,000 IU/day of vitamin D3 is generally considered to be safe. If higher amounts are needed to normalize your 25-hydroxy vitamin D levels I recommend that you consult your physician for the appropriate dose.

 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

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Comments (4)

  • Theresa Bankert

    |

    Is there a version #1 of the Myths e-books? The one I downloaded says #2. Just curious.
    Thank you,
    Theresa

    Reply

    • Dr. Steve Chaney

      |

      Dear Theresa,

      Book #1 of the “Myths” eBook series is still in preparation. I’m following the Star Wars model 🙂

      Dr. Chaney

      Reply

  • support prostate health

    |

    Everything is very open with a precise explanation of the challenges.

    It was truly informative. Your site is very helpful.
    Many thanks for sharing!

    Reply

  • omega 3 fatty acids prostate cancer risk

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    Cancer cann often be detected through a rectal examination conducted byy a doctor and through a prostate-specific antigen (PSA)
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Latest Article

One of the Little known Causes of Headaches

Posted August 15, 2017 by Dr. Steve Chaney

Your Sleeping Position May Be Causing Your Headaches!

Author: Julie Donnelly, LMT – The Pain Relief Expert

Editor: Dr. Steve Chaney

 

Can sleeping position be one of the causes of headaches?  

A Sleeping position that has your head tilted puts pressure on your spinal cord and will cause headaches. I’ve seen it happen hundreds of times, and the reasoning is so logical it’s easy to understand.

causes of headachesYour spinal cord runs from your brain, through each of your vertebrae, down your arms and legs. Nerves pass out of the vertebrae and go to every cell in your body, including each of your organs. When you are sleeping it is important to keep your head, neck, and spine in a horizontal plane so you aren’t straining the muscles that insert into your vertebrae.

The graphic above is a close-up of your skull and the cervical (neck) vertebrae. Your nerves are shown in yellow, and your artery is shown in red.  Consider what happens if you hold your head to one side for hours. You can notice that the nerves and artery will likely be press upon. Also, since your spinal cord comes down the inside of the vertebrae, it will also be impinged.

In 2004 the Archives of Internal Medicine published an article stating that 1 out of 13 people have morning headaches. It’s interesting to note that the article never mentions the spinal cord being impinged by the vertebrae. That’s a major oversight!

Muscles merge into tendons, and the tendons insert into the bone.  As you stayed in the tilted position for hours, the muscles actually shortened to the new length.  Then you try to turn over, but the short muscles are holding your cervical vertebrae tightly, and they can’t lengthen.

The weight of your head pulls on the vertebrae, putting even more pressure on your spinal cord and nerves.  Plus, the tight muscles are pulling on the bones, causing pain on the bone.

Your Pillow is Involved in Your Sleeping Position and the Causes of  Headaches

sleep left side

The analogy I always use is; just as pulling your hair hurts your scalp, the muscle pulling on the tendons hurts the bone where it inserts.  In this case it is your neck muscles putting a strain on your cervical bones.  For example, if you sleep on your left side and your pillow is too thick, your head will be tilted up toward the ceiling. This position tightens the muscles on the right side of your neck.

sleeping in car and desk

Dozing off while sitting in a car waiting for someone to arrive, or while working for hours at your desk can also horizontal line sleepcause headaches. The pictures above show a strain on the neck when you fall asleep without any support on your neck. Both of these people will wake up with a headache, and with stiffness in their neck.

The best sleeping position to prevent headaches is to have your pillow adjusted so your head, neck, and spine are in a horizontal line. Play with your pillows, putting two thin pillows into one case if necessary. If your pillow is too thick try to open up a corner and pull out some of the stuffing.

 

sleeping on stomachSleeping on Your Back & Stomach

If you sleep on your back and have your head on the mattress, your spine is straight. All you need is a little neck pillow for support, and a pillow under your knees.

Stomach sleeping is the worst sleeping position for not only headaches, but so many other aches and pains. It’s a tough habit to break, but it can be done. This sleeping position deserves its own blog, which I will do in the future.

 

Treating the Muscles That Cause Headaches

sleeping position causes of headachesAll of the muscles that originate or insert into your cervical vertebrae, and many that insert into your shoulder and upper back, need to be treated.  The treatments are all taught in Treat Yourself to Pain Free Living, in the neck and shoulder chapters.  Here is one treatment that will help you get relief.

Take either a tennis ball or the Perfect Ball (which really is Perfect because it has a solid center and soft outside) and press into your shoulder as shown.  You are treating a muscle called Levator Scapulae which pulls your cervical vertebrae out of alignment when it is tight.

Hold the press for about 30 seconds, release, and then press again.

Your pillow is a key to neck pain and headaches caused by your sleeping position.  It’s worth the time and energy to investigate how you sleep and correct your pillow.  I believe this blog will help you find the solution and will insure you have restful sleep each night.

Wishing you well,

Julie Donnelly

 

About The Author

julie donnelly

Julie Donnelly is a Deep Muscle Massage Therapist with 20 years of experience specializing in the treatment of chronic joint pain and sports injuries. She has worked extensively with elite athletes and patients who have been unsuccessful at finding relief through the more conventional therapies.

She has been widely published, both on – and off – line, in magazines, newsletters, and newspapers around the country. She is also often chosen to speak at national conventions, medical schools, and health facilities nationwide.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

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