Risks of some cancers may be lowered by vitamin D

MEDICAL MATTERS

Staying Healthy

August 18, 2006|By JUDY FOREMAN | JUDY FOREMAN,SPECIAL TO THE SUN

Does vitamin D reduce the risk of cancer?

Several recent studies presented at meetings of the American Association for Cancer Research and the American Society of Clinical Oncology suggest that adequate consumption of vitamin D - which most Americans do not get - is linked to lower risks of breast cancer.

One study, from researchers at the University of California, San Diego, looked at pooled data on 1,760 women and found that the highest level of vitamin D consumption was correlated with a 50 percent lower risk of breast cancer.

To achieve this level of vitamin D, a person would have to consume at least 1,000 International Units of vitamin D a day, well beyond the recommended levels of 200 IUs a day for children and people up to age 50, 400 IUs for people ages 51 to 70, and 600 IUs for people older than 70.

In another study, researchers at Mount Sinai Hospital in Toronto who interviewed 576 patients with breast cancer and 1,135 people without it found that those who had had frequent sun exposure as teenagers or young adults had a 35 percent to 40 percent reduced risk of breast cancer. (Sunlight helps the body produce vitamin D.)

Yet another study found vitamin D deficiency is highly prevalent among premenopausal women with early stage breast cancer.

On the other hand, a study that was part of the government's Women's Health Initiative found that calcium and vitamin D supplements did not reduce breast cancer risk in post-menopausal women - although vitamin D takers who did develop breast cancer had tumors smaller than those of women not taking supplements.

Dr. Michael F. Holick, a vitamin D expert and professor of medicine, physiology and biophysics at Boston University Medical Center, said that other studies suggest that vitamin D can help prevent colon, ovarian and prostate cancer.

People can get vitamin D by "sensible" sun exposure (5 to 10 minutes several times a week without sunscreen), as well as from supplements and a diet rich in fortified cereals, milk and oily fish.

Holick recommends at least 1,000 IUs of vitamin D per day, preferably the strong form, called D3 - and not D2, the kind that is in most supplements.

"While these studies certainly suggest that getting adequate vitamin D is important," said Dr. Kala Visvanathan, a cancer specialist and epidemiologist at the Johns Hopkins Bloomberg School of Public Health, "it is not clear that taking extra is beneficial or whether the dose should be altered, depending on age."

Viamin D in very high doses can be toxic. The Institute of Medicine, an arm of the National Academy of Sciences, is expected to decide within the next several years whether to recommend increased intakes of vitamin D. The institute sets the upper limit for consumption at 2,000 IUs per day.

If you can't get help from doctors for chronic headaches and facial pain, should you see a dentist?

Absolutely. About 15 million Americans suffer from a cluster of symptoms including jaw pain, ear pain, headaches (especially near the temples) and neck aches.

This syndrome used to be called TMJ, for temporomandibular joint disorder. It is now called TMD, for temporomandibular dysfunction.

"If a person has a severe headache, it's considered a migraine, and the person is given a prescription and sent on his way," said Dr. Robert S. Rosenbaum, a Boston dentist who specializes in orofacial pain dentistry and is past president of the American Academy of Orofacial Pain. "The problem is, most headaches are not migraines, so what happens is the patient flounders from physician to physician."

There are several treatment options. One is a small, plastic device that is worn in the mouth like a retainer that helps reposition the jaw so that tense jaw muscles can relax, easing jaw and headache pain. The device can cost as much as $1,000.

Another is physical therapy, including ultrasound, massage and "myofascial release," in which a therapist puts gentle pressure on the skin over the jaw muscle for about 10 minutes, until muscles relax. "This is probably the single most effective physical therapy technique," Rosenbaum said.

Prescription muscle relaxants also can help, as can antidepressant drugs (because many people with chronic pain also have depression). As a last resort, there's surgery, but in rare cases, that can lead to permanent nerve pain.

Some dentists, such as Dr. James Zonghetti of Braintree, Mass., use computerized images to assess the degree of misalignment of the jaw. Although insurers typically pay for treatment of musculoskeletal disorders of other joints in the body - elbows, knees, hips - they don't typically pay for TMD treatments, Rosenbaum said.

Send your questions to foreman@baltsun.com.

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