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Director's Letter
Carole Baggerly
Director, GrassrootsHealth
At GrassrootsHealth, we consider October breast cancer PREVENTION month. What are you doing to prevent breast cancer - for yourself, your family, your friends, your community?
How can we address PREVENTION?
As always, it starts with recognition that vitamin D has a role in this disease.
Step 1. Awareness--vitamin D does have a role in cancer prevention.
Step 2. Measurement--knowing that it has a role, what is my level, what is the level of the population we deal with?
Step 3. Action/Analysis--what do I need to do with this measurement to get my (our) level to the suggested level of 40-60 ng/ml?
Step 4. Evaluation--how did any change I make work? (This of course, implies measuring again.)
By following these steps, we can very quickly make a big impact, on our lives, on the lives of those around us. Our Community Programs are designed to expand the awareness through screening and education of larger communities. Please contact us about how to do this with your group, whether a business, a social community, a hospital. We're ready to help. Create a Community Screening Project today!
Onwards!
Carole Baggerly
Director, GrassrootsHealth
A Public Health Promotion & Research Organization
Moving Research into Practice NOW!
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 How Does Vitamin D Prevent Breast Cancer?
The Research
 Studies from researchers on the GrassrootsHealth scientists'
panel have shown that there is a correlation between vitamin D serum levels and breast cancer.
Cedric Garland, Dr. P.H. F.A.C.E., UCSD School of Medicine, studied vitamin D serum levels of 1200 healthy, premenopausal women, 600 who later developed breast cancer and 600 who remained cancer-free, and found that those with the lowest levels of vitamin D within three months of their breast cancer diagnosis had a risk three times greater than those in the highest level group. This study does not establish a causal relationship between breast cancer and vitamin D but it points to a relevant window of time for cancer prevention in the last three months preceding a tumor diagnosis. This is a critical time for the growth of the tumor as the tumor is actively recruiting blood vessels necessary for growth.(Read article on study)
DINOMIT Model of Cancer Development
Garland pioneered the 'DINOMIT' model which describes seven steps in the formation of cancer, and shows the potential for intervention at each step. Vitamin D is known to prevent the first stage or the initiation of cancer, called disjunction in this model. Garland strongly believes in the preventive effect of vitamin D, as you can read below in his editorial. More details on the model can be found in his paper, Vitamin D for Cancer Prevention: Global Perspective, and this 15 minute video summary.
Trial Shows Reduced Cancer Risk
 A study at Creighton University led by Joan Lappe, PhD, RN, FAAN, found that a dose of 1100 IU/day of vitamin D along with 1400-1500 mg/day calcium helped women aged 55 and older raise their average serum vitamin D level to 38 ng/ml (from a baseline of 29 ng/ml) and prevent 4 out of 5, or 80%, of all invasive cancers including breast cancer.
How does it work?
JoEllen Welsh, Phd, Empire Innovations Professor at University at Albany, State University of New York and GenNYsis Center of Excellence in Cancer Genomics, explains in this 10 minute interview how vitamin D has direct effects on breast cancer cells. Briefly, vitamin D helps to regulate hundreds of normal cell processes, including cell growth and differentiation, protection from DNA damage, immune system response in breast cells, cellular metabolism, and cell death. When not properly regulated, any of these processes can contribute to growth and proliferation of cancer cells.
GrassrootsHealth Breast Cancer Study
GrassrootsHealth has been advocating vitamin D to reduce breast cancer since its inception but the medical community is slow to respond. In fall of 2011, we launched a new breast cancer study , to parallel our D*action study. The study is open to women 60 years or older and free of cancer at the time of enrollment (they may have had it in the past). Participation includes a home vitamin D test and an online health questionnaire to be completed each 6 months for a period of 5 years.
In an analysis of data gathered through mid-2014, 839 of 844 women remain cancer-free and have a median 25(OH)D serum level of 50 ng/ml. Five women have been diagnosed with breast cancer; four of these women had 25(OH)D values below the median. Overall there was an 80% lower rate of breast cancer among those ≥50 ng/ml compared to those <50 ng/ml. Click here to view the full poster.The study is ongoing and with your help, we can bring research into practice and prevent breast cancer through vitamin D.
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Research News:
How to Prevent Breast Cancer - A Practical Guide
Written by Cedric F. Garland, Dr. P.H. F.A.C.E.
University of California at San Diego Medical Center
Note: References, e.g. (1), are located in the sidebar.
Although it afflicts 232,000 American women each year and kills 40,000 (1), breast cancer is among the 2nd or 3rd most readily preventable cancers (2-4). Another way to reduce risk of breast cancer is to avoid excessive consumption of alcohol. For women the safe limit is no more than 1.5 4-ounce glasses of wine, 12 ounce glasses of beer or cocktails per 24 hours (7).
Approximately 75% of breast cancer (adenocarcinoma) is due to vitamin D deficiency (Table 1). There are also other known causes, the most influential of which are BRCA and a few rare alleles of other genes (5).
While adequate vitamin D status will prevent 75% of breast cancer (Table 1), it also will make occasional "breakthrough cases" that may occur despite vitamin D adequacy much less life-threatening and easier to treat (6). Patients with serum 25-hydroxyvitamin D concentrations of 40-50 ng/ml will likely have a milder form of the disease with substantially better chance of long-term survival. The minimum serum 25(OH)D concentrations needed to prevent breast cancer are summarized in Table 2. The average dose of vitamin D3 needed to achieve specified serum concentrations of 25-hydroxyvutamin D are shown in Table 3.
Still other gains may be achieved by minimizing x-ray exposures that may penetrate the breast epithelium directly or due to scattering from bones or teeth. A recent study indicated that mammographic screening should be obtained no more than once every 2 years. Women who are less than 50 years old also should consider deferring their first mammogram to age 50 unless there are certain risk factors present. This decision should be discussed thoroughly with the individual's physician.
For women with BRCA 1-2 or CDH1 mutations, the only known method of prevention, sadly, is prophylactic mastectomy. This is the approach used by actress Angelina Jolie who was BRCA positive and had several close relatives with breast cancer. Research is badly needed to determine whether vitamin D might reduce the need for prophylactic mastectomy in women with these BCRA mutations.
Summary Breast cancer is one of the easiest of all cancers to prevent. But it requires devotion to consuming an adequate amount of vitamin D3 and testing your serum 25(OH)D concentration faithfully, especially in February or March of each year. Discuss your plan with your doctor, and bring them on board concerning your quest to minimize risk of breast cancer. Any up-to-date well-informed doctor will admire and support what you are doing, and can help you consume adequate vitamin D3 while avoiding needless risk.
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Editor's Letter
Susan Siljander
Marketing Director, GrassrootsHealth
Welcome to the second newsletter of our Breast Cancer PREVENTION month.
Have you ever heard of the downstream parable for public health? Watch this video of the parable. Could vitamin D in the ranges of 40-60 ng/ml (100-150 nmol/L) be the fence that prevents many people from getting cancer? We think so. Vitamin D is a simple, inexpensive, and effective way to build the fence.
Help us get the word out - we need to build a fence!
Susan Siljander Marketing Director, GrassrootsHealth A Public Health Promotion & Research Organization
Moving Research into Practice NOW!
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This special award acknowledges an individual or organization who has worked selflessly and effectively in the broader field of nutrition to benefit humanity.
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Breast Cancer Prevention with Vitamin D
Raising vitamin D levels to the recommended range of 40-60 ng/ml may reduce incidence of breast cancer by 50-80%. On this page you will find resources to dive deeper into this subject.
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| References |
Serum 25-Hydroxyvitamin D Concentrations ≥40 ng/ml are Associated with >65% Lower Cancer Risk: Pooled Analysis of Randomized Trial and Prospective Cohort Study
Sharon McDonnell et al.
GrassrootsHealth
PLOS One
April 2016
Breast Cancer Poster Presentation
Findings from GrassrootsHealth Breast Cancer Study
April 2016
Vitamin D and calcium supplementation reduces cancer risk: results of a randomized trial
Joan Lappe et al.
June 2007
Low Vitamin D Levels Linked to High Risk of Premenopausal Breast Cancer
UCSD News Article
Cedric Garland
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Vitamin D and Breast Cancer Studies |
A 2007 randomized clinical trial at Creighton University led by Joan Lappe, PhD, RN, FAAN, found that a dose of 1100 IU/day of vitamin D along with 1400-1500 mg/day of calcium helped women aged 55 and older raise their average serum vitamin D level to 38 ng/ml (from a baseline of 29 ng/ml) and prevent approximately 4 out of 5, or 80%, of all invasive cancers including breast cancer.
A 2013 case control study at UCSD School of Medicine, Mohr et al. found that the three months prior to tumor diagnosis was a relevant window of time for cancer prevention and that those with vitamin D levels ≥35 ng/ml had a 70% reduction in risk of developing breast cancer than those with levels <15 ng/ml.
Lowe et al. demonstrated in a 2005 case control study that women with serum levels of >60 ng/ml had more than a five-fold (80%) reduction in breast cancer risk compared to women with levels <20 ng/ml.
In a 2008 case control study, Abbas et al. found that those with 25(OH)D levels ≥30 ng/ml had an almost 70% reduced risk of post-menopausal breast cancer compared to those with levels <12 ng/ml.
In a 2009 case control study, Abbas et al. found that women with 25(OH)D levels ≥24 ng/ml had more than a 50% reduction in risk of pre-menopausal breast cancer compared to those with levels <12 ng/ml.
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