Wang-Gillam A, Miles DA, Hutchins LF. Evaluation of Vitamin D Deficiency in Breast Cancer Patients on Bisphosphonates. Oncologist 2008 Jul 9. [Epub ahead of print]
http://theoncologist.alphamedpress.org/cgi/content/abstract/theoncologist.2008-0013v1
http://theoncologist.alphamedpress.org/cgi/reprint/theoncologist.2008-0013v1.pdf
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Oncologist. 2008 Jul 9. [Epub ahead of print]
Evaluation of Vitamin D Deficiency in Breast Cancer Patients on Bisphosphonates.
Wang-Gillam A, Miles DA, Hutchins LF.
Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA;
Background. Bisphosphonates are very effective in treating osteoporosis and metastatic bone disease; however, unfavorable outcomes can occur when they are given to patients with occult vitamin D deficiency. No clear consensus exists on the assessment of vitamin D status in cancer patients undergoing bisphosphonate therapy. This study examines the prevalence of vitamin D deficiency among breast cancer patients treated with bisphosphonates for osteoporosis or metastatic bone disease, and observes the use of calcium and vitamin D supplementation in these patients. Methods. This retrospective study reviewed the electronic records of 321 breast cancer patients treated with bisphosphonates. Information on age, race, and serum levels of 25-hydroxyvitamin D (25-OHD), parathyroid hormone, and calcium were collected, and intakes of calcium and vitamin D supplements were queried in an outpatient pharmacy database. Results. Of the 321 patients treated with bisphosphonates, 209 (65.1%) had their 25-OHD levels checked at least once. Of these patients, 57 (27.3%) had a serum 25-OHD level 600 IU of vitamin D per day, and 41 (19.6%) patients received 400-600 IU of vitamin D daily. Conclusion. Especially in the setting of metastatic bone disease in breast cancer patients, we advocate routine 25-OHD concentration screening for vitamin D deficiency in general. Clear guidelines for the diagnosis of vitamin D deficiency in cancer patients would be extremely beneficial to have, as would identification of the proper dose of vitamin D supplementation. We recommend 1,000 IU daily to our metastatic cancer patients.
PMID: 18614589