Preliminary Report: Vitamin D Deficiency in Advanced Cancer Patients with Symptoms of Fatigue or Anorexia

Dev, Rony; Fabbro, Egidio Del; Schwartz, Gary G.; Hui, David; Palla, Shana L.; Gutierrez, Noah; Bruera, Éduardo

doi:10.1634/theoncologist.2011-0151

Cited by 72 publications

(57 citation statements)

References 35 publications

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“…In addition, we have previously reported that in 61 male patients with advanced cancer who had been tested for 25 hydroxy vitamin D and BT, there was a trend toward a positive association between vitamin D and testosterone. 19 In the current study with a larger sample size, no significant association among TT, FT, or BT with vitamin D was noted.…”

Section: Discussioncontrasting

confidence: 56%

Association between hypogonadism, symptom burden, and survival in male patients with advanced cancer

Dev

Hui

Fabbro

et al. 2014

Cancer

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Background A high frequency of hypogonadism has been reported in male patients with advanced cancer. Objectives To evaluate the association among low testosterone, symptom burden and survival in cancer patients. Methods 119/131 (91%) consecutive male cancer patients had an endocrine evaluation of total/free/bioavailable testosterone (TT, FT, BT, respectively), high-sensitivity C-reactive protein (CRP), vitamin B12, thyroid stimulating hormone, 25-hydroxy vitamin D and cortisol levels when presenting with symptoms of fatigue and/or anorexia-cachexia. Symptoms were evaluated by the Edmonton Symptom Assessment Scale. We examined the correlation with Spearman test and survival with log rank test and Cox-regression analysis. Results The median age was 64; majority were white 85 (71%). Median TT was 209ng/dL (normal ≥200 ng/dL), FT was 4.4 ng/dL (normal ≥9 ng/dL), and BT was 22.0 ng/dL (normal ≥61ng/dL). Low TT, FT, and BT values were all associated with worse fatigue (p≤0.04), poor performance status (p≤0.05), weight loss (p≤0.01), and opioid use (p≤0.005). Low TT and FT were associated with increased anxiety (p≤0.04), decreased feeling of well-being (p≤0.04), and increased dyspnea (p≤0.05); while BT was only associated with anorexia (p=0.05). Decreased TT, FT, and BT values were all significantly associated with elevated CRP, low albumin and hemoglobin. In multivariate analysis, decreased survival was associated with low TT (HR 1.66; p=0.034), declining ECOG performance status (HR 1.55; p=0.004), high CRP (HR 3.28; p<0.001), and decreased albumin (HR 2.52; p<0.001). Conclusion In male cancer patients, low testosterone was associated with systemic inflammation, weight loss, increased symptom burden, and decreased survival.

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Section: Discussioncontrasting

confidence: 56%

Association between hypogonadism, symptom burden, and survival in male patients with advanced cancer

Dev

Hui

Fabbro

et al. 2014

Cancer

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“…[678] There are many reports which indicate high prevalence of low vitamin D in the general population. [910] Low vitamin D leads to bone abnormalities (e.g., osteomalacia, osteopenia, and osteoporosis) and worsens muscle strength.…”

Section: Introductionmentioning

confidence: 99%

Correction of low vitamin D improves fatigue: Effect of correction of low vitamin D in fatigue study (EViDiF study)

et al. 2014

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Background:Fatigue is a common presenting complaint of patients in the primary care offices. Low levels of vitamin D have been associated with fatigue in cancer patients. Normalization of vitamin D level improves their fatigue. Whether low vitamin D plays a role in fatigue in medically stable patients is not known.Aims:This prospective non-randomized therapeutic study observed the prevalence of low vitamin D in fatigue and the effect of normalization of vitamin D on fatigue.Material and Methods:One hundred and seventy four adult patients, who presented in our primary care office with fatigue and stable chronic medical conditions,completed fatigue assessment questionnaires. Patients with low vitamin D levels received ergocalciferol therapy for 5 weeks. Scores of pre- and post-treatment fatigue assessment questionnaires were compared.Results:Prevalence of low vitamin D was 77.2% in patients who presented with fatigue. After normalization of vitamin D levels fatigue symptom scores improved significantly (P < 0.001) in all five subscale categories of fatigue assessment questionnaires.Conclusion:The prevalence of low vitamin D is high in patients who present with fatigue and stable chronic medical conditions, if any. Normalization of vitamin D levels with ergocalciferol therapy significantly improves the severity of their fatigue symptoms.

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“…Vitamin D is not only crucial for proper formation and mineral homeostasis of bones [15], but it is also vital for the proper immune and nervous systems function [16,17]. It was demonstrated that cancer patients more often suffer from vitamin D deficiency (< 50 nmol/L) [18]. Moreover, cancer patients with a lower vitamin D level experienced more intense pain and in consequence, needed higher opioids doses [19].…”

Section: Vitamin Dmentioning

confidence: 99%

Selected aspects of nutrition in palliative care

2019

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Proper nutrition in palliative care is essential to achieve a good quality of life of patients and better treatment results. The diet should include the proper amount of calories and nutrients such as proteins, omega 3 fatty acids, dietary fibre, vitamin D and vitamin C. The meals must be balanced, tasty, diverse and appetizing. In this paper, an example of one-day diet for adult palliative care patients is proposed.

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Preliminary Report: Vitamin D Deficiency in Advanced Cancer Patients with Symptoms of Fatigue or Anorexia

Cited by 72 publications

References 35 publications

Association between hypogonadism, symptom burden, and survival in male patients with advanced cancer

Association between hypogonadism, symptom burden, and survival in male patients with advanced cancer

Correction of low vitamin D improves fatigue: Effect of correction of low vitamin D in fatigue study (EViDiF study)

Selected aspects of nutrition in palliative care

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