vitamin d and cancer
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Vitamin D: from bone to Vitamin D: from bone to cancer therapycancer therapy
Henk R. FrankeHenk R. Franke
The Hague, 12/4/2013
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Who knows their vitamin D Who knows their vitamin D serum level?serum level?
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Vitamin D serum level of Vitamin D serum level of an elderly youngsteran elderly youngster
43 weeks: 1000 IE daily13 weeks: 3600 IE daily
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OutlineOutline
Vitamin D in shortVitamin D in short Cancer stem cell theoryCancer stem cell theory Breast cancerBreast cancer In vitro proofIn vitro proof Practical guidelinesPractical guidelines
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How do we acquire our vitamin D ?How do we acquire our vitamin D ?
Sun-bathing 10 -20000 IE
Margarine 20 - 30 IE / slice of bread
Fatty fish 600 - 1000 IE/100g
Food only supplies < 10 % of our needs
Multivitamins 200 IE/daily
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66Vieth, J Steroid Biochem Mol Biol 2004;89-90:575
NL 52°N
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Muskiet et al, Ned Tijdschr Klin Chem Labgeneesk 2007;32:150
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Vitamin DVitamin D
Regulates 200 genes that influences cell growth and Regulates 200 genes that influences cell growth and differentiation which probably leads to a lesser extent differentiation which probably leads to a lesser extent of malignant degeneration (Holick, 2008)of malignant degeneration (Holick, 2008)
Induces apoptosis of the cancer (stem) cellInduces apoptosis of the cancer (stem) cell Desired serum level is at least 100 nmol/l (Binkley et Desired serum level is at least 100 nmol/l (Binkley et
al, 2008)al, 2008)
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OutlineOutline
Vitamin D in shortVitamin D in short Cancer stem cell theoryCancer stem cell theory Breast cancerBreast cancer In vitro proofIn vitro proof Practical guidelinesPractical guidelines
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Cancer stem cell theoryCancer stem cell theory
Vermeulen et al, NTvG, 2009;153:286
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Kakarala et al, Cancer J 2007;13:271
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Breast Tumor Content Breast Tumor Content
A tumor consists of a small stem cell A tumor consists of a small stem cell compartment (3 -35%) and a large compartment (3 -35%) and a large population of differentiated cellspopulation of differentiated cells
Number of divisions of a differentiated Number of divisions of a differentiated tumor cell: 50-60, division time: 19,5 tumor cell: 50-60, division time: 19,5 hours, total lifetime 1170 hourshours, total lifetime 1170 hours
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Breast Tumor ContentBreast Tumor Content
Tumor doubling time 50-100 dagenTumor doubling time 50-100 dagen Number of doublings needed to Number of doublings needed to
increase the tumor to 1 cm is 30-35increase the tumor to 1 cm is 30-35
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Breast Cancer and HT: early detectionBreast Cancer and HT: early detection
Wertheimer et al. JAMA 1986;255:1311
The Mammographic Window
1 2 3 4 5 6 7 8 9 10 11 12 13 14 Years
1012
1010
108
106
104
1
1mm
1cm
2.5cm
Premammographic Preclinical Clinical
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OutlineOutline
Vitamin D in shortVitamin D in short Cancer stem cell theoryCancer stem cell theory Breast cancerBreast cancer In vitro proofIn vitro proof Practical guidelinesPractical guidelines
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5% more breast cancers present in the left breast
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In The Netherlands each day 68 women and 63 In The Netherlands each day 68 women and 63 men die from cardiovascular events¹men die from cardiovascular events¹
In The Netherlands each day 9 die from breast In The Netherlands each day 9 die from breast cancer²cancer²
¹Wassertheil-Smoller et al Hypertension 2000;36:780²Sluman et al NTvG 2006;150:2018
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Breast cancer prevalence in the USABreast cancer prevalence in the USA
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Crew et al 2009;2(6):598
The association
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OutlineOutline
Vitamin D in shortVitamin D in short Cancer stem cell theoryCancer stem cell theory Breast cancerBreast cancer In vitro proofIn vitro proof Practical guidelinesPractical guidelines
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‘All roads lead to death’
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ApoptosisApoptosis
physiological, programmed cell death, physiological, programmed cell death, during the adult lifespan each day 10during the adult lifespan each day 1099 cells diecells die
It means falling of leaves and was first It means falling of leaves and was first mentioned by Kerr in 1972mentioned by Kerr in 1972
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NECROSIS: cell murder
APOPTOSIS: cell suicide
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HELA cell, cervix carcinoma cell
QuickTime™ en eenCinepak-decompressor
zijn vereist om deze afbeelding weer te geven.
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Development of the hand of an embryo of about 7 weeks gestational age
QuickTime™ en eenCinepak-decompressor
zijn vereist om deze afbeelding weer te geven.
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In vitro proofIn vitro proofApoptosis proliferation ratioApoptosis proliferation ratio
Mark Londema 2009
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OutlineOutline
Vitamin D in shortVitamin D in short Cancer stem cell theoryCancer stem cell theory Breast cancerBreast cancer In vitro proofIn vitro proof Practical guidelinesPractical guidelines
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Advice Vitamin D Council, USAAdvice Vitamin D Council, USA
Children till 1 year 1000 IU/dailyChildren till 1 year 1000 IU/daily Children 1 to 4 years 2000 IU/dailyChildren 1 to 4 years 2000 IU/daily Children 4 to 10 years 3000 IU/dailyChildren 4 to 10 years 3000 IU/daily Adults 2000-5000 IU/dailyAdults 2000-5000 IU/daily
www.vitamindcouncil.org
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Practical AdvicePractical Advice
Every 2 weeks 50.000 IUEvery 2 weeks 50.000 IU
That is 3570 IU/dailyThat is 3570 IU/daily
Half time of vitamin D: 4-5 weeksHalf time of vitamin D: 4-5 weeks
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€ 49,50Daily costs € 0,11
€ 22,15Daily costs € 0,16
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Calcium/vit D and cardiovascularCalcium/vit D and cardiovascular
Bolland et al, BMJ 2011;342:d2049
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Calcium/vit D and cardiovascularCalcium/vit D and cardiovascular
Bolland et al, BMJ 2011;342:d2049
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@hrfranke@hrfranke
www.henkfranke.comwww.henkfranke.com