Patients with vitamin D deficiency who received vitamin D supplements had a reduced need for pain relief and lower levels of fatigue in palliative cancer treatment, a randomized and placebo-controlled study by researchers at Karolinska Institute shows. The study is published in the scientific journal Cancers.
Among patients with cancer in the palliative phase, vitamin D deficiency is common. Studies have shown that low levels of vitamin D in the blood may be associated with pain, sensitivity to infection, fatigue, depression, and lower self-rated quality of life.
A previous study suggested that vitamin D supplementation could reduce opioid doses, reduce antibiotics use, and improve the quality of life in patients with advanced cancer.
244 cancer patients with palliative cancer, enrolled in ASIH, ( advanced medical home care), took part in the current study in Stockholm during the years 2017-2020.
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All study participants had a vitamin D deficiency at the start of the study. They received either 12 weeks of treatment with vitamin D at a relatively high dose( 4000IE/ day) or a placebo.
The researchers then measured the change in opioid doses ( as a measurement of pain) at 0,4,8, and 12 weeks after the start of the study.
“The results showed that vitamin D treatment was well tolerated and the vitamin D- treated patients had a significantly slower increase in opioid doses than the placebo group during the study period. In addition, they experienced less cancer-related fatigue compared to the placebo group,” says Linda Bjorkhem- Bergman, senior physician at Stockholm Sjukhem and associate professor at the Department of Neurobiology, Healthcare Sciences, and Society, Karolinska Institute.
On the other hand, there was no difference between the groups in terms of self-rated quality of life or antibiotics use.
“The effects were quite small, but statistically significant and may have clinical significance for patients with vitamin D deficiency who have cancer in the palliative phase. This is the first time it has been shown that vitamin D treatment for palliative cancer patients can have an effect on both opioid-sensitive pain and fatigue,” says the first author of the study Maria Helde Franklin, senior physician at ASIH and postdoc at the Department of Neurobiology, Healthcare Science and Society, Karolinska Institute.
The study is one of the largest drug studies conducted within ASIH in Sweden. One weakness of the study is the large drop-out rate. Only 150 out of 244 patients were able to complete the 12 weeks study because many patients died of their cancer during the study.
By: Peace Chigozie