Balancing the Risks: Skin Cancer Patients Are Deficient in Vitamin D

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Adrian Weinbrecht

It’s a health conundrum that doctors have been trying to resolve for several years now: most Americans are deficient in vitamin D, which can help to build bones and even protect against certain cancers and autoimmune diseases such as multiple sclerosis, but the most efficient source of D, the sun, can also trigger skin cancers.

That means that skin cancer patients might be at even greater risk of having insufficient amounts of vitamin D, since they are instructed by their doctors to avoid the sun’s cancer-causing ultraviolet rays. A study led by Dr. Jean Tang at Stanford University found that, indeed, skin cancer patients may be three times more likely to be vitamin D deficient than the general population. And the results also raise interesting questions about whether such shortcomings may be responsible for their cancer, or are a consequence of it. (More on Photos: The Landscape of Cancer Treatment)

Tang and her colleagues studied 41 patients with a rare genetic form of skin cancer that predisposes people to develop many skin cancer lesions over their lifetime. Over the two-year study period, the scientists measured the blood levels of a common vitamin D metabolite in the volunteers every three to six months. Not surprisingly, in order to avoid recurrent growths, most of the subjects used sunscreen daily, and avoided extended periods of sun exposure. While the mean levels of the D byproduct for the American population is 27.5 ng/ml, these skin cancer patients averaged 24.5ng/ml. “Even though you say the general population is at high risk of vitamin D deficiency, these skin cancer patients are at even higher risk,” says Tang.

At the moment, experts don’t have a target “healthy” range of vitamin D in the blood, but a government panel is expected to provide more guidance on such a threshold in November. Until then, doctors generally advise their patients to take at least 200 IU to 400 IU of vitamin D daily, in supplement form. As for spending more time in the sun, physicians can’t advise patients on how much sun is safe. “There isn’t an easy answer,” says Tang. “But the safest recommendation is that some amount of sun exposure, such as what you would get by exercising outside or walking to your car or walking to work, is always reasonable. But it would be foolish to say go out and get a lot of sunlight to boost your vitamin D levels because sunlight is still a risk factor for skin cancer.” (More on Special Report: Advances for Breast Cancer Patients)

The results point out that while dermatologists are understandably focused on their patients’ skin cancer risk, they should also be checking their vitamin D levels and advising those who are low to supplement their levels with a pill. And with additional studies, experts may better understand how vitamin D and skin cancer interact; rather than simply being a side effect of patients avoiding the sun, low levels of D could possibly be creating an environment that promotes tumor growth. “As dermatologists, we have to not only recommended to our patients that they avoid excessive sunlight because it increases skin cancer risk, but we also have to counsel them about vitamin D levels because our patients are at greater risk of having dangerously low levels. We should be more proactive at checking these levels,” says Tang. And that may yield more valuable information about whether supplements are effective in not only addressing the vitamin D deficiency but skin cancer risk as well.

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