There is a large body of evidence that vitamin D reduces the risk of many types of cancerand improves survival after cancer diagnosis. Solar ultraviolet-B (UVB) light is the primary source of vitamin D for most people. The idea that UVB and vitamin D could reduce the risk of cancer was proposed in 1980 by the brothers Cedric and Frank Garland after seeing the map of colon cancer mortality rates in the United States and recognizing that the lowest rates were in the Southwest, which is the sunniest part of the country while the highest rates were in the Northeast, which is the least sunny part of the country. This geographical statistical correlation approach has been used to link increased solar UVB doses to reduced risk of about 15 types of cancer: bladder, breast, colon, endometrial, esophageal, gallbladder, kidney, ovarian, pancreatic, prostate, rectal, stomach, vulvar cancer, Hodgkin’s and non-Hodgkin’s lymphoma.

Since these studies were based on solar UVB, additional studies are required to show that production of vitamin D provides the link between UVB light and cancer risk reduction. Observational studies, in which vitamin D levels for those who develop cancer are compared to those who do not, have provided strong evidence for vitamin D reducing the risk of breast, colon, pancreatic, and rectal cancer. Observational studies for breast cancer show that risk is highest for levels below 15 ng/ml and lowest above 30-40 ng/ml. For comparison, African-Americans have an average of 16 ng/ml while white-Americans have an average of 26 ng/ml.

There is also increasing evidence that higher vitamin D levels at time of cancer diagnosis are associated with better survival rates. The cancers for which this has been reported include breast, colon, lung, prostate, rectal cancer, lymphoma, and Hodgkin’s lymphoma. For colon and rectal cancer, those with higher vitamin D levels had twice the survival rate as those with low vitamin D levels.

So, what can the individual do to reduce the risk of cancer with sunlight and vitamin D? The most efficient way to increase vitamin D level is through taking vitamin D3 and calcium supplements. In the absence of testing, taking 1000-4000 IU/day vitamin D3 plus about 500 mg/day calcium and 250 mg/day magnesium is recommended. Since different people reach different vitamin D levels for the same vitamin D intake, measuring vitamin D levels before and after starting to take vitamin D supplements can be used to adjust the intake. Tests can be ordered through one’s physician or through two websites. GrassRootsHealth.net and VitaminDCouncil.orgoffer test kits from ZRT Laboratory that include a lance for pricking the finger and a piece of paper for two blood spots. The cost is about $70. The test is very accurate as I determined by comparing test results with those from two national testing companies. Both organizations also have large amounts of information on vitamin D.

Solar UVB is the primary source of vitamin D for most people, so exposing as much of the body as possible when the sun is high in the sky for an amount of time less than it takes to have any signs of burning (pinkness) daily is worthwhile. However, in the northern parts of the United States, it is not possible to make any vitamin D from sunlight during the four-to-five darkest months of the year. The fears about skin cancer and melanoma are largely overblown, so the sun should not be feared.

Additional information about the health benefits of vitamin D can be found at vitamindwiki.com and pubmed.gov.

Statistical analysis is a vital part of good medical research. But it’s equally vital that patients and caregivers not get misleading impressions from the numbers they read.

First, realize that statistics apply to populations, not individuals. 32% of humans have blue eyes and 25% have brown, but that doesn’t mean that your two eyes are 32% blue and 25% brown – you’re an individual, not the population.

Second, many studies report “median survival time,” which can scare the pants off you. For my profile, median survival time was 24 weeks. This does not mean “they gave me 24 weeks to live.” The median is the middle person in a study, which tells you nothing about either the best or the worst cases. In my case, some people are still alive 13 years after the study was done.

The classic layman’s article on this is Stephen Jay Gould’s The Median Isn’t the Message. His cancer’s median survival time was 8 months; he lived 20 years.

As it happens, I was further thrown off by the fact that the study I found was done before any of today’s treatments existed. But without even knowing that, I did the right thing: I asked “What can I do to put myself in the group that did better than the median?”

I’d heard a lot about cancer in the news, and I’d known a few people who had it. But when it hit me, the only question that mattered was, am I going to die?

The answer was, maybe. My case was bad: researching my profile of symptoms, I read “Prognosis is grim” and “Outlook is bleak.” Later, I learned that the most current information isn’t on the best medical sites(!), because it takes 17 years for research to go from concept to funding to study to analysis to publication. Instead, the only reliable source I found was my peers on ACOR. I came to learn that when your butt is on the line, the most reliable advice comes from others whose butts are on the same line.

I learned that cancer is no longer a death sentence. That’s not to say it’s never fatal – a half million Americans a year do die of cancer. But most patients don’t.

I learned that there are numerous ways that having cancer doesn’t spell doom. Survival rates are markedly better than a generation ago, and increasingly cancer becomes a manageable chronic condition that you live with, similar to congestive heart disease or diabetes.

Face it: if you live long enough to die of something else first, you didn’t die of cancer! (Some people are discovered at autopsy to have had an unrelated cancer they never even knew about.) And some people have tumors that appear on their scans but never change, which suggests that the tumors might be dead – not the person.

I know, a cancer diagnosis is no picnic. But the only important question is, what do I do now?

Answer: get it in gear. Do everything in your power to find the best treatments. Start by finding a community of patients with your disease.

Breast feeding may help protect you from a painful, sometimes even crippling, condition later in life. Okay, I don’t think this benefit will be the deciding factor for starting or continuing breastfeeding for many women, but Swedish researchers uncovered an interesting association that underlines the power of breast feeding.

We already know that breast feeding has numerous benefits for babies and for their mothers (including lowering the lifetime risk of cancer for both of them). In this study the researchers found that breast feeding was associated with slashing the risk of rheumatoid arthritis. They looked at over 18,000 women to identify those with rheumatoid arthritis and four healthy matched controls for each patient. The longer they breast fed, the lower the risk. Breast feeding for longer than a year was associated with cutting the risk in half; breast feeding for 1 to 12 months was associated with dropping the risk by a quarter. Cause and effect have not been proven, but we do know that rheumatoid arthritis is much more common in women, and it appears that hormones play a role.

In this study, no association was found either way with childbearing itself or with oral contraceptive pills, but the association of breast feeding and health was strong. Rheumatoid arthritis rates have been falling in recent years, and shifting to later in life when it does occur. In Sweden, breast feeding rates have been rising steadily since the beginning of the 1970s, from fewer than 5 percent of women breast feeding for longer than 6 months to about 73 percent doing so today. We’ve seen things moving in the same directions in the US. Whatever the reasons, this is good news.

Pikwer M, Bergström U, Nilsson J-Å, Jacobsson L, Berglund G, and Turesson C. Breast-feeding, but not oral contraceptives, is associated with a reduced risk of rheumatoid arthritis. Ann Rheum Dis. published online 13 May 2008; doi:10.1136/ard.2007.084707