Preliminary report: Vitamin D deficiency in advanced cancer patients with symptoms of fatigue or anorexia

Rony Dev, Egidio del Fabbro, Gary G. Schwartz, David Hui, Shana L. Palla, Noah Gutierrez, Eduardo Bruera

Research output: Contribution to journalReview article

41 Scopus citations

Abstract

Background. Vitamin D deficiency in noncancer patients is associated with symptoms of fatigue, muscle weakness, and depression. These symptoms are common among advanced cancer patients. We investigated the prevalence of low serum vitamin D levels in cancer patients with fatigue or poor appetite and their association with symptom burden and other correctable endocrine abnormalities. Methods. This was a retrospective review of 100 consecutive cancer patients with appetite or fatigue scores of ≥4 of 10 referred to a supportive care clinic. We investigated serum levels of 25(OH) vitamin D, cortisol, thyroid-stimulating hormone, and bioavailable testosterone. Symptoms were measured by the Edmonton Symptom Assessment Scale. Serum 25(OH) vitamin D <20 ng/mL was considered deficient; ≥20 ng/mL and <30 ng/mL were considered insufficient. Results. Patients were predominantly male (68%) and white (66%), with a median age of 60 years (range, 27-91 years). Gastrointestinal (30%) and lung (22%) cancers were predominant. Forty-seven patients (47%) were vitamin D deficient and 70 (70%) were insufficient. Thirteen of 70 patients (19%) with vitamin D insufficiency were on supplementation. Vitamin D deficiency was more common among nonwhites (82% versus 36%) and females. No significant association was found between vitamin D and symptoms. Hypogonadic males had a significantly lower mean 25(OH) vitamin D level than eugonadic males. Conclusions. Low vitamin D levels were highly prevalent among advanced cancer patients with cachexia or fatigue. Vitamin D deficiency was more frequent among nonwhite and female patients. Vitamin D levels were also signifi-cantly lower in male patients with hypogonadism.

Original languageEnglish (US)
Pages (from-to)1637-1641
Number of pages5
JournalOncologist
Volume16
Issue number11
DOIs
StatePublished - Dec 2 2011

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Keywords

  • Cancer
  • Symptoms
  • Testosterone
  • Vitamin D

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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