The following is a transcription of an interview between Dr. Cedric Garland and Carole Baggerly on vitamin D and breast Cancer. To view the video, click here. The two windows can be minimized and placed side by side for concurrent viewing.
D*Facts: Breast CancerInterview with Dr. Cedric Garland and Carole Baggerly
Carole: There are over 1 million people that get breast cancer every year. Approximately 465,000 die of it. Somewhere between 75 and 80% of these people who get breast cancer don't need to get it. That's close to 800,000 lives each and every year that are affected by breast cancer. The facts are that with a serum level, a Vitamin D serum level, in the 40-60 ng/ml range you could prevent this disease.
Welcome to GrassrootsHealth and our D*Action publication of D*Facts. Today we have Dr. Cedric Garland here with us to talk to us about breast cancer and Vitamin D. I'm Carole Baggerly and right now I'm going to say a very hearty welcome to Dr. Cedric Garland. Thank you so much for coming!
Dr. Garland: Thank you! I'm glad to be here.
Carole: What is some of the background history, Dr. Garland?
Dr. Garland: Well, we only have data in the United States beginning in 1935 when the Connecticut Cancer Registry was established. But we do have data for each year since then on incidents in Connecticut and its believed that the pattern is indicative of incidents throughout the country. And what’s been found is that it shot up, nearly more than doubled, since 1935, the incidence has, and this is also true for the whole United States. We have data beginning in 1974 from the National Cancer Institute Cancer program. So it’s shooting up, and it’s going up at a very high rate and we haven't done anything to stop the incidence. As far as mortality is concerned, we've done a little better. We were around 26 in 1935 and we're around 21 now. It went up during the interim but it seems to be holding steady, sort of flattening out now, at a rate that's at least 5 times what it needs to be.
Carole: That's pathetic. Right? That's really pathetic!
Dr. Garland: It is! It’s pathetic!
Carole: With regard to cancer and Vitamin D, Dr. Garland, what are some of the most significant findings that you've seen in the last few years that totally substantiate this theory that Vitamin D really does prevent cancer?
Dr. Garland: Well, there are about 200 observational studies which are epidemiological studies, almost all of them showing the same effect with few exceptions. But we've always wanted a clinical trial, a randomized control clinical trial, to put the bow on the package in a sense, and we have that now. The clinical trial was completed and published in The American Journal of Clinical Nutrition by Joan Lappe, Robert Heaney and their colleagues recently and this clinical trial shows that approximately 80% of cancer in women can be prevented with intake of appropriate amount of Vitamin D and calcium.
Carole: And as I recall, the serum level that they got to there was right at 38 ng/ml. It wasn't even extremely high, was it?
Dr. Garland: It wasn't extremely high. It was right at the bottom of the recommended range of 40-60 ng/ml but if we don't get quite to that point it won't happen. It requires... There's a threshold effect which means we need to get right around 38-39-40 and in the range of 40-60 ng to get the full effect. But even with that modest effect, we saw nearly 80% reduction in the incidents of all cancers combined.
Carole: With my experience with some breast cancer groups, they have done an excellent job of helping their members pay attention to evidence based medicine. To some extent this also means they have focused almost exclusively on randomized control trials. Could you help explain to us why the evidence for breast cancer prevention with Vitamin D has substantial evidence for it of all kinds?
Dr. Garland: There's an intersection of points of evidence coming from ecological studies, observational studies, including cohort studies – major studies such as the Harwood cohorts, that all points to the same direction. That there is a strong preventive effect of Vitamin D on breast cancer. This was well known before the clinical trial was performed. Clinical trials are often difficult to do. They can take as long as 20 years. Very costly, people drop out of them and they're not the sole answer to the question of whether there's an association between a factor and a disease. In fact, in preventive medicine we generally do not have a clinical trial at the time we begin action. They often come later, if at all, unlike clinical medicine where a clinical trial is usually required before widespread adoption of a drug.
Carole: How long has evidence been being gathered on the preventive effect of Vitamin D on cancer?
Dr. Garland: Well, it began in 1990 with the paper in the Canadian Journal of Public Health, another one in the US Journal of Preventive Medicine and another in the International Journal of Epidemiology all published in that year. And it’s been going on since then.
Carole: That's specifically with Vitamin D. And with regards to the sun and the latitude effect. Carry that one back.
Dr. Garland: Well, in terms of general health, Hippocrates believed that we should live on the side of a hill that was exposed to the sun and many physicians and scientists throughout history have recognized the value of the sun in modest amounts for the prevention of disease. So it isn't really a new idea just now, though, with science, we've been able establish that a product of exposure to the sun, namely 25-Hydroxy Vitamin D in the blood, prevents most breast cancer.
Carole: Imagine having 20 years, maybe 30 years, of evidence about a disease and this millions of people that are affected every year by breast cancer, just imagine how many lives have been impacted by this. I have one more question for Dr. Garland. What should we be doing?
Dr. Garland: Well the first thing is universal testing of serum Vitamin D. There's a test called the 25-hydroxy Vitamin D test. Very easily done. Every man, woman and child, every girl, every woman, should be tested immediately for their level of 25-hydroxy Vitamin D. That's the most important thing we can do because it gives us the context in which to decide what therapy is appropriate. And usually it will turn out to be quite low. For almost everyone it will be below 40-60 ng/ml. Then we need to treat using Vitamin D just rather modest levels to get into the 40-60 ng/ml, but we don't know how much to treat until we have the test.
Carole: Thank you very much. My message to all of you again is going to end up with exactly the same way I started which is help! We need to get this message out to the various clinics, we definitely need to reach the breast cancer organizations to say “help us get this message out to your members”. Again, I, Carole Baggerly, thank you from the bottom of my heart. I am a breast cancer survivor and it means immensely much to me to ask you to help get this message out. Thank you for tuning in to D*Facts. Tune in frequently to grassrootshealth.net and see what the latest is. Thanks again for your help.