Vitamin D May Help Reduce Peripheral Neuropathy Caused by Chemotherapy
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A new study has found evidence that vitamin D supplements may reduce chemotherapy-induced neuropathy (CIPN) in people with low levels of the vitamin.
Peripheral neuropathy is often described as numbness, tingling, or burning sensation in the hands and feet that can dramatically interfere with a person’s ability to perform normal activities of daily living including bathing, dressing, and cooking, according to the senior researcher Daniel L. Hertz, PharmD, PhD, an associate professor at the University of Michigan College of Pharmacy in Ann Arbor.
The findings, published in the November 2023 issue of JNCCN — Journal of the National Comprehensive Cancer Network, suggest that this inexpensive and easy-to-access solution could improve long-term quality of life for people with cancer and potentially lessen racial disparities, according to the authors.
Chemo Drug Paclitaxel Treats a Variety of Cancers
It’s estimated that as many as 6 in 10 people treated with the cancer chemotherapy drug paclitaxel develop peripheral neuropathy, and as many as 3 in 10 have severe symptoms, according to a study published in the February 2019 BMC Cancer.
Paclitaxel is used to treat advanced cancer of the ovaries and breasts, non-small-cell lung cancer, and Kaposi sarcoma (a cancer of the skin and mucous membranes that is commonly found in people with AIDS), according to Mayo Clinic.
The drug interferes with the growth of cancer cells, which are eventually destroyed. Since the growth of normal body cells may also be affected, other unwanted side effects occur, sometimes right away, but others may not develop until months or years after the medicine is used.
Peripheral Neuropathy From Chemo Is More Likely to Occur in People Who Are Vitamin D Deficient
The lingering numbness, tingling, or burning can be largely untreatable and sometimes permanent, making it critical that people receiving chemotherapy and their care teams monitor for and address the development of treatment-related peripheral neuropathy — before symptoms become intolerable, according to the authors. “The condition can irreversibly reduce their physical, social, emotional, and financial quality of life,” says Dr. Hertz.
To look at how vitamin D levels might impact the likelihood of peripheral neuropathy in people undergoing chemotherapy, investigators used data on about 1,200 patients with early-stage breast cancer from the SWOG S0221 study, which compared chemotherapy regimens in high-risk early stage breast cancer.
They found that 20.7 percent of patients with vitamin D deficiency experienced at least a grade 3 level of chemotherapy-induced peripheral neuropathy (CIPN), compared with 14.2 percent of those with adequate vitamin D levels.
In an accompanying study, researchers strengthened this connection by inducing vitamin D deficiency in mice, which caused symptoms suggesting brain toxicity.
These findings reveal a significant association between vitamin D insufficiency and an increased incidence of chemotherapy induced peripheral neuropathy, said Mei Wei, MD, an oncologist who specializes in treating breast cancer at the Huntsman Cancer Institute at the University of Utah, in a press release. “This study finding uncovers a new potential strategy to combat CIPN, thereby improving the quality of life for cancer patients undergoing treatment. It is an exciting step forward in our continuous mission of patient-centered cancer care,” said Dr. Wei, who was not involved in this research.
Findings Could Be Used to Help Reduce Health Disparities in CIPN
It’s well established that Black individuals have much higher risk of vitamin D deficiency, says Hertz. “We are excited by the possibility of this research providing an explanation for the known racial disparity: Black patients have about double the risk of reporting CIPN,” he says.
Vitamin D supplements could potentially provide a simple, cheap, and safe strategy to reduce chemotherapy-induced peripheral neuropathy and reduce this disparity, says Hertz.
Should People Who Undergo Paclitaxel Chemotherapy Treatment Take Vitamin D Supplements?
Patients can easily take over-the-counter vitamin D supplements to increase levels without much risk of negative consequences, says Hertz.
But should everyone who undergoes this type of cancer treatment start taking vitamin D?
If testing indicates you’re vitamin D deficient, you should receive supplementation for several reasons, regardless of whether it prevents CIPN, says Hertz. Before starting on the supplements, talk to your provider about the recommended dose — too much vitamin D can be harmful, according to MedlinePlus.
It is likely too early to recommend vitamin D assessment prior to treatment in all patients, since it hasn’t been demonstrated that vitamin D supplementation prevents CIPN, says Hertz. “Further research is needed to prospectively demonstrate that vitamin D supplementation in vitamin D deficient patients prevents peripheral neuropathy,” he says.
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