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Palliative cancer benefit of 4,000 IU of Vitamin D – less opioids, infection, and CRP – Aug 2017

Vitamin D supplementation to palliative cancer patients shows positive effects on pain and infections—Results from a matched case-control study

PLOS x, August 31, 2017 https://doi.org/10.1371/journal.pone.0184208
Maria Helde-Frankling, Jonas Höijer, Jenny Bergqvist, Linda Björkhem-Bergman

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"Palliative care (pronounced pal-lee-uh-tiv) is specialized medical care for people with serious illness. This type of care is focused on providing relief from the symptoms and stress of a serious illness. The goal is to improve quality of life for both the patient and the family."
"Both palliative care and hospice care provide comfort. But palliative care can begin at diagnosis, and at the same time as treatment. Hospice care begins after treatment of the disease is stopped and when it is clear that the person is not going to survive the illness "


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Decreased use of Opiates

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Decreased use of antibiotics

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Increased Vitamin D levels

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Background
We previously showed an association between low vitamin D levels and high opioid doses to alleviate pain in palliative cancer patients. The aim of this case-controlled study was to investigate if vitamin D supplementation could improve pain management, quality of life (QoL) and decrease infections in palliative cancer patients.

Methods
Thirty-nine palliative cancer patients with levels of 25-hydroxyvitamin D < 75 nmol/L were supplemented with vitamin D 4000 IE/day, and were compared to 39 untreated, matched “control”-patients from a previous study at the same ward. Opioid doses, antibiotic consumption and QoL-scores measured with the Edmonton Symptom Assessment Scale (ESAS) were monitored. The primary endpoint was the change from baseline after 1 and 3 months compared between the groups using linear regression with adjustment for a potential cofounding factor.

Results
After 1 month the vitamin D treated group had a significantly decreased fentanyl dose compared to the untreated group with a difference of 46 μg/h; 95% CI 24–78, which increased further at 3 months to 91 μg/h; 95% CI 56–140 μg/h. The ESAS QoL-score improved in the Vitamin D group the first month; -1.4; 95% CI -2.6 - (-0.21). The vitamin D-treated group had significantly lower consumption of antibiotics after 3 months compared to the untreated group, the difference was -26%; 95%CI -0.41%–(-0.12%). Vitamin D was well tolerated by all patients and no adverse events were reported.

Conclusion
Vitamin D supplementation to palliative cancer patients is safe and improvement in pain management is noted as early as 1 month after treatment. Decreased infections are noted 3 months after vitamin D treatment. The results from this pilot-study have been used for the power-calculation of a future randomized, placebo-controlled, double-blind study called “Palliative-D” that will start in Nov 2017 and will include 254 palliative cancer patients.

Created by admin. Last Modification: Monday January 15, 2018 16:39:30 GMT-0000 by admin. (Version 9)

Attached files

ID Name Comment Uploaded Size Downloads
8374 pallative D.jpg admin 01 Sep, 2017 01:47 30.23 Kb 154
8373 Antibiotics.jpg admin 01 Sep, 2017 01:47 22.49 Kb 146
8372 Opiates.jpg admin 01 Sep, 2017 01:46 22.06 Kb 258
8371 palliative cancer.pdf PDF 2017 admin 01 Sep, 2017 01:23 2.13 Mb 94
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