1. Vitamin D: from bone to cancer
therapy
Henk R. Franke
The Hague, 12/4/2013 1

2. Who knows their vitamin D serum
level?
2

3. Vitamin D serum level of an
elderly youngster
43 weeks: 1000 IE daily
13 weeks: 3600 IE daily 3

4. Outline
 Vitamin D in short
 Cancer stem cell theory
 Breast cancer
 In vitro proof
 Practical guidelines
4

5. How do we acquire our vitamin D ?
Sun-bathing Fatty fish 600 - Multivitamins 200 Margarine 20 - 30 IE /
10 -20000 IE 1000 IE/100g IE/daily slice of bread
Food only supplies < 10 % of our needs
5

6. NL 52°N
Vieth, J Steroid Biochem Mol Biol 2004;89-90:575
6

7. Muskiet et al, Ned Tijdschr
Klin Chem Labgeneesk
2007;32:150 7

8. Vitamin D
 Regulates 200 genes that influences cell growth
and differentiation which probably leads to a lesser
extent of malignant degeneration (Holick, 2008)
 Induces apoptosis of the cancer (stem) cell
 Desired serum level is at least 100 nmol/l (Binkley
et al, 2008)
8

9. Outline
 Vitamin D in short
 Cancer stem cell theory
 Breast cancer
 In vitro proof
 Practical guidelines
9

10. Cancer stem cell theory
Vermeulen et al, NTvG, 10
2009;153:286

11. Kakarala et al, Cancer J 2007;13:27
11

12. Breast Tumor Content
 A tumor consists of a small stem cell
compartment (3 -35%) and a large
population of differentiated cells
 Number of divisions of a differentiated tumor
cell: 50-60, division time: 19,5 hours, total
lifetime 1170 hours
12

13. Breast Tumor Content
 Tumor doubling time 50-100 dagen
 Number of doublings needed to increase
the tumor to 1 cm is 30-35
13

14. Breast Cancer and HT: early detection
The Mammographic Window 2.5cm
1012
1010
1cm
108
106 1mm
104
1
1 2 3 4 5 6 7 8 9 10 11 12 13 14 Years
Premammographic Preclinical Clinical
14
Wertheimer et al. JAMA 1986;255:1311
14

15. Outline
 Vitamin D in short
 Cancer stem cell theory
 Breast cancer
 In vitro proof
 Practical guidelines
15

16. 5% more breast
cancers present in
the left breast
16

17.  In The Netherlands each day 68 women and 63 men die
from cardiovascular events¹
 In The Netherlands each day 9 die from breast cancer²
¹Wassertheil-Smoller et al Hypertension 2000;36:780
²Sluman et al NTvG 2006;150:2018 17

18. Breast cancer prevalence in the USA
18

19. The association
Crew et al 2009;2(6):598
19

20. Outline
 Vitamin D in short
 Cancer stem cell theory
 Breast cancer
 In vitro proof
 Practical guidelines
20

21. ‘All roads lead to death’
21

22. Apoptosis
 physiological, programmed cell death, during
the adult lifespan each day 109 cells die
 It means falling of leaves and was first
mentioned by Kerr in 1972
22

23. NECROSIS: cell murder
APOPTOSIS: cell suicide
23

24. HELA cell, cervix
QuickTime™ en een
Cinepak-decompressor carcinoma cell
zijn vereist om deze afbeelding weer te geven.
24

25. Development of the
QuickTime™ en een hand of an embryo
Cinepak-decompressor
zijn vereist om deze afbeelding weer te geven. of about 7 weeks
gestational age
25

26. In vitro proof
Apoptosis proliferation ratio
Mark Londema 26
2009

27. Outline
 Vitamin D in short
 Cancer stem cell theory
 Breast cancer
 In vitro proof
 Practical guidelines
27

28. Advice Vitamin D Council, USA
 Children till 1 year 1000 IU/daily
 Children 1 to 4 years 2000 IU/daily
 Children 4 to 10 years 3000 IU/daily
 Adults 2000-5000 IU/daily
www.vitamindcouncil.org
28

29. Practical Advice
Every 2 weeks 50.000 IU
That is 3570 IU/daily
Half time of vitamin D: 4-5 weeks
29

30. € 49,50 € 22,15
Daily costs € 0,11 Daily costs € 0,16
30

31. 31

32. Calcium/vit D and cardiovascular
Bolland et al, BMJ 2011;342:d2049
32

33. Calcium/vit D and cardiovascular
Bolland et al, BMJ 2011;342:d2049
33

34. 34

35. @hrfranke
www.henkfranke.com
35