Vitamin D and Renal Cancer

Renal Cancer

Each year, kidney (renal) cancer affects approximately 61,000 Americans and kills about 13,000.

Risk factors

• Diet high in animal products
• Environmental chemicals (pesticides or herbicides)

Sunlight exposure and renal cancer risk

Kidney cancer is one of the top 19 cancers sensitive to vitamin D. Death rates from this disorder are lower in areas with more ultraviolet-B (UVB) light. This is similar to studies of breast cancer.

Vitamin D levels

The rates of breast, colon, and rectal cancer decrease as vitamin D levels increase. At first there is a rapid decrease, as very low levels of vitamin D [less than 10 ng/mL [25 nmol/L]) increase to 20–30 ng/mL (50-75 nmol/L). Then the cancer rate decreases more slowly until vitamin D levels reach about 50 ng/mL (125 nmol/L). There are no comparable findings for other cancers. However, it is assumed that renal cancer acts in a similar manner.

How vitamin D works

Vitamin D blocks the growth of cancer tumors. Calcitriol, an active form of vitamin D, is produced by the body. Calcitriol provides numerous benefits against cancer:

• Encourages cells to either adapt to their organ or commit apoptosis (cell suicide)
• Keeps the surface layer of organs intact, making it harder for cancer to invade.
• Limits blood supply to the tumor
• Reduces the spread of cancer

Prevention

Based on studies of breast and colorectal cancer, compared to low vitamin D levels (less than 20 ng/mL [50 nmol/L]), higher levels (30–40 ng/mL [75–100 nmol/L]) may lower kidney cancer risk by 15% to 25%. These levels may also increase survival after diagnosis. Taking 1000–4000 international units (IU) (25–100 mcg)/day of vitamin D is generally needed to reach blood levels of 30–40 ng/mL (75–100 nmol/L).

Vitamin D and calcium

Studies have shown that taking both vitamin D and calcium provides additional cancer protection for many types of cancer. This includes kidney cancer. Calcium intake of more than 1000 mg/day from either diet or supplements may be beneficial.

Treatment

There are no reported studies using vitamin D to treat kidney cancer. However, based on studies of other cancers, it seems likely that vitamin D would be beneficial for people with kidney cancer. People with kidney cancer might consider taking 5000 IU (125 mcg)/day of vitamin D3 (cholecalciferol). This will raise vitamin D levels to more than 40 ng/mL (100 nmol/L).

Acknowledgements

• Martin Blomberg Jensen <mabj@rh.regionh.dk>

Complete bibliography of research used in this summary

We found a significant body of evidence when researching the role of vitamin D in renal cancer.  The research we have cited in our summary is listed below, with links to PubMed abstracts and full-text for those who wish to explore further.

References

1. Aviner S The epidemiolog of renal cell carcinoma. J Urol. 2007; 178 (3 Pt 1): 1120-1.
2. Ben-Shoshan M, Amir S, Dang DT, Dang LH, Weisman Y, Mabjeesh NJ. 1alpha,25-dihydroxyvitamin D3 (calcitriol) inhibits hypoxia-inducible factor-1/vascular endothelial growth factor pathway in human cancer cells. Mol.Cancer Ther. 2007 Apr; 6 (4): 1433-9.
3. Blomberg Jensen, M. Andersen, C. B. Nielsen, J. E. Bagi, P. Jorgensen, A. Juul, A. Leffers, H. Expression of the vitamin D receptor, 25-hydroxylases, 1alpha-hydroxylase and 24-hydroxylase in the human kidney and renal clear cell cancer. J Steroid Biochem Mol Biol. 2010 Jul; 121 (1-2): 376-82.
4. Boscoe, F. P. Schymura, M. J. Solar ultraviolet-B exposure and cancer incidence and mortality in the United States, 1993-2002. BMC Cancer. 2006; 6264.
5. Bosetti, C. Scotti, L. Maso, L. D. Talamini, R. Montella, M. Negri, E. Ramazzotti, V. Franceschi, S. La Vecchia, C. Micronutrients and the risk of renal cell cancer: a case-control study from Italy. Int J Cancer. 2007 Feb 15; 120 (4): 892-6.
6. Chen, W. Clements, M. Rahman, B. Zhang, S. Qiao, Y. Armstrong, B. K. Relationship between cancer mortality/incidence and ambient ultraviolet B irradiance in China. Cancer Causes Control. 2010 Jun 16;
7. Devesa, S. S. Grauman, D. J. Blot, W. J. Pennello, G. A. Hoover, R. N. Fraumeni, J. F. Jr. Atlas of Cancer Mortality in the United States, 1950-1994. NIH Publication No. 99-4564. 1999 November 8, 2008;
8. Fujioka, T. Hasegawa, M. Ishikura, K. Matsushita, Y. Sato, M. Tanji, S. Inhibition of tumor growth and angiogenesis by vitamin D3 agents in murine renal cell carcinoma. J Urol. 1998 Jul; 160 (1): 247-51.
9. Fujioka, T. Suzuki, Y. Okamoto, T. Mastushita, N. Hasegawa, M. Omori, S. Prevention of renal cell carcinoma by active vitamin D3. World J Surg. 2000 Oct; 24 (10): 1205-10.
10. Gallicchio, L. Moore, L. E. Stevens, V. L. Ahn, J. Albanes, D. Hartmuller, V. Setiawan, V. W. Helzlsouer, K. J. Yang, G. Xiang, Y. B. Shu, X. O. Snyder, K. Weinstein, S. J. Yu, K. Zeleniuch-Jacquotte, A. Zheng, W. Cai, Q. Campbell, D. S. Chen, Y. Chow, W. H. Horst, R. L. Kolonel, L. N. McCullough, M. L. Purdue, M. P. Koenig, K. L. Circulating 25-hydroxyvitamin D and risk of kidney cancer: Cohort Consortium Vitamin D Pooling Project of Rarer Cancers. Am J Epidemiol. 2010 Jul 1; 172 (1): 47-57.
11. Garland, C. F. Gorham, E. D. Mohr, S. B. Garland, F. C. Vitamin D for cancer prevention: global perspective. Ann Epidemiol. 2009 Jul; 19 (7): 468-83.
12. Giovannucci, E. Liu, Y. Rimm, E. B. Hollis, B. W. Fuchs, C. S. Stampfer, M. J. Willett, W. C. Prospective study of predictors of vitamin D status and cancer incidence and mortality in men. J Natl Cancer Inst. 2006 Apr 5; 98 (7): 451-9.
13. Goodwin, P. J. Ennis, M. Pritchard, K. I. Koo, J. Hood, N. Frequency of vitamin D (Vit D) deficiency at breast cancer (BC) diagnosis and association with risk of distant recurrence and death in a prospective cohort study of T1-3, N0-1, M0 BC. J Clin Oncol. 2008; 26 (May 20 suppl): abstr 511.
14. Grant, W. B. An estimate of premature cancer mortality in the U.S. due to inadequate doses of solar ultraviolet-B radiation. Cancer. 2002 Mar 15; 94 (6): 1867-75.
15. Grant, W. B. Ecologic studies of solar UV-B radiation and cancer mortality rates. Recent Results Cancer Res. 2003; 164371-7.
16. Grant, W. B. An ecologic study of cancer mortality rates in Spain with respect to indices of solar UVB irradiance and smoking. Int J Cancer. 2007 Mar 1; 120 (5): 1123-8.
17. Grant, W. B. A critical review of Vitamin D and cancer: A report of the IARC Working Group on vitamin D. Dermato-Endocrinology. 2009; 1 (1): 25-33.
18. Grant, W. B. How strong is the evidence that solar ultraviolet B and vitamin D reduce the risk of cancer? An examination using Hill’s criteria for causality. Dermato-Endocrinology. 2009; 1 (1): 14-21.
19. Gnarra, J. R Mutations of the VHL tumour suppressor gene in renal carcinoma. Nat. Genet. 1994; 7 (1): 85–90.
20. Grant, W. B. Effect of interval between serum draw and follow-up period on relative risk of cancer incidence with respect to 25-hydroxyvitamin D level; implications for meta-analyses and setting vitamin D guidelines. Dermato-endocrinology. 2011; 3 (3):
21. Grant, W. B. Garland, C. F. The association of solar ultraviolet B (UVB) with reducing risk of cancer: multifactorial ecologic analysis of geographic variation in age-adjusted cancer mortality rates. Anticancer Res. 2006 Jul-Aug; 26 (4A): 2687-99.
22. Helzlsouer, K. J. Overview of the Cohort Consortium Vitamin D Pooling Project of Rarer Cancers. Am J Epidemiol. 2010 Jul 1; 172 (1): 4-9.
23. Hofmann, J. N. Yu, K. Horst, R. L. Hayes, R. B. Purdue, M. P. Long-term variation in serum 25-hydroxyvitamin D concentration among participants in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial. Cancer Epidemiol Biomarkers Prev. 2010 Apr; 19 (4): 927-31.
24. Hu, J. Mao, Y. White, K. Renal cell carcinoma and occupational exposure to chemicals in Canada. Occup Med (Lond). 2002 May; 52 (3): 157-64.
25. Hu, J. Mao, Y. White, K. Diet and vitamin or mineral supplements and risk of renal cell carcinoma in Canada. Cancer Causes Control. 2003 Oct; 14 (8): 705-14.
26. Hypponen, E. Power, C. Hypovitaminosis D in British adults at age 45 y: nationwide cohort study of dietary and lifestyle predictors. Am J Clin Nutr. 2007 Mar; 85 (3): 860-8.
27. Ingraham, B. A. Bragdon, B. Nohe, A. Molecular basis of the potential of vitamin D to prevent cancer. Curr Med Res Opin. 2008 Jan; 24 (1): 139-49.
28. Jorde, R. Sneve, M. Hutchinson, M. Emaus, N. Figenschau, Y. Grimnes, G. Tracking of serum 25-hydroxyvitamin D levels during 14 years in a population-based study and during 12 months in an intervention study. Am J Epidemiol. 2010 Apr 15; 171 (8): 903-8.
29. Karami, S. Boffetta, P. Stewart, P. Rothman, N. Hunting, K. L. Dosemeci, M. Berndt, S. I. Brennan, P. Chow, W. H. Moore, L. E. Occupational sunlight exposure and risk of renal cell carcinoma. Cancer. 2010 Apr 15; 116 (8): 2001-10.
30. Karami, S. Brennan, P. Hung, R. J. Boffetta, P. Toro, J. Wilson, R. T. Zaridze, D. Navratilova, M. Chatterjee, N. Mates, D. Janout, V. Kollarova, H. Bencko, V. Szeszenia-Dabrowska, N. Holcatova, I. Moukeria, A. Welch, R. Chanock, S. Rothman, N. Chow, W. H. Moore, L. E. Vitamin D receptor polymorphisms and renal cancer risk in Central and Eastern Europe. J Toxicol Environ Health A. 2008; 71 (6): 367-72.
31. Karami, S. Brennan, P. Navratilova, M. Mates, D. Zaridze, D. Janout, V. Kollarova, H. Bencko, V. Matveev, V. Szesznia-Dabrowska, N. Holcatova, I. Yeager, M. Chanock, S. Rothman, N. Boffetta, P. Chow, W. H. Moore, L. E. Vitamin d pathway genes, diet, and risk of renal cell carcinoma. Int J Endocrinol. 2010; 2010879362.
32. Karami, S. Brennan, P. Rosenberg, P. S. Navratilova, M. Mates, D. Zaridze, D. Janout, V. Kollarova, H. Bencko, V. Matveev, V. Szeszenia-Dabrowska, N. Holcatova, I. Yeager, M. Chanock, S. Menashe, I. Rothman, N. Chow, W. H. Boffetta, P. Moore, L. E. Analysis of SNPs and haplotypes in vitamin D pathway genes and renal cancer risk. PLoS One. 2009; 4 (9): e7013.
33. Krishnan, A. V. Trump, D. L. Johnson, C. S. Feldman, D. The role of vitamin D in cancer prevention and treatment. Endocrinol Metab Clin North Am. 2010 Jun; 39 (2): 401-18, table of contents.
34. Lappe, J. M. Travers-Gustafson, D. Davies, K. M. Recker, R. R. Heaney, R. P. Vitamin D and calcium supplementation reduces cancer risk: results of a randomized trial. Am J Clin Nutr. 2007 Jun; 85 (6): 1586-91.
35. Leffell, D. J. Brash, D. E. Sunlight and skin cancer. Sci Am. 1996 Jul; 275 (1): 52-3, 56-9.
36. Mohr, S. B. Gorham, E. D. Garland, C. F. Grant, W. B. Garland, F. C. Are low ultraviolet B and high animal protein intake associated with risk of renal cancer?. Int J Cancer. 2006 Dec 1; 119 (11): 2705-9.
37. Newton, R. Roman, E. Fear, N. Carpenter, L. Ng, K. Wolpin, B. M. Meyerhardt, J. A. Wu, K. Chan, A. T. Hollis, B. W. Giovannucci, E. L. Stampfer, M. J. Willett, W. C. Fuchs, C. S. Prospective study of predictors of vitamin D status and survival in patients with colorectal cancer. Br J Cancer. 2009 Sep 15; 101 (6): 916-23.
38. Obara, W. Suzuki, Y. Kato, K. Tanji, S. Konda, R. Fujioka, T. Vitamin D receptor gene polymorphisms are associated with increased risk and progression of renal cell carcinoma in a Japanese population. Int J Urol. 2007 Jun; 14 (6): 483-7.
39. Peterlik, M, Grant , W. B, Cross, H.S. Calcium, vitamin D and cancer. Anticancer Res. 2009 Sept; 29 (9): 3687-98.
40. Seidler, A. Hammer, G. P. Husmann, G. Konig, J. Krtschil, A. Schmidtmann, I. Blettner, M. Cancer risk among residents of Rhineland-Palatinate winegrowing communities: a cancer-registry based ecological study. J Occup Med Toxicol. 2008; 312.
41. Siegel, R. Ward, E. Brawley, O. Jemal, A. Cancer statistics, 2011: The impact of eliminating socioeconomic and racial disparities on premature cancer deaths. CA: a cancer journal for clinicians. 2011 Jun 17;
42. Tuohimaa, P. Pukkala, E. Scelo, G. Olsen, J. H. Brewster, D. H. Hemminki, K. Tracey, E. Weiderpass, E. Kliewer, E. V. Pompe-Kirn, V. McBride, M. L. Martos, C. Chia, K. S. Tonita, J. M. Jonasson, J. G. Boffetta, P. Brennan, P. Does solar exposure, as indicated by the non-melanoma skin cancers, protect from solid cancers: vitamin D as a possible explanation. Eur J Cancer. 2007 Jul; 43 (11): 1701-12.