Sore mouth due to cancer therapy (oral mucositis) substantially reduced by daily 1,000 IU of vitamin D

Created November 2017

Expression of vitamin D receptor and vitamin D status in patients with oral neoplasms and effect of vitamin D supplementation on quality of life in advanced cancer treatment

Contemp Oncol (Pozn). 2017; 21(2): 145–151, online 2017 Jun 30. doi: 10.5114/wo.2017.68623

PMCID: PMC5611504

Akshay Anand,1 Suyash Singh,1 Abhinav A. Sonkar,corresponding author1 Nuzhat Husain,2 Kul Ranjan Singh,1 Sudhir Singh,1 and Jitendra K. Kushwaha1

* Oral mucositis is associated with a variety of chemotherapy & radiation therapies of the head/neck * Suspect that a Vitamin D mouthwash - homemade or spray would have been better than oral since vitamin D can be activated by many tissues, including the mouth * Suspect that restoring vitamin D levels in a week would be much better than in 2 months, as the oral mucositis starts about 10 days after chemo/radiation therapy * Overview Loading of vitamin D * Oral cancer risk and vitamin D status, intake, and supplementation - review May 2013 * Chemotherapy might be augmented with Vitamin D – Jan 2017 * Cancer Chemotherapy and vitamin D – Review March 2013 * Chemotherapy and vitamin D - many studies * Standard level of chemo/radiation therapy intensity can be deadly if you have a high level of vitamin D * * * items in Quality of Life category * 1. See also web * Medscape * “Oral mucositis is a common complication of cancer chemotherapy. It begins 5-10 days after the initiation of chemotherapy and lasts 7-14 days. Chemotherapy-induced oral mucositis causes the mucosal lining of the mouth to atrophy and break down, forming ulcers” * Mucositis Wikipedia * “Oral and gastrointestinal (GI) mucositis affects almost all patients undergoing high-dose chemotherapy and hematopoietic stem cell transplantation (HSCT), 80% of patients with malignancies of the head and neck receiving radiotherapy, and a wide range of patients receiving chemotherapy.” * “For most cancer treatment, about 5–15% of patients get mucositis” * “Seventy-five to eighty percent of bone marrow transplantation recipients experience mucositis,” * “In grade 3 oral mucositis, the patient is unable to eat solid food, and in grade 4, the patient is unable to consume liquids as well” * Radiotherapy to the head and neck Grade 3 oral mucositis - often exceeding 50% of patients

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Note SPSS = swallowing performance status scale

Aim of the study

Vitamin D receptor (VDR) expression and serum vitamin D scores in oral premalignant lesions and oral cancer have not been widely analyzed. The role of vitamin D supplementation in advanced oral cancer for improving quality of life (QOL) is also a matter of research.

Material and methods

Vitamin D receptor expression and vitamin D scores were analyzed in normal oral mucosa (n = 95), leukoplakia (n = 23) and oral cancer (n = 87). 45 patients with advanced oral cancer subjected to chemoradiation were evaluated for the effect of vitamin D supplementation on most observable QOL parameters such as oral mucositis, swallowing performance and overall QOL.

Results

Vitamin D receptor expression was increased in oral neoplastic lesions. Vitamin D scores were significantly lower in cases compared to healthy controls (p = 0.002). Vitamin D supplementation significantly reduced the therapy-related toxicities in advanced cancer, thus reducing morbidity and improving QOL.

Conclusions

Vitamin D receptor expression is increased in premalignant lesions and oral cancer. Vitamin D insufficiency and deficiency are prevalent in patients with oral neoplastic lesions. Vitamin D supplementation has a role in reducing treatment-related toxicities, especially in advanced cancer.

Tags: Cancer - Other Cancer - after diagnosis Quality of Life