I have the pleasure of publishing the “MANIFESTO” a document on Integrative Medicine in oncology, in Tuscany.
Recently, between ARTOI and one of the few Italian realities of U.H. Integrative Medicine in Tuscany begun a strict cooperation, in particular with Pitigliano Hospital, where a medical team consisting of general practitioners and doctors on integrative medicine care of the patient.
This Unit Hospital is one of the first in Italy to provide this service. In fact, there is only one other in Bolzano. I have already spoken about it.
The cooperation is growing more and more because of the increasing need of integrative intervention in oncology.
Our knowledge will be at disposal of the colleagues of Pitigliano and I hope it will give all patients the opportunity to use the hospital services (as far as possible).
I would thank Dr. Bernardini, Director of the U.H. and her colleague Dr. Cracolici for this collaboration, with the hope to aid all Tuscan patients and also those of other regions.
Massimo Bonucci M.D.
Spec. Oncologia medica
Spec. Anatomia patologica
We inaugurate this new section of the Blog ARTOI to publish Scientific Items of our members or other senior figures of the Integrative Therapies in oncology.
The summer draws to a close and we head into the long winter of vitamin D deficiency.
Vitamin D is actually not even a vitamin in the proper sense of the term, but it is a very powerful steroid hormone that is produced when our skin gets hit by an adequate amount of sunlight (ultraviolet, a wavelength of 290-315 nanometres) and it is then activated in the liver and kidneys.
Today we are increasingly less exposed to sunlight, especially in winter. Our life flows almost entirely in closed places ( homes, offices , shops , cars ) and every time we expose ourselves to the sun we are extra careful to protect ourselves with sunscreens increasingly selective, especially for the widespread concern that exposure to the sun is dangerous.
Studies show that the lack of vitamin D is linked to a higher incidence of cancer (especially breast, lung, colon and prostate), heart attacks, arterial hypertension, stroke, diabetes, multiple sclerosis, autoimmune diseases, seasonal depression and other mental disorders: Alzheimer’s disease, osteoporosis, chronic pain in muscle and joints, flu and colds, asthma and chronic fatigue.
The Vitamin D accelerates the healing of the tissues and with its anti-proliferative effect reduces the risk of neoplastic degeneration, it regulates apoptosis and cell differentiation.
In the United States the integration of 1000 international units per day of vitamin D reduces cancer mortality in 9% of women and 7% of men.
In a study published in 2007 on the American Journal of Clinical Nutrition postmenopausal women who assumed calcium and vitamin D had a 77 % decreased risk of developing cancer. For every increase of 10 ng/ml of vitamin D in the blood, the relative risk of cancer fell by 35%.
According to the American Cancer Society breast cancer is the second leading cause of death in women in the United States. The rate of this tumor is high in white women after the age of 40 and in black women under the age of 40. Black women have also most likely to die of breast cancer at any age. The breast tissues have vitamin D receptors so they suffer the rate of vitamin D available.
Vitamin D acts on tumors by interfering in the formation of blood vessels that feed them. Women who have blood level of vitamin D lower than 20 ng/ml may have an incidence of breast cancer increased 50%; on the other hand, the average (RD) of vitamin D is too low to increase the levels up to 30 ng/ml. The low levels of vitamin D (below 20 ng/ml) are associated with an increased risk of colon cancer by 20 to 50%. A meta-analysis has shown that blood levels of vitamin D on the 33 ng/ml are associated with a 50% decrease in the risk of colon cancer compared to levels of 12 ng/ml.
With regard to the cardiovascular system, the “Health Professional Follow Up Study” has collected blood samples of more than 51 million health male workers who in 1986 were between 40 and 75 years showed that those who had a deficiency of vitamin D (with lower levels of 15 ng/ml) had 242% more chance of having a heart attack than those who had levels of at least 30 ng/ml.
Lack of vitamin D is now universal and affects almost the entire population, particularly in countries above the 35th parallel as Italy. The more is latitude the less ultraviolet rays are effective in producing the vitamin.
At our latitudes from November to March the UV rays are not able to produce the vitamin. A sunscreen with a protection factor of 8 reduces up to 92% the production of vitamin D, a protection factor of 15 to 99%.
On the other hand people who spend a lot of time to be brown produce more melanin on the skin and therefore have a reduced ability to convert sunlight into vitamin D.
To enjoy the sun safely it is necessary to observe the following rule: 25% of the exposed skin (hands, arms and lower legs) for a period of time ranging from 25 to 50% of the time it is presumed to be necessary to the skin to turn red.
So if you do not live in the tropics and if you spend most of your day nude in the sun, it is almost impossible that your body produces enough vitamin D for all its needs so it is necessary to take it as a supplement.
In fact, to take at least 1000 international units (IU) should drink 10 glasses of milk, 240 ml each.
In our population there is deficiency of vitamin D, less than 5% reach a blood level of 40-50 ng/ml which is good, while the most is located between 5 and 20 ng/ml. That is already low levels even for obsolete normal range in our laboratories based on a minimum of 20 ng/ml to prevent rachitis. Besides, elderly people between 40 and 100% are deficient in vitamin D.
Practice has proved that to reach 50 ng/ I need at least 5000 IU per day of vitamin D3, compared with an RDA of 600-800 IU. The administration of these quantities, however, is recommended only under medical supervision while who doesn’t perform blood tests should not exceed 2000 IU daily.
Excess of vitamin D is actually more uncommon than previously thought and blood levels up to 100 ng/ml do not create any problem. The problem is merely not to get enough.
Prof. Massimo Fioranelli
Scientific Director of ARTOI
Director of “Life Sciences Study Center ”
“G. Marconi ” University – Rome