Is Vitamin D Status at Time of Melanoma Diagnosis Associated with Stage of Tumor?
Abstract
Fiscal Year 2014 (FY14) Peer Reviewed Cancer Research Program Topic Area Addressed: Melanoma. FY14 Military Relevance Focus Area Addressed: Identification of predictive and prognostic biomarkers of developing cancers due to exposure to militarily relevant environmental or chemical carcinogens. Vitamin D is produced by the action of ultraviolet radiation (UVR) from sunlight on exposed skin. On the other hand, exposure to UVR is the main risk factors for development of melanoma -- the deadliest form of skin cancer. Active duty personnel in the US military (particularly older men and those in the Air Force) have a higher incidence of melanoma than similar groups in the general population. This may be due to the amount and patterns of UVR exposure that they receive during their training and deployment, which are often in sunny locations. Evidence suggests an intriguing relationship between UVR exposure, vitamin D, and melanoma. While on the one hand, UVR is an environmental carcinogen that increases the risk of melanomas, on the other hand there are data that show that higher levels of vitamin D (a by-product of UVR exposure) at the time of melanoma diagnosis may be associated with less aggressive tumors (reduced tumor thickness). Having a reduced tumor thickness is greatly beneficial in terms of survival from melanoma. The potential relationship between vitamin D and melanoma is an important gap in our understanding of melanoma development, and one that should be explored, particularly for these high-risk military personnel. In this proposed study, we will recruit 600 newly diagnosed patients with a primary melanoma cases in Brisbane, Queensland -- the "melanoma capital of the world." We will investigate the research question, "Is vitamin D concentration at the time of diagnosis associated with prognostic characteristics for melanoma?" In our study sample, we will measure vitamin D levels (as measured by serum 25(OH)D concentration), recent and lifetime patterns of sun exposure/sun protection, and other factors that are known to affect vitamin D levels and melanoma tumor characteristics. Melanoma patients will be recruited from the study investigators established networks of determatologists and surgeons in skin cancer clinics in Brisbane. We expect the demographic characteristics and sun exposure patterns of these melanoma patients will closely resemble those of melanoma patients in the US military. Our hypothesis is that lower vitamin D levels at the time of melanoma diagnosis will be associated with increased tumor thickness, and conversely, that increased vitamin D levels at diagnosis will be associated with decreased tumor thickness. The proposed research will add significantly to current knowledge in melanoma development and progression, through an avenue that has not previously been investigated. Our study has a number of strengths, the most important being recruitment of large numbers of melanoma patients obtained over a short time period. If an association is found between low vitamin D levels at the time of diagnosis and increased tumor thickness, routine testing for vitamin D concentration and oral supplementation with vitamin D may be recommended as cost-effective, easily administered preventive strategies to improve military health. The outcomes of this investigation will have direct benefits to the US military population, aiming to reduce the higher incidence of melanoma in this group and to minimize the likelihood of disease progression in those personnel already diagnosed with melanoma.
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Apr 04, 2016
- Source ID
- W81XWH1510541
Entities
People
- Michael Kimlin
Organizations
- United States Army
- University of the Sunshine Coast