Vitamin D deficiency in the oncology setting.

BACKGROUND: Vitamin D deficiency is common in the United States. Regardless of whether or not vitamin D deficiency increases the risk of cancer and decreases survival of cancer, the established adverse impact of its deficiency on bone health is of particular concern for cancer patients. The extent of vitamin D deficiency is not well defined in the oncology setting, and there are no standardized protocols for screening and supplementation for individuals found to be deficient in vitamin D. OBJECTIVE: To determine the prevalence of vitamin D deficiency as measured by levels of serum 25-hydroxyvitamin D (25[OH]D) in cancer patients at an outpatient oncology practice. METHODS: A total of 177 patients representing a range of oncologic diagnoses were tested for 25(OH)D between January 1, 2011 and December 31, 2011. Suboptimal vitamin D levels were defined either as less than 20 ng/mL or less than 30 ng/mL, according to standards proposed by the Institute of Medicine and the Endocrine Society, respectively. LIMITATIONS: The point of testing was subjective to the clinician. Some patients may have had their vitamin D levels tested and treated elsewhere, therefore that data was not captured. RESULTS: At baseline, 18.1% of patients tested had vitamin D levels of less than 20 ng/ml, and 49.1% of patients had vitamin D levels of less than 30 ng/ml. Follow-up rates were low. In all, 54% of patients with 25(OH)D levels of less than 30 ng/ml obtained a second reading, and only 38% of those patients achieved sufficient levels at the second reading. CONCLUSION: Vitamin D deficiency is prevalent in patients with cancer and should be monitored in patients who are at high risk for vitamin D deficiency or poor bone health.

Assessing the nutritional status of patients with sarcoma by using the scored patient-generated subjective global assessment.

An intervention with the Scored Patient-Generated Subjective Global Assessment was implemented at a community cancer center to identify patients with sarcoma at risk for malnutrition. This population usually is not considered to be at nutritional risk because of young age and the site of diagnosis; however, 60% of patients assessed were at risk for malnutrition or were severely malnourished. Nurses and dietitians should be aware of potential nutritional risk in this population and learn about possible interventions.