The effect of the ex vivo addition of vitamin D on the prothrombotic and fibrinolytic potential in prostate cancer patients' blood.

Abstract

Cancer and its consequences are amongst the major causes of death worldwide. Prostate cancer (PCa) is the most frequent non-cutaneous malignancy in men globally, with South Africa having the fourth highest prostate cancer mortality rate in the world. Patients diagnosed with PCa have been found to have a hypercoagulable state as a result of the elevated systemic inflammation that is a hallmark of cancer. Vitamin D supplementation has been shown in recent studies to improve the survival rates of individuals with PCa due to its anti-tumorigenesis properties. Given the link between chronic inflammation, hypercoagulation and PCa survival rates, improving the thrombotic status of PCa patients could be beneficial in the management of these patients. This study investigated the hypercoagulable state of both metastatic and nonmetastatic PCa patients, in comparison to a reference group, before and after the ex vivo supplementation with vitamin D. The morphological and viscoelastic properties of whole blood and platelet poor plasma were investigated using light microscopy, scanning electron microscopy and thromboelastography®. This study indicated that vitamin D supplementation might potentially aid the pathology caused by abnormal RBC shape, albeit caution should be used in metastatic PCa populations since supplementation was seen to result in a tendency to create stronger, more rigid clots at a faster pace. Although vitamin D supplementation shows potential as a more cost-effective therapy regime for the elevated thrombotic risk commonly seen in individuals with PCa, additional research is needed to determine the impact of vitamin D supplementation on hypercoagulability in vivo.