I say this, because I simply wrote “70.3% of Americans are Vitamin D deficient” (with source) and that this line was deleted as a last minute editorial change in an ASCO chapter I wrote for education purposes in June 2025. My later statement “It should be reasonable standard of care to screen for a vitamin D25 before starting conventional therapy” (particularly in patients presenting with fatigue before starting treatment) was deleted and substituted with the above ASCO party line. I can understand the latter decision. But why does ASCO not want clinicians to know the prevalence of vitamin D deficiency in this country when that is arguably the best reason to do screening?
I joined a for-profit hospital system called Cancer Treatment Centers of America 2014-2024 after a start in academia, because I wanted to learn what works in a for-profit integrative oncology practice. I have now joined academia again to help share the data that is already sitting in front of them, that says very powerfully that we should be checking serum D25 levels before starting conventional therapy. Yet I find myself opposed by ASCO (American Society of Clinical Oncology) who maintains it should be standard of care to check a vitamin D25 only when about to start a bone-weakening agent for cancer care without any RCT (randomized controlled trials) evidence to justify the safety of waiting that long.
Here is my argument for future scientific discourse of why it should be standard of care with the available evidence. Vitamin D deficiency particularly <20 ng/ml is associated with significant fatigue symptoms which can improve by 65% on fatigue scores within days of vitamin D3 replacement (placebo usually only works 20-30% on fatigue). Fatigue affects 40% of patients who present with cancer at cancer centers, and now the research is saying we want them to get up and exercise during or after chemotherapy to improve survival without addressing their baseline fatigue? Fatigue predicts lack of willingness to engage with healthier lifestyle behaviors, and people embrace unhealthy lifestyles to cope with fatigue. Targeted vitamin D replacement is what we call one of the easiest wins in integrative oncology, and this has become an unfortunate “blind spot” for academia. It’s why patients would leave NCI designated cancer centers to get second opinions and stay at CTCA during its prime. It was part of the business model, improving quality of life in the first three days of the visit by optimizing human biology first.
Knowing this will likely not be published by a major medical publishing company unfiltered, I am making it available for free here, so we can finally drive knowledge into action in 2025 and beyond. As of 3.15.26, 6 years after the COVID19 pandemic, I have updated the free vitamin D chapter to version 2.0 which now includes all references, and a more patient-friendly organization with the more academic discussions left for the latter half of the chapter.
The above and below photo belongs to Jean Makanna and is of the Salar de Uyuni in Bolivia, one of the most beautiful geographic areas to explore in such a small region. Her husband does amazing photography of classic airplanes in flight: https://ghosts.com/pages/about-us.
The third degree sunburns we took care of that day…Definitely could be called melanoma lake.
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