When local treatments for prostate cancer have failed, and prostate-specific antigen (PSA) rises in the absence of symptoms, there is little consensus as to the best management strategy. Calcitriol has been shown to prolong the doubling time of PSA in this context, but near-toxic doses are required. We investigated the effect of the nutrient vitamin D (cholecalciferol), a biochemical precursor of calcitriol, on PSA levels and the rate of rise of PSA in these patients. Fifteen patients were given 2,000 IU (50 microg) of cholecalciferol daily and monitored prospectively every 2-3 mo. In 9 patients, PSA levels decreased or remained unchanged after the commencement of cholecalciferol. This was sustained for as long as 21 mo. Also, there was a statistically significant decrease in the rate of PSA rise after administration of cholecalciferol (P = 0.005) compared with that before cholecalciferol. The median PSA doubling time increased from 14.3 mo prior to commencing cholecalciferol to 25 mo after commencing cholecalciferol. Fourteen of 15 patients had a prolongation of PSA doubling time after commencing cholecalciferol. There were no side effects reported by any patient. Further study is needed to confirm this finding and to explore the potential therapeutic benefit of nutrient vitamin D in prostate cancer.

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Radiotherapy is an available treatment for management of basal cell carcinoma (BCC). This study aims to analyse the published literature about radiotherapy in treatment of BCC. A focus of this study will be to compare the dosing regimens adopted in these studies. A search of the Medline database was conducted from 1984 to August 2013. Search terms used were 'basal cell carcinoma', 'radiotherapy', 'epithelial skin cancer' and 'external irradiation'. Fourteen studies on the use of radiotherapy for BCC were included. Seven studies included only cases of BCC, while six studies also included patients treated for squamous cell carcinoma. The overall cure rates ranged from 79·2% to 100%. More than 90% of the patients reported good or excellent aesthetic outcome from radiotherapy (three studies). There was a wide variation in the total dose and dose per fraction of radiotherapy used. Nine studies utilized dosing regimens within the recommended guidelines of the National Comprehensive Cancer Network. There are a limited number of high-quality prospective studies of radiotherapy for BCC. Based on the available evidence, radiotherapy provides a high rate of local control with low rates of complications that are comparable with surgery.