VA study validates vitamin B3 in skin cancer prevention

The study, co-authored by Dr. Lee Wheless, a VA Tennessee Valley Healthcare System staff physician and Vanderbilt University assistant professor of dermatology, involved over 12,000 patients over 25 years who had previously been exposed to nicotinamide, the dietary supplement, and had at least one prior skin cancer.

This large sample size enabled the research team to perform a robust analysis, considering various factors such as demographics and the number of prior skin cancers.

"Not only did we find an overall 14% reduced risk of developing new skin cancers…but we also discovered that patients who started nicotinamide after their first skin cancer saw a 54% reduction in the rate of new skin cancers," Wheless said.

Previous research showed that Veterans have about a 70% increased risk of developing skin cancers compared to non-Veterans. According to Wheless, at baseline, Veterans are a very high-risk population in the dermatology service.

“This is an important study for Veterans given the large number who work in jobs that have significant sun exposure or other risk factors for skin cancer,” Associate Chief of Staff of Research and Development Dr. Stokes Peebles said. “There are very few interventions which can reduce the risk of recurrent cancer by such a large percentage.”

Given the increased risk of skin cancer among Veterans, this study highlights the potential for affordable treatment options that can significantly reduce the incidence of the disease. Notably, treating skin cancers is one of the highest costs for community care referrals in dermatology, making these findings particularly impactful in terms of both patient health and healthcare expenditures.

“We have patients that can get over 100 skin cancers and that's a lot of individual cancers to be treating, a lot of surgeries, and a lot of time healing from all.” Wheless said. “If we can reduce the rate of skin cancers by 50%, if a patient normally is getting, say 10 skin cancers per year…That's five fewer surgeries and a major impact on that patient's life.”

Looking ahead, Dr. Wheless aims to advance precision medicine in skin cancer treatment, ensuring the right treatment reaches the right patient at the right time.

“This work by Dr. Wheless is just one example of the high impact research that is being performed at TVHS that can have a major positive impact on Veteran health. Dr. Wheless’s

work is supported by a VA Career Development Award (CDA) and it will be exciting to see what other important therapies that Dr. Wheless will discover as his research career at the VA progresses,” Peebles said.

He is also working on identifying biomarkers to pinpoint patients who would benefit most from nicotinamide preventive treatment and is keen to investigate whether nicotinamide is effective in primary prevention, potentially offering benefits before any skin cancer diagnosis is made.

“We're really hopeful that we can reduce the number of skin cancers that we see in the VA system.” 

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