Intravenous vitamin C in cancer

Cell culture

There are many studies that look at vitamin C and its effects on cancer in a tissue culture. The concentrations of vitamin C used against cancer in tissue culture is achievable in humans, but only with intravenous dosing.

In 2008, the Journal of the Proceedings of the National Academy of Sciences reported on an experiment that showed that such intravenous levels could reduce tumor volumes by 41-53%. The effect was believed to be from hydrogen peroxide being formed and sustained in the tumors within 30 minutes of exposure.

Iron inside the cell is vital to the effect of hydrogen peroxide generation by the vitamin C. We also know from cell culture studies that we need to achieve 400 mg/dl of vitamin C in the blood to have an effect on cancer tissue cultures. This requires an intravenous dose of 60-75 grams (65000 - 75000 mg) per IV. Using oral lipoic acid 500 mg before the IV may lower the concentration needed to 1/4th the above, thus prolonging the effect of the IV.

Drawbacks: cell culture studies that used tumor models of a single layer of cancer cells were able to show 100% kill of cancer cells.

Unfortunately, when a hollow fiber model of cancer was used, 100% kill was not achievable, though reduction was. Because of this, and limited trials in humans, intravenous vitamin C for cancer should be considered palliative, or if used as active treatment, in conjunction with conventional therapy.

Human studies

Properly controlled human studies are lacking in intravenous vitamin C. There are abundant anecdotal reports (physician and patient reported) of both quality of life and increased life span / survival in cancer patients receiving vitamin C intravenously. As with any medication or intervention, anecdotal reports have limited use in evaluating a therapy for specific diseases.

Recently, a study that was conducted by McGill University and Jewish Hospital in Montreal used appropriately dosed intravenous vitamin C in advanced cancer patients who had failed conventional therapy. There was a trend to improved quality of life, but no effect on survival or cancer progression. Thus, intravenous vitamin C for cancer should be considered as palliative therapy, or as an adjunct (done in conjunction with) conventional therapy.

A study of 39 terminal cancer patients was done in Korea using small palliative doses (10 grams intravenously). The study found clear evidence of improved quality of life, with improved physical, cognitive, and emotional function. The patients also had significantly less fatigue, nausea, pain, and appetite loss. This study used 10 grams of intravenous vitamin C twice a week, with 4 g of vitamin C in divided doses orally every day.

Safety

Intravenous vitamin C has an excellent safety record.

The risks, as with any intravenous procedure, include infection, clotting and loss of the vein, infiltration (leakage) of fluid into the tissues around the needle site, bruising, and occasionally pain in arm. These are very rare.

Vitamin C is commonly believed to be associated with kidney stones.  A large study showed that patients who had the highest intakes of vitamin C had the lowest kidney stone risk. However, since it is intravenous dosing we are considering with the vitamin C, if there is a strong history of kidney stones a 24 hour urine test for oxalate excretion can be performed to assess any risk. B6 and magnesium, added to the IV, is reported to reduce kidney stone risk.

Side effects during administration are markedly low. At the higher doses, some patients may need to focus on drinking plenty of water (to prevent dehydration) and eating during treatment (to prevent low blood sugar).

Use with chemotherapy

Many oncologists are concerned that vitamin C may interfere with conventional radiation or chemotherapy. Their concerns lie in the belief that vitamin C always is an antioxidant, and radiation and chemotherapy act as oxidants to cause damage to cancer cells.

We know from published studies that intravenous vitamin C achieves concentrations that at the tissue level generate hydrogen peroxide, which is an oxidant. Negative reactions are thus unlikely.

We also know from tissue culture studies, that have looked at bathing cancer cells in different chemotherapy drugs with or without vitamin C that in fact, the vitamin C makes the chemotherapy more effective. Still, such studies are not done in humans but rather on tissue culture.

Intravenous vitamin C in cancer patients receiving chemotherapy is thus a personal choice. Many patients choose to receive vitamin C no closer than 2 days before the chemotherapy, so that all the vitamin C is cleared from the body prior to the chemotherapy. Others choose to wait until chemotherapy is on a rest cycle. If a patient is receiving radiation, there are studies that show ozone therapy would be a better choice than intravenous vitamin C; this is my preference as well.

Making the intravenous vitamin C more effective

Intravenous vitamin C works to form hydrogen peroxide in the presence of iron, and with adequate oxygen levels. Further, the vitamin C must be oxidized (used up in a reaction) in order to form the hydrogen peroxide. Theoretically, increasing oxidants (things that react with vitamin C) and oxygen prior to the intravenous vitamin C will make this treatment more effective. Thus, ozone therapy done immediately prior to the vitamin C can be considered. However, because this is a theoretical benefit, it should be weighed against increased time and cost.

Protocol:

Treatment of cancer with IAA should never be considered to replace an effective, proven treatment. It should only be considered in:

Cases of treatment failure using proven methods
cases with no known effective treatments;
and, cases in which it is used as an adjunct to proven treatments.

Labs:
CBC (complete blood count)
chemistry panel (assess liver, kidney, electrolytes)
ferritin (assess iron levels, as iron is needed for the vitamin C to be effective)
appropriate tumor markers (assess the treatment after 6 weeks)

Week 1: 1 x 25 g infusion per day, 2-3 per week
Week 2: 1 x 50 g infusion per day, 2-3 per week
Week 3: 1 x 75 g infusion per day, 2-3 per week

Rest one week, then repeat 3 weeks at 75 g infusion per day, 2-3 per week.