In Part 1 of this article, we took at look at the history of vitamin C use in cancer care. We noted that at least six clinical studies had reported a survival benefit for people diagnosed with advanced cancers who had received a combination of oral and intravenous vitamin C. Many of these patients also noted significant improvements in their energy levels, pain reduction, appetite, and other measures of quality of life.

The original protocol recommended by Dr. Linus Pauling and his Scottish colleague Ewan Cameron, MD, involved a 10-day course of IV vitamin C in which the vitamin was given as a slow-drip infusion of 10 grams sodium ascorbate. After this, vitamin C was given orally in the form of a syrup, at a dose of 2.5 grams every 6 hours for a total dose of 10 grams per day. This strategy enables patients to avoid the diarrhea that otherwise accompanies vitamin C doses in excess of 6 to 7 grams per day. Subsequent studies used oral and intravenous doses ranging from10 to 30 grams per day.

Since Pauling’s day, the recommended dose for IV vitamin C has steadily increased, and some physicians have observed some striking benefits. In the March 2008 issue of Puerto Rico Health Sciences Journal, researchers reported that, “only by intravenous administration, the necessary [vitamin C] levels to kill cancer cells are reached in both plasma and urine.” By giving the vitamin intravenously, one can readily achieve the blood levels (at least 20 mM) that have been reported to selectively kill tumor cells. In at least two clinical trials now in progress, scientists are trying to determine the safety, tolerability, best therapeutic dose, and other key aspects of using IV vitamin C.

Mainstream medical journals have documented the power and potential of this approach. In March 2006, the Canadian journal CMAJ (Canadian Medical Association Journal) told the story of three patients with advanced cancer who had received IV vitamin C. One was a 49-year-old man with “terminal” bladder cancer who had declined chemotherapy. Nine years after receiving the deadly prognosis, he was still alive and apparently free of cancer.

Another patient, a 66-year-old woman, had an aggressive lymphoma with an extremely poor prognosis. After IV vitamin C, her disease went into remission and she was alive and well 10 years later. In a third case, IV vitamin C was given to a 51-year-old woman with kidney cancer that spread to her lungs. Two years later, she had a normal chest X-ray, and a pathologist confirmed the findings.

Why did these patients succeed where others have not? It could be that the secret is in the dosage. Only two controlled clinical trials of vitamin C have been done, and both used oral vitamin C rather than the IV route. But oral doses can never achieve the high blood levels provided by IV methods, the levels necessary for killing cancer.

Reporting in the Proceedings of the National Academy of Sciences, Dr. Mark Levine of the National Institutes of Health has presented new evidence that taking vitamin C intravenously is necessary for achieving the desired blood levels. In five out of nine different cancer lines, Levine’s team found a 50% decrease in cell survival (with lymphoma cells being killed 100%), while normal cells were unaffected. The effective dose was around four millimoles, a concentration much higher than an oral dose but easily achievable with IV vitamin C.

Why is an intravenous infusion more likely to succeed than the oral method? Evidently, when you take vitamin C by mouth, your kidneys will get rid of vitamin C as fast as your gut can absorb it. With the IV approach, blood levels of the vitamin are immediately elevated, and it takes much more time for the kidneys to eliminate the excess. Thus, for a prolonged period, you’re able to expose cancer cells in your body to the levels that may ultimately make a difference.

Dr. Levine also confirmed that vitamin C is metabolized to hydrogen peroxide. Unlike normal cells, cancer cells lack the internal defenses to protect themselves from this highly unstable compound. As a result, they die. (Many chemotherapy agents operate, in part, through a similar mechanism. Green tea, resveratrol, and artemisinin may have similar effects; taken in combination, these natural agents may reach levels of peroxide lethal to malignant tumors.)

These days, IV vitamin C doses may range from 10 grams to as high as 300 grams per day (300,000 mg!), though most doses are in the range of 30 to 80 grams per day. The most widely used strategy is the one created by Dr. Hugh Riordan, a former colleague of Pauling’s and founder of the Center for the Improvement of Human Functioning in Wichita, Kansas. In addition to vitamin C, the protocol includes certain other nutrients, such as alpha lipoic acid. Most clinics charge between $100 and $150 per treatment.

If you have cancer, talk to a nutrition-savvy physician about IV vitamin C. Preliminary reports from a clinical trial in Kansas City indicate that giving IV vitamin C prior to chemotherapy can dramatically reduce the toxicity of those treatments while bolstering the tumor-killing impact of the chemo. Dr. Levine’s most recent clinical report, published in the June 25th issue of the Annals of Oncology, suggests that the combination of chemotherapy or other therapies with IV vitamin C may be critical to achieving therapeutic success in advanced cancer cases.

Sources:

Duconge J, Miranda-Massari JR, Gonzalez MJ, Jackson JA, Warnock W, Riordan NH. Pharmacokinetics of vitamin C: insights into the oral and intravenous administration of ascorbate. P R Health Sci J. 2008;27(1):7-19.

González MJ, Miranda-Massari JR, Mora EM, Guzmán A, Riordan NH, Riordan HD, Casciari JJ, Jackson JA, Román-Franco A. Orthomolecular oncology review: ascorbic acid and cancer 25 years later. Integr Cancer Ther. 2005;4(1):32-44.

Riordan HD, Riordan NH, Jackson JA, Casciari JJ, Hunninghake R, González MJ, Mora EM, Miranda-Massari JR, Rosario N, Rivera A. Intravenous vitamin C as a chemotherapy agent: a report on clinical cases. P R Health Sci J. 2004;23(2):115-8.

Padayatty SJ, Riordan HD, Hewitt SM, Katz A, Hoffer LJ, Levine M. Intravenously administered vitamin C as cancer therapy: three cases.CMAJ. 2006;174(7):937-42.

Chen Q, Espey MG, Sun AY, et al. Ascorbate in pharmacologic concentrations selectively generates ascorbate radical and hydrogen peroxide in extracellular fluid in vivo. Proc Natl Acad Sci U S A. 2007;104(21):8749-54.

Hoffer LJ, Levine M, Assouline S, et al. Phase I clinical trial of i.v. ascorbic acid in advanced malignancy. Ann Oncol. 2008 Jun 25.

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