Comment; Linus Pauling received the Nobel Peace Prize for his work on structure and function of DNA. He spent the rest of his life studying Vitamin C, ascorbic acid. Primates cannot make their own Vitamin C; they must get it in their diet. It’s anti-cancer, anti-inflammatory, anti-histamine effects are remarkable. Inexpensive with a great safety profile, but underused.
This article reviews intravenous vitamin C (IV C) in cancer care and offers a rational approach to enable medical oncologists and integrative practitioners to safely provide IV C combined with oral vitamin C to patients. The use of IV C is a safe supportive intervention to decrease inflammation in the patient and to improve symptoms related to antioxidant deficiency, disease processes, and side effects of standard cancer treatments. A proposed rationale, together with relevant clinical safety considerations for the application of IV C in oncologic supportive care, is provided.
CONCLUSIONS
In doses up to 25 g, IV C can safely be used to treat presumptive ascorbate deficiency based on symptoms and could favourably affect clinical parameters such as inflammation, fatigue, and qol. Using a rational, evidence-based approach such as that presented in Table v, clinicians can safely provide IV C as supportive care to patients with cancer.
The potential synergy of IV C with chemotherapy or radiation treatment, and the effect on overall outcomes, including survival, of a combined treatment approach, warrant further study. Studies that have already explored the effects of IV C in supportive care have design flaws such as small sample sizes and lack of a control group; thus, future studies could add a placebo control in a parallel-arm or crossover design. Studies that include blood biomarkers are also needed. How long any potential effect of an individual IV C treatment lasts is unknown. Studies designed to test that factor could be useful in creating evidence-based guidelines for optimal or sustained improvement in qol. Studies measuring vitamin C status before and during standard-of-care treatment could elucidate whether ongoing or intermittent deficiencies exist and whether such deficiencies could be related to symptoms that affect qol. Additional research is needed to study the roles of IV C and oral ascorbate with respect to dose, metabolic clearance, and infusion time. The role of target vitamin C plasma levels in relation to objective treatment response in humans requires further investigation as well. Although caution is warranted with respect to the use of IV C with surgery, chemotherapy, and radiation in the curative setting, vitamin C is a low-cost, safe therapy for the supportive care setting that might be an effective tool for improved supportive care.
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