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Intravenously administered vitamin C as cancer therapy: three cases

From the Molecular and Clinical Nutrition Section, Digestive Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases (Padayatty, Katz, Levine), and the Laboratory of Pathology, Centers for Cancer Research, National Cancer Institute (Hewitt), National Institutes of Health, Bethesda, Md.; Lady Davis Institute for Medical Research (Hoffer), McGill University, Montréal, Que.; Bio-Communications Research Institute (Riordan) (deceased), Wichita, Kan.

Correspondence to: Dr. Mark Levine, Molecular and Clinical Nutrition Section, Bldg. 10, Rm 4D52–MSC 1372, National Institutes of Health, Bethesda MD 20892–1372; MarkL{at}mail.nih.gov

Early clinical studies showed that high-dose vitamin C, given by intravenous and oral routes, may improve symptoms and prolong life in patients with terminal cancer. Double-blind placebo-controlled studies of oral vitamin C therapy showed no benefit. Recent evidence shows that oral administration of the maximum tolerated dose of vitamin C (18 g/d) produces peak plasma concentrations of only 220 µmol/L, whereas intravenous administration of the same dose produces plasma concentrations about 25-fold higher. Larger doses (50–100 g) given intravenously may result in plasma concentrations of about 14 000 µmol/L. At concentrations above 1000 µmol/L, vitamin C is toxic to some cancer cells but not to normal cells in vitro. We found 3 well-documented cases of advanced cancers, confirmed by histopathologic review, where patients had unexpectedly long survival times after receiving high-dose intravenous vitamin C therapy. We examined clinical details of each case in accordance with National Cancer Institute (NCI) Best Case Series guidelines. Tumour pathology was verified by pathologists at the NCI who were unaware of diagnosis or treatment. In light of recent clinical pharmacokinetic findings and in vitro evidence of anti-tumour mechanisms, these case reports indicate that the role of high-dose intravenous vitamin C therapy in cancer treatment should be reassessed.

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