Archive for the ‘Vitamin C’ Category

High Doses of Antioxidants Including Vitamin C Do Not Decrease the Efficacy of Chemotherapy by Abram Hoffer, M.D., Ph.D.

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Posted 21 Jun 2011 — by James Street
Category antioxidants, Chemotherapy, Vitamin C

(For a 2008 update on this important topic: http://www.doctoryourself.com/chemovitC.html )

Reprinted with permission of the author and the Townsend Letter for Doctors and Patients, 911 Tyler Street, Pt. Townsend WA 98368;             (360) 385-6021 begin_of_the_skype_highlighting (360) 385-6021 end_of_the_skype_highlighting

The idea that the use of antioxidants decreases the efficacy of chemotherapy is being used more and more by orthodox oncologists. It is based upon their hypothesis that anything which decreases the oxidant effect of drugs will decrease the efficacy of chemotherapy. More and more I hear this from my patients after they are diagnosed and chemotherapy is discussed with them by their oncologists. This opinion is not universal, but my guess is that about 75% of oncologists hold this view.

Their view is that chemotherapy destroys tumor tissue because it introduces powerful oxidation products, free radicals, and that anything which decreases that must interfere with treatment. They know they are using sub-lethal amounts of toxic compounds which would never pass FDA standards in any different context. The aim is to kill all the tumor tissue without killing all the other tissues in the body. This is always a close call. Therefore, since vitamin C is a good antioxidant it must not be given with chemotherapy. One of my patients was told by his oncologist that if he took vitamin C he would not be given any chemotherapy.

Well, what are the facts? The first fact is that there are no clinical series which show that patients given vitamin C and chemotherapy fare worse than those not given this vitamin. On the contrary, all the published series show just the opposite. I have treated over 1,100 cases with large doses of vitamin C and most of them had chemotherapy.(1-4) I have examined the follow up data and find that the mean difference on prolongation of life was heavily in favor of the use of the vitamins. In the first series I published with Linus Pauling those patients on my program lived 10 to 20 times as long as the patients not receiving the vitamin.

Recently Kedar N. Prasad et al. (5) after reviewing 71 scientific papers, found no evidence that antioxidants did interfere with the therapeutic effect of chemotherapy and, on the contrary, suggest the hypothesis that it would increase the efficacy. He is properly cautious, but anyone reading his paper knows that it is clear the probability that these antioxidants prevent the therapeutic activity of chemotherapy is very low, and the probability that they do the opposite, i.e enhance the action of these toxic drugs, is relatively high. Prasad et al. (6) concluded, “Antioxidants such as retinoids, vitamin E, vitamin C and carotenoids inhibit the growth of cancer cells. These antioxidants individually, and in combination, enhance the effects of x-irradiation, chemotherapeutic agents, and certain biological response modifiers such as hyperthermia, sodium butyrate and interferon, on cancer cells. Antioxidants individually protect normal cells against some of the toxicities produced by these therapeutic agents. Therefore, the fear of oncologists and radiation therapists that these antioxidants may protect cancer cells against free radicals that are generated by these agents is unfounded. It should be pointed out that other antioxidants such as sulfhydryl compounds will protect cancer cells at least against radiation damage. This is not true for any of the proposed antioxidant vitamins and carotenoids.”

Even earlier Charles B. Simone et al. (7) on the basis of a large number of clinical studies (he also examined 71 scientific papers) came to the same conclusion. He reported, “In a recent study of 50 patients with early-stage breast cancer I evaluated the treatment side effects of radiation alone, or radiation combined with chemotherapy, while the patients took therapeutic doses of nutrients. Patients also followed the Simone Ten Point Plan. Patients were asked to evaluate their own response to the treatment in terms of its impact on their quality of life. The results of the study were impressive: “More than 90% of both groups noted improvement in their physical symptoms, cognitive ability, performance, sexual function, general well-being and life satisfaction. Not one subject in either group reported a worsening of symptoms.” He concluded, “…cancer patients should modify their lifestyles using the Ten Point Plan, which included modifying nutritional factors and taking certain vitamins and minerals especially if they are receiving chemotherapy, and/or radiation.” (my emphasis)

Labriola et al. (8) concluded that vitamin C may prevent the therapeutic effect of chemotherapy if given concurrently and recommended that antioxidants be withheld until after the chemotherapy is completed. It is not clear whether they meant that the antioxidants should be withheld throughout the entire series of chemotherapy sessions or that it should be withheld only for the day that chemotherapy is being given. If the latter is his suggestion, there is no harm done to the patients. Most of them cannot take anything, including vitamins, during these sessions. He based his conclusion on one case which suggested this had happened and upon a hypothetical examination of the role of free radicals and antioxidants on the action of chemotherapy on cancer cells.

His report elicited two rebuttals, Reilly (9) and Gignac. (10) I will not repeat the arguments, but it was evident that Dr. Labriola was not convinced by the points put forward by Reilly and Gignac. I think the factoid repeated by Dr. Labriola would have a much better chance of becoming a fact if he had considered the following points:

ONE:  What is the therapeutic value of chemotherapy without any antioxidants? Even within the field of standard oncology there is a debate whether chemotherapy has any merit except for a small number of cancers (Moss). (11) Before one can claim that a treatment has been inhibited, surely there must be pretty good evidence that the treatment has any merit to begin with. It is possible (we do not know the probability for this) that chemotherapy interferes with the therapeutic value of the antioxidants. Almost all the studies testing large doses of vitamin C yielded positive results while there is no such unanimity with respect to chemotherapy.

TWO: The difference between possibility and probability. Most people do not distinguish between these two. Theoretically anything is possible, and it is certainly possible that taking vitamin C might prevent the toxic “beneficial” effect of chemotherapy. In the same way when one buys a lottery ticket, it is possible they may win. People confuse these two terms, which is why lotteries are so popular. The real statistic is the probability. What is the probability that patients receiving vitamin C during their chemotherapy will not fare as well? The lottery ticket may give one a probability of winning of one in a million, and the possibility that vitamin C may prevent the therapeutic effect of chemotherapy may be equally low. We can only assume from the literature reviewed by Simone, by Prasad, by Lamson and Brignall, and more recently by Moss (12) that the real probability must be extremely low. As I have pointed out earlier, I have seen no evidence that adding vitamin C inhibited the therapeutic effect of chemotherapy. Just the opposite. Patients on my orthomolecular program live substantially longer and about 40% achieved over four year cure rates.(13)

THREE: If he had not tried to bolster his argument by referring so frequently to the peer-reviewed journal in which his paper appeared. This is certainly no guarantee of fact. The first factoid that vitamin C caused kidney stones appeared in eminently peer-reviewed journals. All the factoids regarding vitamins appeared first in peer-reviewed journals. You may recall Linus Pauling’s joke that peers are people who pee together. I can assure you that articles attacking the use of vitamins have very ready access to peer-reviewed journals, but they would not have accepted their report had they tried to conclude from one patient that vitamin C taken during chemotherapy was therapeutic. This would not even be sent to the peer review committee because they do not accept anecdotes – unless of course they become scientific when they contain something adverse against vitamins.

FOUR: Moss points out that oncologists have no objection to using xenobiotic antioxidants during chemotherapy. This includes Amifostine which decreases the toxicity of radiation but is too toxic on its own and is not used; Mesna, a drug used around the world to protect against the toxic side effects of ifosfamide which damages the urinary system; and Cardiozane, which counters Adriamycin’s toxicity. There are over 500 papers showing the safety of the latter drug. In one clinical trial using a drug similar to Adriamycin, one-quarter of the patients suffered damage to their hearts. When given Cardiozane concurrently only 7% did. Thus it appears that only orthomolecular or natural antioxidants are potentially dangerous. Synthetic antioxidants protect against the toxic effect of drugs but do not increase their therapeutic value. In sharp contrast, natural antioxidants not only protect against the toxic effect of drugs but also increase their efficacy in destroying cancer cells.

FIVE: Dr. Labriola emphasizes that long term studies must be used. I agree, and for this reason I followed up my patients since 1977. In my series, hardly any patients receiving chemotherapy but not antioxidants survived very long. But chemotherapy is used by many oncologists who know it will not extend life, because there is nothing else that they can do and they feel they have to do something.

A. Hoffer MD PhD

References
1. Hoffer A & Pauling L: Hardin Jones biostatistical analysis of mortality data for cohorts of cancer patients with a large fraction surviving at the termination of the study and a comparison of survival times of cancer patients receiving large regular oral doses of vitamin C and other nutrients with similar patients not receiving those doses. J Orthomolecular Medicine 5:143-154, 1990. Reprinted in, Cancer and Vitamin C, E Cameron and L Pauling, Camino Books, Inc. P.O. Box 59026, Phil. PA, 19102, 1993.

2. Hoffer A & Pauling L: Hardin Jones biostatistical analysis of mortality data for a second set of cohorts of cancer patients with a large fraction surviving at the termination of the study and a comparison of survival times of cancer patients receiving large regular oral doses of vitamin C and other nutrients with similar patients not receiving these doses. J of Orthomolecular Medicine, 8:1547-167, 1993.

3. Hoffer A: Orthomolecular Oncology. In, Adjuvant Nutrition in Cancer Treatment, Eds. P Quillin & RM Williams. 1992 Symposium Proceedings, Sponsored by Cancer Treatment Research Foundation and American College of Nutrition. Cancer Treatment Research Foundation, 3455 Salt Creek Lane, Suite 200, Arlington Heights, IL 60005-1090, 331-362, 1994.

4. Hoffer A. One Patient’s Recovery From Lymphoma. Townsend Letter for Doctors and Patients #160:50-51, 1996.

5. Prasad KN, Kumar A, Kochupillai V & Cole WC. High Doses of Multiple Antioxidant Vitamins: Essential Ingredients in Improving the Efficacy of Standard Cancer Therapy. Journal American College of Nutrition 18:13-25, 1999.

6. Prasad KN, Cole WC & Prasad JE. Multiple Antioxidant Vitamins as an Adjunct to Standard and Experimental Cancer Therapies. Z.Onkol/J. of Oncol 31:1201-1078, 1999.

7. Simone CB, Simone NL & Simone CB. Nutrients and Cancer Treatment. International Journal of Integrative Medicine 1:20-24, 1999.

8. Labriola D & Livingston R. Possible Interactions Between Dietary Antioxidants and Chemotherapy. Oncology 13:1003-1008, 1999, and Editorial to Townsend Letter for Doctors and Patients, November 1999.

9. Reilly P. Dr. Labriola’s Editorial on Antioxidants and Chemotherapy, Townsend Letter for Doctors and Patients Feb/Mar 2000, 90-91.

10. Gignac MA. Antioxidants and Chemotherapy. What You Need to Know Before Following Dr. Labriola’s Advice. Townsend Letter for Doctors and Patients Feb/March 2000, 88-89.

11. Moss RW. Questioning Chemotherapy. Equinox Press, Brooklyn, New York.

12. Moss RW. Antioxidants Against Cancer. Equinox Presss Inc. Brooklyn, New York, 1999.

13. Hoffer A. Vitamin C and Cancer. Quarry Press, Kingston, ON 2000.

Chemotherapy Doesn’t Work, So Blame Vitamin C

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Posted 21 Jun 2011 — by James Street
Category Antioxidants, antioxidants, antioxidents, Chemotherapy, Vitamin C



FOR IMMEDIATE RELEASE
Orthomolecular Medicine News Service, October 7, 2008

(OMNS, October 7, 2008) When Memorial Sloan-Kettering Cancer Center announces that vitamin C may interfere with chemotherapy, the news media trumpet it far and wide. But before cancer patients throw away their vitamin C supplements, they need to know rest of the story.

Most of the media dutifully reported the researchers’ claim that the equivalent of 2,000 mg of vitamin C “blunted the effectiveness of the chemotherapy drugs.” But only some of the media included a study author’s incredible statement that “If you take an oral dose even as low as 100 milligrams a day” even “that could be harmful” during chemotherapy (1)

100 mg “could be harmful”? That’s the amount of vitamin C in a few glasses of orange juice. Something is very wrong here.

First of all, this research involved mice with implanted cancerous tumors; it was not a trial on cancer patients. A mouse study is a long way from a human clinical trial. This obvious difference was conceded by the study authors. However, there is a more subtle, and probably much more important factor they did not consider: all mice make their own vitamin C. Indeed, mice make quite a lot. Adjusted for body weight, mice synthesize the human body weight equivalent of approximately 10,000 milligrams of vitamin C each day. (2) Incredibly, sick mice make even more. Mice given transplanted tumors become sick mice.

Secondly, previous research has demonstrated that mice with cancer respond well to high-dose vitamin C therapy. One study found, “With an increase in the amount of ascorbic acid there is a highly significant decrease in the first-order rate constant for appearance of the first spontaneous mammary tumor. . . Striking differences were observed between the 0.076% ascorbic acid and the control groups, which synthesize the vitamin.” (3) Another study concluded that: “A pronounced effect of vitamin C in decreasing the incidence and delaying the onset of malignant lesions was observed with high statistical significance. By 20 weeks, approximately five times as many mice had developed serious lesions in the zero-ascorbate as in the high-ascorbate group.” (4) Interestingly enough, when this research was first publicized, the media discounted these findings saying that mouse studies were not particularly applicable to people.

Thirdly, a mouse’s ability to make vitamin C, and a great deal of it, is an overlooked confounding factor that may well render the entire experiment invalid. If the Sloan-Kettering team had tried their experiment on Guinea pigs, their results might have been very different. Guinea pigs are more like human beings in that they cannot make their own vitamin C. As controls for comparison, the researchers also treated “no-added-vitamin C” mouse cancers with chemotherapy. Chemo worked just fine on those mice, by the researchers own admission. And each of those mice was internally synthesizing a body weight equivalent of 10,000 mg/day of vitamin C, even though given none supplementally.

So how come 10,000 mg of vitamin C does not interfere with chemo treatment, and 2,000 mg – or even 100 mg – supposedly does?

A sweeping recommendation warning cancer patients to not take supplemental vitamin C, not even 100 mg, is irresponsible. It is impossible to justify caution about taking 100 mg of vitamin C daily when your animal subjects made the equivalent of one hundred times that amount, and chemotherapy in them was still reported as effective. You cannot have it both ways. If a synthesized 10,000 mg of C does not interfere, there can be no real “interference” or “blunting” from a supplemental 2,000 mg. And most certainly not from 100 mg.

The study did report tumor shrinkage, in both groups of mice receiving chemo. That is not surprising. Chemotherapy’s claimed success is based on tumor shrinkage. But tumor shrinkage, encouraging though it is, is not a reliable indicator of long-term cancer survival. As cancer research critic Philip Day puts it, many patients are “cured but dead” after five years, hardly a long-term survival. Day, noting that this is not because oncologists are not trying, explains the chemotherapy quandary: “You can be insincere, or you can be sincerely wrong.” (5)

The Sloan-Kettering study team seems to have missed the essential point that vitamin C is not just an antioxidant. Inside cancer tumors, it also acts as a prooxidant, killing malignant cells. Comments Dr. Steve Hickey, of Manchester, UK: “Essentially, the paper seems to be rather misguided and shows a lack of understanding of the dual nature of vitamin C in tumors. Chemotherapy has been shown by over 40 years of clinical trials not to work in the majority of tumors, and its use is counterproductive.”

Chemotherapy drugs have come and gone; the five year survival rate for cancer treated with chemo has remained virtually unchanged for decades. Unfortunately, just over 2% of all cancers respond to chemotherapy. Specifically, one scientific review concluded, “The overall contribution of curative and adjuvant cytotoxic chemotherapy to 5-year survival in adults was estimated to be 2.3% in Australia and 2.1% in the USA . . . chemotherapy only makes a minor contribution to cancer survival. To justify the continued funding and availability of drugs used in cytotoxic chemotherapy, a rigorous evaluation of the cost-effectiveness and impact on quality of life is urgently required.” (6)

Perhaps this new, very well-publicized study results from an ever-growing realization that chemotherapy is largely ineffective, and the search is on for the reason why. Vitamin C should not be made the scapegoat.

Vitamin C, in doses well over 100 mg/day, is known to help prevent cancer. (7) Nearly 30 years ago, a review concluded that “Many factors involved in host resistance to neoplasia are significantly dependent upon the availability of ascorbate.” (8) Beginning in the 1970s, many well-designed studies show that very large doses of vitamin C improve both quality and length of life for cancer patients since they invariably are “significantly depleted of ascorbic acid.” When given intravenous vitamin C, “The mean survival time is more than 4.2 times as great for the ascorbate subjects . . . This simple and safe form of medication is of definite value in the treatment of patients with advanced cancer.” (9) Additional clinical trials have confirmed this over the past several decades. (10)

Even more importantly, recent research indicates that in high doses, vitamin C is selectively toxic to cancer cells. That means vitamin C can function very much like chemotherapy is supposed to, but without the severe side effects of chemotherapy. “A regimen of daily pharmacologic ascorbate treatment significantly decreased growth rates of ovarian, pancreatic, and glioblastoma tumors established in mice. Similar pharmacologic concentrations were readily achieved in humans given ascorbate intravenously.” (11)

“Cautioning” the public to avoid taking any supplemental amount of vitamin C will decrease host resistance to cancer, increase the incidence of this dreaded disease, and shorten survival times. A cynic might say it will also create a larger market for chemotherapy.

Is vitamin C a commercial competitor for chemo? To answer this, one needs to consider what appears to be serious conflict of interest at Sloan-Kettering. Bristol-Myers-Squibb makes chemotherapeutic drugs. According to a DEF 14A SEC filing of March 22, 2006, the Chairman of the Board of Bristol-Myers-Squibb is also a director of the Coca-Cola Company, and Honorary Chairman of Memorial Sloan-Kettering Cancer Center. (http://sec.edgar-online.com/2006/03/22/0001193125-06-060566/Section8.asp). A previous Bristol-Myers-Squibb Chairman of the Board was a director of the New York Times Company. He was also Vice Chairman of the Board of Overseers and the Board of Managers of Memorial Sloan-Kettering Cancer Center and Chairman of the Board of Managers of Sloan-Kettering Institute for Cancer Research. (http://www.secinfo.com/dsvrt.bC7.htm) Some sources say that there are even more Bristol-Myers-Squibb directors who have or held positions on the board at Memorial Sloan-Kettering Cancer Center. (12)

Positive endorsements for vitamin C as a cancer fighter are not in the interests of any pharmaceutical company. Scaring the public away from vitamin C might be profitable. It appears that Sloan-Kettering is biased. So are media reports that attack vitamins.

If the Sloan-Kettering study authors’ recommendations to not take 2,000 mg, or even 100 mg, of vitamin C are followed, there will definitely be an increase in the number of people that need chemotherapy.

References:

(1) Doheny K. Vitamin C and chemotherapy: bad combo? Supplementing with vitamin C may reduce effectiveness of chemotherapy drugs, study shows. WebMD Health News. http://www.webmd.com/cancer/news/20081001/vitamin-c-chemotherapy-bad-combo

(2) Chatterjee IB, Majumder AK, Nandi BK, Subramanian N. Synthesis and some major functions of vitamin C in animals. Ann N Y Acad Sci. 1975 Sep 30;258:24-47.

(3) Pauling L, Nixon JC, Stitt F et al. Effect of dietary ascorbic acid on the incidence of spontaneous mammary tumors in RIII mice. Proc Natl Acad Sci U S A. 1985 Aug;82(15):5185-9.

(4) Pauling L. Effect of ascorbic acid on incidence of spontaneous mammary tumors and UV-light-induced skin tumors in mice. Am J Clin Nutr. 1991 Dec;54(6 Suppl):1252S-1255S. Read the full paper free of charge at http://www.ajcn.org/cgi/reprint/54/6/1252S

(5) Day P. in the documentary film Food Matters, http://www.foodmatters.tv See also: Day P. Cancer: why we’re still dying to know the truth. Credence Publications, 1999. ISBN-10: 0953501248; SBN-13: 978-0953501243

(6) Morgan G, Ward R, Barton M. The contribution of cytotoxic chemotherapy to 5-year survival in adult malignancies. Clin Oncol (R Coll Radiol). 2004 Dec;16(8):549-60.

(7) Enstrom JE, Kanim LE, Klein MA. Vitamin C intake and mortality among a sample of the United States population. Epidemiology. 1992 May;3(3):194-202.

(8) Cameron E, Pauling L, Leibovitz B. Ascorbic acid and cancer: a review. Cancer Res. 1979 Mar;39(3):663-81.

(9) Cameron E, Pauling L. Supplemental ascorbate in the supportive treatment of cancer: Prolongation of survival times in terminal human cancer. Proc Natl Acad Sci U S A. 1976 Oct;73(10):3685-9. Read the original paper at http://profiles.nlm.nih.gov/MM/B/B/K/Z/_/mmbbkz.pdf

(10) Murata A, Morishige F, and Yamaguchi H. Prolongation of survival times of terminal cancer patients by administration of large doses of ascorbate. International Journal of Vitamin and Nutrition Research Suppl., 23, 1982. p. 103-113. And: Null G, Robins H, Tanenbaum, M, and Jennings P. Vitamin C and the treatment of cancer: abstracts and commentary from the scientific literature. The Townsend Letter for Doctors and Patients, 1997. April/May. And: Vitamin C and cancer revisited. Proc Natl Acad Sci U S A. 2008 Aug 12;105(32):11037-8. Also: Riordan HD, Riordan NH, Jackson JA et al. Intravenous vitamin C as a chemotherapy agent: a report on clinical cases. Puerto Rico Health Sciences J, June 2004, 23(2): 115-118.

(11) Chen Q, Espey MG, Sun AY et al. Pharmacologic doses of ascorbate act as a prooxidant and decrease growth of aggressive tumor xenografts in mice. Proc Natl Acad Sci U S A. 2008 Aug 12;105(32):11105-9. See also: 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 May 22;104(21):8749-54. And: Chen Q, Espey MG, Krishna MC et al. Pharmacologic ascorbic acid concentrations selectively kill cancer cells: action as a pro-drug to deliver hydrogen peroxide to tissues. Proc Natl Acad Sci U S A. 2005 Sep 20;102(38):13604-9. And: Padayatty et al. Intravenously administered vitamin C as cancer therapy: three cases. Canadian Medical Association Journal, 2006. 174(7), March 28, p 937-942. http://www.cmaj.ca/cgi/reprint/174/7/937. Also: Riordan NH et al. Intravenous ascorbate as a tumor cytotoxic chemotherapeutic agent. Medical Hypotheses, 1995. 44(3). p 207-213, March.

(12) Moss R. Questioning Chemotherapy. Equinox Press, 1995. ISBN-10: 188102525X; ISBN-13: 978-1881025252. See also: The Cancer Industry. Equinox Press, 1996. ISBN-10: 1881025098; ISBN-13: 978-1881025092.

For more information:

Cameron E. and Pauling L. Cancer and vitamin C, revised edition. Philadelphia: Camino Books, 1993.

Hickey S and Roberts H. Cancer: nutrition and survival. Lulu Press, 2005. ISBN: 141166339X.

Hoffer A. Healing cancer: complementary vitamin and drug treatments. Ontario: CCNM Press, 2004. ISBN-10: 1897025114; ISBN-13: 978-1897025116.

For free access to an online archive of peer-reviewed, full-text nutrition therapy papers: http://www.orthomed.org/jom/jomlist.htm or http://orthomolecular.org/library/jom

Nutritional Medicine is Orthomolecular Medicine

Orthomolecular medicine uses safe, effective nutritional therapy to fight illness. For more information: http://www.orthomolecular.org

The peer-reviewed Orthomolecular Medicine News Service is a non-profit and non-commercial informational resource.

Editorial Review Board:

Damien Downing, M.D.
Harold D. Foster, Ph.D.
Steve Hickey, Ph.D.
Abram Hoffer, M.D., Ph.D.
James A. Jackson, PhD
Bo H. Jonsson, MD, Ph.D
Thomas Levy, M.D., J.D.
Erik Paterson, M.D.
Gert E. Shuitemaker, Ph.D.

Andrew W. Saul, Ph.D., Editor and contact person. Email: omns@orthomolecular.org