En excerpt from the book :
IN CANCER THERAPY"
by Ross, R.Ph. Pelton, Lee Overholser
IN THE 1970s Dr. Ewan Cameron and two-time Nobel Prize winner Dr. Linus Pauling published Cancer and Vitamin C, which proposed that taking regular high doses of vitamin C can play a part both in the prevention of cancer and in the treatment of an established cancer. Evidence is steadily accumulating to support this view. (13)
Pauling and Cameron do not believe that vitamin C is a primary cancer therapy. Instead, it should be used as an adjunct to other types of therapy, either conventional or alternative. They summarize:
There is good reason to believe that the most important factor in determining the progress and outcome of any cancer illness is the natural resistance of the patient to his disease. The results of standard cancer treatments would be vastly improved if safe methods could be devised to enhance this natural resistance. Evidence shows that increasing the intake of vitamin C (ascorbic acid, sodium ascorbate, calcium ascorbate) does exert this effect. Cancer patients taking vitamin C report an improved appetite, increased mental alertness, and a decrease in pain and the need for pain-controlling drugs. (11)
Vitamin C 55
Vitamin C works in several ways to support the patient's natural defense against cancer. It supports the encapsulation, or sealing off, of tumors; resists metastasis, or spreading of the cancer; reduces cachexia, or severe weight loss; enhances the immune system; and improves overall health. (13)
In the 1960s Dr. Cameron began studying the process of uncontrolled invasiveness in tumor growth. He started to look for ways to inhibit cancer cells from infiltrating and damaging surrounding normal tissue and from metastasizing to distant organs. His work led him to study the intercellular cement (also called the ground substance) that binds the cells of normal tissues together. In his book Hyaluronidase and Cancer of 1966, Cameron contended that a strengthening of the ground substance could increase the resistance of normal tissues surrounding a malignant tumor against infiltration by the tumor. (3)
The intercellular cement contains long molecular chains, called glycosaminoglycans, which give it strength. Its structure also includes filaments of the protein called collagen, which further strengthens the cement, in much the same way that steel rods strengthen reinforced concrete.
Cameron pointed out that malignant tumors liberate an enzyme named hyaluronidase, which cuts the glycosaminoglycans into smaller molecules, thus weakening the cellular cement. Also some, and possibly all, malignant tumors liberate another enzyme, collagenase, which breaks up the collagen fibers. The activity of the two enzymes makes it easier for the malignant tumor to grow into the surrounding tissues.
If the tumor enzymes that cause a breakdown of the intercellular cement could be inhibited, this might stop cancers from invading and destroying bodily tissues and organs. No one had found a way of doing this until 1971, when two new ideas, both involving vitamin C, were put forth.
Mechanism of Action
Drs. Cameron and Douglas Rotman found that increased vitamin C stimulates normal cells to produce increased amounts of a substance called hyaluronidase inhibitor. This combines with the hyaluronidase that is liberated by cancer cells and prevents it from breaking down the intercellular cement. (14) Also in 1971, Dr. Pauling discovered that vitamin C is required for the synthesis of collagen. Therefore increasing the intake of vitamin C might cause more collagen fibers to be made, further strengthening the intercellular cement. (26)
Dr. Pauling wrote to Dr. Cameron, suggesting that doses of 10 grams of vitamin C per day could be given to advanced cancer patients. At the time Dr. Cameron was a surgeon at Vale Hospital in Loch Lomondside, Scotland. In November 1971, Cameron began clinical trials giving vitamin C to patients with advanced cancer. Conventional treatment had already failed for these patients, and they were classified as "untreatable."
Several of these first patients exhibited an almost unbelievable response to supplemental vitamin C, regaining energy, returning to work, showing remarkable physical well-being, and far outliving their expected life span. Virtually every patient reported feeling much better and much stronger. (9) The experiences of his first few brave patients led Dr. Cameron to believe that vitamin C therapy was doing something that was not yet understood, but very significant.
Vitamin C and Carnitine
It was not until some ten years later that Cameron came across the work of Dr. R. E. Hughes on scurvy, which is the classical syndrome that accompanies severe vitamin C depletion. Scurvy produces extreme physical weakness and exhaustion, along with other unpleasant symptoms, such as tooth loss.
Hughes discovered that vitamin C is an essential co-factor for the biosynthesis ofcarnitine. Carnitine's only known function is the transport of fatty acids across the mitochondrial membranes of all cells so that they can be oxidized for the production of energy. (21)
Guinea pigs, like humans, do not have the ability to produce their own vitamin C. Hughes was able to show that guinea pigs deficient in vitamin C also have very low muscle carnitine levels.
It has been well documented that cancer patients have very low body reserves of vitamin C. (13) Dr. Cameron hypothesized that cancer patients would also have a greatly reduced ability to synthesize their own muscle carnitine. (4, 5) He hypothesized that "this is the clear biochemical explanation for cancer cachexia, the systemic syndrome of progressive muscular weakness, muscle wasting, steady weight loss, increasing apathy, lassitude and fatigue, even constipation, that accompanies every advanced cancer illness." (7)
Vitamin C and the Immune System
It is generally accepted that the immune system plays an important part in an individual's resistance to cancer. Also, standard tests show that many cancer patients tend to have decreased immunocompetence. There is substantial evidence that vitamin C is essential for the immune system to function efficiently. (16)
The natural killer (NK) cells are the most important cells in our immune system in the battle against cancer, because they attack and destroy abnormal cells. It has been shown that NK cells are active only if they contain relatively large amounts of vitamin C. (31)
Cancer patients given 5 grams of vitamin C orally on three consecutive days experienced a doubling in the number of lym-phocytes in their bloodstream and continued high levels for another week. A dose of 10 grams per day caused this rate to triple, and a dose of 18 grams per day caused the production of lym-phocytes to increase to four times the original value. (30) This study indicates that a high intake of vitamin C by cancer patients may very well increase the effectiveness of their body's immune system in the fight against cancer.
PGE1, a member of the group of chemicals called the pros-taglandins, plays a major role in the regulation of lymphocyte function. The production of PGE1 is dependent upon vitamin C. (20) Vitamin C has also been shown to increase the body's production of interferon, which has shown anticancer activity. (27)
Encapsulation of Tumors
Adequate levels of vitamin C must be available for the body to encapsulate a tumor. Tumor encapsulation is a complex process involving a number of factors; one of these is the localized production of collagen fibers, which encapsulate and imprison tumor cells. (13) The synthesis of collagen for encapsulation is dependent on the body's available supply of vitamin C. (26)
Vitamin C's ability to stimulate the synthesis of collagen explains why vitamin C helps promote wound healing. Well-informed surgeons add 5 grams or more of sodium ascorbate to each liter of intravenous fluid, in addition to giving the patient supplemental vitamin C before and after surgery. (13)
Extra vitamin C given to a patient undergoing surgery for cancer has the added benefit of stimulating the immune system. It may enable NK cells to destroy any wandering malignant cells that might be released into the bloodstream during the operation, thus decreasing the chance of future metastasis.
Vitamin C and Radiation
A paper published in 1978 indicates that vitamin C could radio-sensitize certain tumor cells and potentially enhance the effects of radiation. (22) Dr. Paul Okunieff, associate professor of radiation medicine at Harvard University Medical School, has recently reported that vitamin C can enhance the effectiveness of radiation therapy by protecting healthy tissue. When laboratory animals were given vitamin C prior to radiation, there was a significant reduction in the radiation damage to both the exposed skin and the bone marrow. (25)
Vitamin C and Chemotherapy
Vitamin C has been shown to enhance the anticancer activity of some chemotherapeutic drugs, including adriamycin. (29) Adria-mycin is a potent chemotherapeutic drug that frequently produces severe side effects. At a recent vitamin C symposium, Dr. Kan Shimpo presented research describing a significant reduction in adriamycin-induced toxicity to the heart, along with a prolongation in survival time in animals receiving vitamin C, without diminishing the antitumor effect of the drug. (18) Dr. Shimpo has suggested that vitamin C should be tried in clinical trials in patients treated with adriamycin.
Vitamin C: A Powerful Antioxidant
It is well established that free-radical activity can cause cancer. Vitamin C has been shown to be one of the body's most effective antioxidant agents. It can act directly by destroying free radicals and indirectly by restoring the antioxidant properties of vitamin E.(l)
At the National Cancer Institute's symposium on vitamin C and cancer, Dr. Balz Frei presented his recent work, in which he exposed human blood plasma to various types of cancer-causing chemicals, including cigarette smoke. Dr. Frei found that no cancer-causing activity, like lipid peroxidation of cellular membranes, could be detected in the human blood plasma as long as adequate vitamin C was present. Yet as soon as the vitamin C was depleted, the cancer-causing chemical reactions began again. (18)
Clinical Studies and Controversy
The early studies published by Cameron and Pauling on the use of vitamin C in cancer patients have generated one of the most famous controversies in the history of medical science. Cameron and Pauling initially published several studies showing that terminal cancer patients receiving high doses of vitamin C survive almost twice as long as controls, with a substantially improved quality of life. (10, 12, 15)
Due to widespread interest among cancer patients, the National Cancer Institute (NCI) funded what eventually turned out to be a series of three randomized trials, which have come to be known as the Moertel studies. The primary objective of these studies was to confirm or disprove Cameron and Pauling's assertion that advanced cancer patients treated with high doses of vitamin C would live longer than controls and realize a substantial improvement in their quality of life.
Dr. Pauling indicated his willingness to consult on the protocol and design for the first of these studies. Instead, Moertel and his colleagues ignored his offer. Dr. Pauling learned that the study was completed when he read headlines announcing the "Failure of High-Dose Vitamin C (Ascorbic Acid) Therapy to Benefit Patients with Advanced Cancer." (17) Cameron and Pauling both vigorously questioned these results. They pointed out major flaws in the Moertel studies, such as the selection of patients (nearly 90 percent) who had previously been aggressively treated with chemotherapy.
Subsequently two more Moertel studies were conducted. Each of these trials has also been strongly criticized for improper patient selection, administering the vitamin C orally instead of intravenously, lack of testing for compliance, shorter duration of treatment, and return of the patients to chemotherapy.
In one of these studies, patients were abruptly taken off vitamin C, which probably caused a rebound effect that hastened their demise. People who are taking high levels of vitamin C can experience symptoms of vitamin C deficiency if they suddenly decrease their dosage level.
One can only wonder why so much time and money were spent to test the Cameron/Pauling claims without giving proper attention to following their exact protocols.
At about the same time that the Moertel/Mayo Clinic studies were claiming to disprove the Cameron and Pauling research,Morishige and Murate published a study of terminal Japanese cancer patients who were treated with vitamin C. These patients survived almost five times longer than the controls, and the authors of the study stated that their study "may be considered to substantiate the observations reported by Cameron and Pauling." (24)
The NCI Symposium
In September 1989 the NCI and the National Institute of Diabetes and Digestive and Kidney Diseases co-sponsored a major conference on the relation between vitamin C and cancer. (18) Dr. Linus Pauling gave the opening talk at this three-day conference, and was acknowledged for his continuing efforts in the field.
Perhaps the most important aspect of the conference is that the NCI, after years of ignoring the subject, now seems to acknowledge the link between vitamin C and cancer. In a review of this symposium, Dr. Samuel Broder, director of the NCI, acknowledged that vitamin C may well be of value in preventing cancer and as an adjunct in cancer treatment. (18)
A summary of study results on vitamin C and cancer in humans by Gladys Block, M.D., has impressed many in the field of cancer research. She is an epidemiologist in the Division of Cancer Prevention and Control at NCI, and when a respected scientist like Dr. Block presents a conclusion, other researchers take notice. Her summary presented exciting evidence that vitamin C has a protective effect in cancers of the lung, larynx, oral cavity, esophagus, stomach, colon, rectum, pancreas, bladder, cervix, brain, endometrium, and breast. Out of a total of forty-six studies, thirty-three found that vitamin C had a protective, preventive effect for these cancer sites. (2)
Cameron and Pauling have stated, "It is our opinion that supplemental vitamin C is of some benefit to patients with all forms of cancer, and it is our belief that, in time, this simple and safe form of supportive treatment will become an accepted part of all regimes for the treatment of cancer." (11)
Vitamin C in the Treatment of Cancer
In 1991 Dr. Cameron published a protocol for using vitamin C in the treatment of cancer. (8) Cameron stresses that this protocol, which has been developed over years of clinical experience, is both safe and effective. He states that it need not be followed "to the letter," but rather provides general guidance to physicians who are unfamiliar with this therapy.
The protocol recommends that all cancer patients receiving vitamin C supplementation be given an initial course of intravenous ascorbate, followed by a maintenance oral dose to be continued indefinitely thereafter. The importance of continuous as opposed to intermittent administration is emphasized.
According to Dr. Cameron, the best responses are obtained when a continuous high plasma ascorbate level is maintained. Since long-term intravenous administration is impractical, he recommends an initial ten-day intravenous course, followed by a continuous oral dose maintenance regime. (8)
Cameron and Pauling have always stressed that vitamin C is not to be substituted for conventional methods of cancer therapy, but is meant to be utilized as a complementary measure along with whatever other treatments are indicated.
Upon request, the Linus Pauling Institute in Palo Alto, California, will send out an international list of physicians who may be using intravenous vitamin C as an adjuvant therapy. However, the institute stresses that it does not provide specific physician referrals and is unable to give an opinion on the professional competence of any particular doctor on the referral list.
Vitamin C has remarkably low toxicity (23), but the following side effects should be mentioned. An overdose orally will produce temporary diarrhea. A small percentage of patients will experience gastric distress (gas and bloating) from high-dose vitamin C. Often switching the patient to the less acidic calcium ascorbate salt will alleviate this problem.
Occasionally transient fluid retention can result from sodium overload when IV sodium ascorbate is being given. Caution should be exercised in patients with concurrent cardiac impairment.
A very rare side effect, seen only in patients witKvery rapidly growing malignant tumors and a heavy tumor load, is\the sudden precipitation of widespread tumor necrosis. This rare complication can be fatal if not carefully treated. (8)
There is an unfortunate, erroneous widespread belief in the medical community that large intakes of vitamin C can cause kidney damage. Studies on healthy individuals ingesting large amounts of vitamin C for years have shown plasma and urinary oxalate levels to be well within the normal range. (28) Dr. Cam-eron reports that no instance of this complication has been encountered in over one thousand cancer patients under his care, or in many other patients ingesting multigram amounts of ascorbate for many years. (19)
The Rebound Effect
The ingestion or administration of high-dose vitamin C (as ascorbic acid or as one of the ascorbate salts) should never be discontinued abruptly. Certain enzymes that metabolize vitamin C become systemically conditioned to the higher intake of the vitamin. Abrupt cessation can cause a sudden drop in the blood level of vitamin C, producing the scorbutic symptoms referred to as the rebound effect. Although only a few anecdotal cases have been reported, the rebound effect could be much more important in a person fighting a serious illness like cancer. (6)
Oral vitamin C can be taken to what is called bowel tolerance. When the body's maximum saturation tolerance is reached, diarrhea results. The aim is to adjust the oral intake to a point just below the diarrhea point. The following general recommendations are summarized from the Linus Pauling Institute's protocol for oral vitamin C ingestion.
- Large amounts of vitamin C should be taken in divided doses throughout the day.
- Begin with 1 or 2 grams (equivalent to '/»to Vi teaspoonful) of pure crystalline vitamin C dissolved in juice or water.
- Increase the intake by 1 or 2 grams on each subsequent day until a laxative action develops. At this point, reduce the dose by 1 or 2 grams below this bowel tolerance level and maintain that dose thereafter.
Crystalline vitamin C can be obtained at reasonable cost as ascorbic acid or as the calcium and sodium ascorbate salts. See the appendix for a source of reliable, inexpensive supply.
It is important that vitamin C therapy be consistent and be maintained indefinitely, once the dose level is decided upon. If there should be any need to discontinue the therapy, it is important to decrease the dosage gradually to avoid the rebound effect.
It is estimated that at least one thousand cancer patients in the United States are currently taking various levels of vitamin C,