I.V. VITAMIN C

Recent studies demonstrate that vitamin C, infused intravenously, can achieve a plasma concentration high enough to exert cytotoxic effects on many types of cancer cells. Interestingly, vitamin C has both anti-oxidant and oxidant activities. At low to moderate dosage (achieved by taking Vitamin C orally), vitamin C is a potent antioxidant with important functions in immune response, wound healing and recycling of other antioxidants such as vitamin E. However at large dosage (achieved by taking Vitamin C intravenously), vitamin C can induce oxidative damages to cancer cell DNA, mainly through the increased production of hydrogen peroxides. This increase in oxidative stress preferentially induces cancer cells to undergo apoptosis (i.e. cell death) since cancer cells are relatively deficient in catalase, an enzyme that neutralizes hydrogen peroxide. Studies completed in Japan have successfully demonstrated that vitamin C infusion can enhance the therapeutic effects of chemotherapies.

I.V. vitamin C is usually given 3 times per week for at least 4 weeks, according to the following schedule:

Typical schedule	1st time	2nd time	3rd time
Week 1	15 gm	15gm	30 gm
Week 2	40 gm	40 gm	50 gm
Week 3	50 gm	50 gm	50 gm
Week 4	60 gm	60 gm	60 gm
Week 5 on	Varies depending on clinical presentations and lab workup

Note: This schedule is typical for a patient not currently on chemotherapy or radiation. Schedule and dosage may vary depending on clinical symptoms, lab and/or conventional treatment schedules.

SIDE EFFECTS/COMPLICATIONS:

A phase I study done at the University of Nebraska medical centre has shown no side effects or toxicities associated with intravenous vitamin C procedure. However, some relative contra-indications and potential side effects to be considered are:

• Rapid tumour necrosis, hemorrhage and subsequent death: very rare, but has been described by Campbell and Jack (Scot Med J 1979;24-p151). Small initial dosage and gradual increase is recommended according to the above schedule.
  
• Localized pain at the infusion site, which can be minimized with slow drip.
  
• Allergic reaction, including slow onset anaphylactic shock.
  
• G-6-phosphate deficiency: risk of hemolysis
  
• Kidney stones: relative contra-indication. The administration of magnesium and vitamin B6 inhibits the formation of kidney stones.
  
• Any condition which could be adversely affected by increased fluid (such as congestive heart failure) would be relatively contraindicated, due to the relatively large amount of fluid being used.