Effect of high-dose intravenous vitamin C on inflammation in cancer patients

Abstract

Background: An inflammatory component is present in the microenvironment of most neoplastic tissues. Inflammation and elevated C-reactive protein (CRP) are associated with poor prognosis and decreased survival in many types of cancer.Vitamin C has been suggested as having both a preventative and therapeutic role in a number of pathologies when administered at much higher-than-recommended dietary allowance levels.Since in vitro studies demonstrated inhibition of pro-inflammatory pathways by millimolar concentrations of vitamin C, we decided to analyze the effects of high dose IVC therapy in suppression of inflammation in cancer patients.

Methods: 45 patients with prostate cancer, breast cancer, bladder cancer, pancreatic cancer, lung cancer, thyroid cancer, skin cancer and B-cell lymphoma were treated at the Riordan Clinic by high doses of vitamin C (7.5 g -50 g) after standard treatments by conventional methods.CRP and tumor markers were measured in serum or heparin-plasma as a routine analysis. In addition, serum samples were collected before and after the IVCs for the cytokine kit tests.

Results: According to our data positive response to treatment, which was demonstrated by measurements of C- reactive protein, was found in 75% of patients and progression of the inflammation in 25% of patients. IVC treatments on all aggressive stage cancer patients showed the poor response of treatment.There was correlation between tumor markers (PSA, CEA, CA27.29 and CA15-3) and changes in the levels of C-reactive protein.Our test of the effect of IVC on pro-inflammatory cytokines demonstrated that inflammation cytokines IL-1α, IL-2, IL-8, TNF-α, chemokine eotaxin and CRP were reduced significantly after treatments.

Conclusions: The high dose intravenous ascorbic acid therapy affects C-reactive protein levels and pro-inflammation cytokines in cancer patients. In our study, we found that modulation of inflammation by IVC correlated with decreases in tumor marker levels.In summary, our data support the hypothesis that high dose intravenous ascorbate treatments may reduce inflammation in cancer patients. Our results suggest that further investigations into the use of IVC to reduce inflammation in diseases where inflammation is relevant are warranted.

Figure 1

C-reactive protein levels after intravenous vitamin C treatments are compared to CRP levels before treatments. Data points (squares) under the diagonal line demonstrate a positive effect of treatment introducing CRP levels. Data points above the diagonal indicate CRP increases after treatment.

Figure 2

Tracking of CRP concentration (solid squares and curve) over time in a 67 year old subject with ductal carcinoma. The subject was given ten IVC treatments of 15 g (time of treatment indicated by open squares near the x axis) and eleven treatments of 50 g (indicated by open circles near the x axis). Treatments were typically given weekly. CRP concentration decreased from an initial value of 16 mg/L level to a final value of 5.5 mg/L after the last treatment.

Figure 3

Changes in PSA levels after IVC treatments are compared to PSA levels before treatments. Data points (squares) under the diagonal line demonstrate a positive effect of treatment in reducing PSA levels. Data points above the diagonal line indicate PSA increases after treatment.

Figure 4

(A, B) – Tracking of PSA levels (circles, squares and curve) over time in two subjects with prostate cancer. Subjects were given IVC treatments at times indicated by the open squares. Subject A: initial Gleason score = 4; treatments typically given monthly at doses of either 25 g (34 treatments) or 50 g (38 treatments); At maximum PSA values (~ 60 ng/mL) treatments were given weekly. PSA levels decreased from initial values of 10–60 ng/mL to final values of 1–2.4 ng/mL. Subject B: initial Gleason score = 6–9; treatments typically given weekly at doses of either 7.5 g (2 treatments) or 25 g (40 treatments); PSA levels decreased from maximum values of 1500 ng/mL to a final value of 7 ng/mL.

Figure 5

(A, B) - Tracking of PSA levels (solid circles and curve) over time in two subjects with prostate cancer. Subjects were given IVC treatments at times indicated by the open squares. Subject A: initial Gleason score =6; treatments typically given weekly or twice weekly at doses of 25 g; PSA levels decreased from initial values of 60 ng/ml to final values in the normal range. Subject B: initial Gleason score = 6 – 8; treatments typically given weekly or twice weekly at doses of either 25 g (140 treatments) or 50 g (7 treatments); PSA levels rose and fell during treatments, and then experienced a steep increase after treatment was discontinued.

Figure 6

Correlation between changes in CRP levels and changes in tumour markers after IVC therapy. Linear regression indicates a positive correlation (R² = 0.62) between changes in CRP and changes in the values of tumour markers PSA and CA 27.29. Data excluded several cases of aggressive tumours when the changes in CRP and tumour markers were higher than 300%.

Figure 7

Percentage of reduction in serum cytokine levels after IVC therapy. Data present the changes in the level of proinflamatory cytokines after treatment by single dosage of 50 g IVC (pre6/post6) and after 6 treatments by IVC with dosages 15 g-50 g (pre1/post6). In all cancer patients initial level of vitamin C in plasma was low (0.9-1.2 mg/dl) and increased to the levels 200–300 mg/dL after last IVC. In all cases, proinflammatory cytokine levels decreased during IVC treatment.