Abstract
High-dose intravenously administered vitamin C (IVC) is widely used in cancer patients by complementary and alternative medicine practitioners. The most frequent indications for IVC therapy result from the belief in its effectiveness as a potent anti-cancer agent which additionally enhances chemosensitivity of cancer cells and reduces chemotherapy-related toxicities and fatigue intensity. In this narrative review, we decided to deal with this issue, trying to answer the question whether there is any scientific evidence supporting the rationale for application of high-dose IVC therapy in advanced-stage cancer patients. Although results obtained from preclinical studies demonstrated that millimolar ascorbate plasma concentrations achievable only after IVC administration were cytotoxic to fast-growing malignant cells and inhibited tumor growth as well as prolonged the survival of laboratory animals, such positive effects were not found in human studies with advanced-stage cancer patients. We also have not found the rationale for the use of IVC to increase the effectiveness of chemotherapy and to reduce the chemotherapy-induced toxicity in the above mentioned group. Nevertheless, in palliative care, high-dose IVC might be considered as a therapy improving the quality of life and reducing cancer-related symptoms, such as fatigue and bone pain. However, because of the absence of placebo-controlled randomized trials on IVC efficacy in advanced-stage cancer patients, the placebo effect cannot be excluded.
Highlights
The discussion about the anti-cancer properties of vitamin C and its possible application in palliative care has been continued for over 50 years
(1.596 in a study group vs. 2.067 in the control group, p = 0.002), which proved the positive effect of vitamin C on patients’ functional status [105]. As it was shown in studies presented above, a positive effect on Cancer-related fatigue (CRF) can be more expressed in patients with basically better performance status and in patients with chemotherapyrelated fatigue, whereas CRF in advanced-stage cancer patients refractory to standard therapy with features of disease progression may benefit less or not at all from intravenous vitamin C (IVC) therapy
Results obtained from in vitro studies demonstrated that millimolar ascorbate plasma concentrations, achievable only after intravenous vitamin C (IVC) administration, were cytotoxic to the fast-growing malignant cells and enhanced anti-cancer effect of chemotherapeutic agents
Summary
The discussion about the anti-cancer properties of vitamin C and its possible application in palliative care has been continued for over 50 years. The most frequent questions asked by patients and their families to palliative medicine specialists concern the effectiveness of high-dose IVC as anti-cancer therapy and its use as an agent enhancing chemosensitivity of cancer cells or reducing chemotherapy-related toxicities and fatigue. In this narrative review, we decided to deal with this issue, trying to answer the question whether there is any scientific evidence supporting the rationale for application of high-dose IVC therapy in advanced-stage cancer patients
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