Abstract
The history of ascorbic acid (AA) and cancer has been marked with controversy. Clinical studies evaluating AA in cancer outcome continue to the present day. However, the wealth of data suggesting that AA may be highly beneficial in addressing cancer-associated inflammation, particularly progression to systemic inflammatory response syndrome (SIRS) and multi organ failure (MOF), has been largely overlooked. Patients with advanced cancer are generally deficient in AA. Once these patients develop septic symptoms, a further decrease in ascorbic acid levels occurs. Given the known role of ascorbate in: a) maintaining endothelial and suppression of inflammatory markers; b) protection from sepsis in animal models; and c) direct antineoplastic effects, we propose the use of ascorbate as an adjuvant to existing modalities in the treatment and prevention of cancer-associated sepsis.
Highlights
The history of ascorbic acid (AA) and cancer has been marked with controversy
Personal Perspective Having worked in the area of cancer research for over a decade, the major focus of one of the authors’ investigations has been to develop therapeutic solutions by using siRNA to directly inhibit growth of tumors [1], and to stimulate tumor immunity using antigen-specific vaccines [2,3,4] or unorthodox immune-modulatory approaches [5,6,7,8,9]
Not until the author’s mother passed away from leukemia did he realize that, while many options have been developed in the treatment of cancers, relatively little can be performed at end-of-life
Summary
AA administered intravenously has a long and controversial history in relation to reducing tumors in patients. This has impeded research into other potential benefits of this therapy in cancer patients such as reduction of inflammation, improvement of quality of life, and reduction ofSIRS initiation and progression to MOF. While ongoing clinical trials of i.v. AA for cancer may or may not meet the bar to grant this modality a place amongst the recognized chemotherapeutic agents, it is critical that we collect as much biological data as possible, given the possibility of this agent to be a wonderful adjuvant therapy
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