Intravenous Vitamin C and
Evidence Based Medicine

The research of Dr. Linus Pauling PhD, Nobel Prize Winner, and Dr. Ewen Cameron, MD, was what first put IV vitamin C on the map as an effective anti-cancer therapy, back in 1971. In their clinical trial they found a four fold increase in survival rates by those treated with 10,000mg of vitamin C intravenously.

Subsequent trials have had mixed results however there is enough positive statistically significant research that more continues to be done and there is a renewed interest in this intervention that is gaining acceptance around the world as an additive treatment in cancer therapy.

There are some studies evaluating the use of vitamin C with conventional treatments in ovarian, breast and pancreatic cancer that have shown the vitamin C to be both well tolerated and that the vitamin C may reduce the side effects of conventional treatments, improve quality of life and possibly positively impact treatment response. New research from the National Institute of Health in the United States has illustrated various mechanisms of actions leading to anti-cancer effects:

Chemosensitization. Vitamin C (ascorbic acid) has been tested on various animal tissues in cultures, in combination with various chemotheraputic drugs. Most well designed studies are showing positive results in that the vitamin C enhance the power of the drug. The studies that show adverse responses have resulted in a few chemotheraputics to be contraindicated with IV vitamin C therapy.

Inhibition of tumor growth and metastasis. Most tumors require certain enzymes to proliferate however vitamin C appears to inhibit the activity of these enzymes possibly by promoting collagen formation; which may be playing a role in stablizing the tumor and preventing local tissue invasion.

Selective cytotoxicity (cancer cell killing). Large doses of IV vitamin C increase hydrogen peroxide production in connective tissues. In healthy cells, this is absorbed and then quenched by intracellular anti-oxidants. In cancer cells however, there aren’t many anti-oxidants, so it builds up resulting in cell death.

Intravenous Vitamin C and Evidence-based Medicine

Chen, Q., Espey, M. G., Krishna, M. C., Mitchell, J. B., Corpe, C. P., Buettner, G. R., … Levine, M. (2005). Pharmacologic ascorbic acid concentrations selectively kill cancer cells: action as a pro-drug to deliver hydrogen peroxide to tissues. Proceedings of the National Academy of Sciences of the United States of America, 102(38), 13604–9. doi:10.1073/pnas.0506390102

Pathi, S. S., Lei, P., Sreevalsan, S., Chadalapaka, G., Jutooru, I., & Safe, S. (2011). Pharmacologic doses of ascorbic acid repress specificity protein (Sp) transcription factors and Sp-regulated genes in colon cancer cells. Nutrition and Cancer, 63(7), 1133–42. doi:10.1080/01635581.2011.605984

Chen, Q., Espey, M. G., Sun, A. Y., Lee, J.-H., Krishna, M. C., Shacter, E., … Levine, M. (2007). Ascorbate in pharmacologic concentrations selectively generates ascorbate radical and hydrogen peroxide in extracellular fluid in vivo. Proceedings of the National Academy of Sciences of the United States of America, 104(21), 8749–54. doi:10.1073/pnas.0702854104

Chen, Q., Espey, M. G., Sun, A. Y., Pooput, C., Kirk, K. L., Krishna, M. C., … Levine, M. (2008). Pharmacologic doses of ascorbate act as a prooxidant and decrease growth of aggressive tumor xenografts in mice. Proceedings of the National Academy of Sciences of the United States of America, 105(32), 11105–9. doi:10.1073/pnas.0804226105

Hoffer, L. J., Levine, M., Assouline, S., Melnychuk, D., Padayatty, S. J., Rosadiuk, K., … Miller, W. H. (2008). Phase I clinical trial of i.v. ascorbic acid in advanced malignancy. Annals of Oncology : Official Journal of the European Society for Medical Oncology / ESMO, 19(11), 1969–74. doi:10.1093/annonc/mdn377

Monti, D. a, Mitchell, E., Bazzan, A. J., Littman, S., Zabrecky, G., Yeo, C. J., … Levine, M. (2012). Phase I evaluation of intravenous ascorbic acid in combination with gemcitabine and erlotinib in patients with metastatic pancreatic cancer. PloS One, 7(1), e29794. doi:10.1371/journal.pone.0029794

Welsh, J. L., Wagner, B. a, Van’t Erve, T. J., Zehr, P. S., Berg, D. J., Halfdanarson, T. R., … Cullen, J. J. (2013). Pharmacological ascorbate with gemcitabine for the control of metastatic and node-positive pancreatic cancer (PACMAN): results from a phase I clinical trial. Cancer Chemotherapy and Pharmacology, 71(3), 765–75. doi:10.1007/s00280-013-2070-8

Vollbracht, C., Schneider, B., Leendert, V., Weiss, G., Auerbach, L., & Beuth, J. (2011). Intravenous Vitamin C Administration Improves Quality of Life in Breast Cancer Patients during Chemo-/Radiotherapy and Aftercare: Results of a Retrospective, Multicentre, Epidemiological Cohort Study in Germany. In Vivo (Athens, Greece), 25(6), 983–990. Retrieved from

Ma, Y., Chapman, J., Levine, M., Polireddy, K., Drisko, J., & Chen, Q. (2014). High-dose parenteral ascorbate enhanced chemosensitivity of ovarian cancer and reduced toxicity of chemotherapy. Science Translational Medicine, 6(222), 222ra18. doi:10.1126/scitranslmed.3007154