High Dose Vitamin C Cancer Treatment Guide
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50 years of research and clinical use has collected substantial evidence that proves high doses of vitamin C (VitC) can safely and effectively kill cancer cells while protecting normal cells from chemo and radiation.
This guide compiles and references information that was pulled from over 100 cancer treatment studies exploring how VitC kills cancer cells. We untangle the scientific vocabulary used in the reports and make the research information accessible to everyone.
In many places you will find links that take you directly to the source information. By the end of the article, you will understand how high dose intravenous vitamin C (IVC) can safely improve the ability to beat cancer and protect patients from short and long term side effects of standard treatments.
If you have questions about this information, you are welcome to contact us for clarification.
Quick note:
You may see vitamin C referenced as “ascorbic acid” and “ascorbate” in medical articles we link to. In this article, we will mostly refer to the nutrient as simply “VitC”, or “IVC” when describing intaking high doses of vitamin C intravenously (IV).
What is a “high dose” of vitamin C?
While the recommended daily value of vitamin C (VitC) is 90mg, studies show taking high or “mega” doses can be used to address certain health issues. According to the National Institute for Health (NIH), 2,000mg of vitamin C taken orally is a safe daily upper limit for a healthy adult.
However, NIH studies have shown IV doses of up to 100,000mg can be well tolerated. High doses of VitC used to treat an illness or disease are commonly referred to as “pharmacological ascorbate”. For most adults, high doses of vitamin C taken intravenously are generally considered safe since it is a water-soluble nutrient; excess amounts are removed through urination.
What is the difference between oral and intravenous (IV) intake of vitamin C?
Comparison of intravenous (IV) vs oral intake
Vitamin C intake via IV (IVC) produces peak plasma (blood content) concentrations far greater than what can be achieved through oral intake of nutrient dense foods or supplements.
When VitC is taken orally, our body by default will absorb only a small amount, then excrete the rest. However, when vitamin C is administered via IV, those tight biological controls are bypassed, and higher amounts of VitC can safely concentrate in the bloodstream for long periods.
*Heads up, the next paragraph talks about scientific measurements, but you can handle it!
The NIH studied how much VitC enters and stays in the bloodstream via IV vs oral intake, the gap is tremendous. For example, vitamin C at a dose of 50 grams administered orally would only produce mean peak plasma concentrations of approximately 220 micromole/L compared with 13,400 micromole/L when vitamin C is administered intravenously (IV); this means over 60 times more vitamin C was available for use in the bloodstream when taken through an IV.
Why are high VitC plasma concentrations important?
We want high VitC peak plasma concentrations because lab studies have shown that vitamin C concentrations of 1,000 micromol/L and greater kill tumor cells. Clinical studies aimed at cancer patients are showing 20,000 micromole/L and greater to be the peak target blood concentration when using vitamin C as a cancer therapy. The evidence shows it is not possible for oral vitamin C consumption to achieve the necessary plasma concentrations to be used as a cancer treatment.
Early studies of using high dose vitamin C to assist in cancer treatment.
Dr. Linus Pauling, early pioneer of high dose vitamin C for cancer treatment
Discussions around using high dose vitamin C for cancer treatment involves some controversy because of early conflicting studies. In the 1970’s clinical trials led by Dr. Ewan Cameron and Dr. Linus Pauling (a two-time Nobel Prize winner) showed encouraging results in the fight against cancer using vitamin C.
Their trials were focused on patients that were considered terminally ill with cancer, they found the terminal patients treated with vitamin C lived 20 times longer and enjoyed a much greater quality of life than those that were not treated with high dose vitamin C. An independent clinical trial in the early 1980’s conducted in Japan showed similar results.
Dr. Linus Pauling challenged the medical community to conduct further testing of using vitamin C to treat cancer. Charles Moertel of the Mayo Clinic heeded the call and lead double-blind randomized trials. His clinical trials failed to show any positive effect of using vitamin C to treat cancer. Since his trials were considered to be conducted more rigorously, people trusted the Mayo Clinic’s data over the Cameron-Pauling trials.
What was missing in the Mayo study?
A National Cancer Institute article authored by Dr. Lewis Cantley from Cornell and Dr. Jihye Yun of Johns Hopkins clearly explains the two critical differences between how the Mayo Clinic and Cameron-Pauling administered vitamin C in their trials.
1. The Mayo Clinic provided vitamin C treatment for much less time.
2. The Mayo Clinic only administered vitamin C orally while Cameron-Pauling used oral and intravenous (IV) methods.
The 2004 NIH study we reviewed earlier shows orally taking vitamin C generates far lower plasma concentrations than intake with IV. Cantley and Yun calculate that the Mayo Clinic study would have produced peak plasma concentrations of 200 micromole/L while the Pauling studies would produce peak plasma concentrations of nearly 6,000 micromoles/L in patients that received vitamin C IV.
Let’s remember, lab studies have shown plasma concentrations of 1,000micromole/L can kill cancer cells, with clinical studies showing 20,000 micromole/L or greater being an optimal peak target.
The Mayo Clinic study helped prove that oral vitamin C intake is not enough, but more modern studies have shown that Cameron and Pauling were absolutely correct; vitamin C administered via IV can help patients kill their cancer.
Important note: The Mayo Clinic has acknowledged the shortcoming of their previous clinical trial, they are now conducting a randomized double blind Phase 2 clinical trial to study the benefits of using high dose IVC in combination with chemotherapy. Results are expected to be published in March 2024.
Using high dose vitamin C as a monotherapy vs combination treatment.
It should be noted that VitC has been researched to fight cancer as a monotherapy (administered by itself) and as a combination/complementary therapy (used in conjunction with other standard care treatments).
While you can find positive case studies and preclinical studies that suggest VitC has an effect as a monotherapy, we believe not enough evidence exists for anyone to recommend monotherapy as an initial sole cancer treatment.
However, we will see evidence that shows monotherapy can be an effective palliative care for those with an illness that is considered terminal. In these cases monotherapy may deliver much better quality of life and lengthen survival.
Much more research has been completed for high dose vitamin C infusions as a complementary cancer therapy that shows it plays a role in killing cancer, helps boost the efficacy of standard cancer treatments, and protects the patient from the toxic effect of the standard therapy.
Preclinical studies using high dose IVC as cancer treatment
Since 1989, 71 preclinical studies (44 occuring between 2016 to 2021) were conducted to determine if high dose vitamin C improves cancer treatment outcomes when combined with other therapies. The evidence firmly points to “YES!”. In these preclinical studies, a positive effect was observed 92% of the time. Most of these studies involved high doses of VitC combined with chemotherapy and/or radiotherapy.
Preclinical studies treating cancer with vitamin C in combination with chemotherapy
20 preclinical studies report high-dose VitC improves the cancer killing capability of chemotherapeutics such as:
Patient receiving chemo and high dose vitamin C cancer treatment
The studies observed that VitC selectively targets cancer cells increasing oxidative stress on the tumor which results in damaging the cancer cell DNA. This has a chemosensitizing effect on cancer cells, making them more susceptible to the chemotherapy.
This means VitC can improve the outcome of patients with cancer that is resistant to chemotherapy. These studies provide evidence that chemotherapy is more potent with high dose IVC than without it. In addition to the improved efficacy, VitC regularly showed an ability to reduce the toxicity from chemotherapy (37, 38 ). This trait can reduce the side effects of chemo helping patients feel better during treatment.
Preclinical studies using vitamin C in combination with radiotherapy
Similar to its role with chemotherapy, high-dose VitC has also been found to act as a radio-sensitizer in radiation or chemo-radiation preclinical studies. There is ample evidence (39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49) that VitC enhances cell radiation cytotoxicity in addition to offering protection from radiation damage in normal surrounding tissue. There are examples of combination radio-chemotherapy with high dose VitC increasing overall survival by 50%.
Preclinical studies using VitC in combination with targeted therapy
Targeted therapy for cancer treatment focuses on proteins that are involved with how cancer cells grow, divide, and spread. A significant amount of preclinical studies have examined the use of high-dose VitC combined with targeted therapies such as kinase inhibitors (i.e. sorafenib, gefitinib, vemurafenib: 51, 52, 53), mitochondrial inhibitors (i.e. doxycycline, venetoclax, oligomycin A, metformin: 54, 55, 56), poly ADP ribose polymerase (PARP) inhibitors (57) and glycolysis inhibitors (58).
The listed studies show synergistic anti-cancer action and prolonged regression can be achieved with the combination. Again, in situations where certain cancer types were resistant to targeted therapy drugs, VitC showed an ability to help overcome the non-responsiveness.
Targeted therapy aims at disrupting cancer proteins
Like radio and chemo therapies, emerging anti-cancer compounds targeting telomerases, mitochondrial activity or glycolysis also have shown in preclinical studies to synergize with high-dose VitC. An article in The Journal of Clinical Cancer Research reports that “enhanced treatment efficacy was confirmed for high-dose VitC in combination with several hormonal treatments such as oestrogen receptor ER and human epidermal growth factor receptor 2 (HER2) inhibitors in breast cancer cells, as well as for PARP inhibition in the treatment of AML-TET2 deficient cells and JQ1 (thieno-triazolo-1,4-diazepine), a Bromodomain and extra terminal inhibitor, in the treatment of melanoma”.
The available data strongly suggests the potential of high-dose VitC as a secondary (adjuvant) therapy for targeted cancer therapies.
How has high dose vitamin C performed in cancer clinical trials?
Many clinical trials have shown that IVC combined with chemo and/or radiation “increased overall survival and progression free survival compared to the institutional averages”, “decreased toxicities compared to patients treated without IVC”, and was considered “safe and well tolerated” (61). Overall, the positive results observed in the preclinical trials have also occurred in phase 1 & 2 clinical trials.
Note: Clinical trials are the best way to determine if a treatment is effective at fighting cancer because they include human patients in a well-structured program that is documented in detail. Searching Pubmed (the main database for medical research) shows there were 16 completed studies that included medium to high dose IVC as a cancer treatment.
Clinical evidence that using vitamin C improves chemo, radiation, and targeted therapy treatments
The National Cancer Institute is the primary funder of high dose vitamin C research.
Clinical results are consistent with preclinical positive results, chemo and/or radiation treatments perform better with high dose vitamin C than without it. The phase 1/2 studies combining high dose vitamin C infusions with chemo and/or radiation therapy report an increase in disease control, objective response rate (decrease in tumor size), and overall survival.
These clinical studies included administration of targeted therapies, chemo and/or radiation treatments temozolomide (TMZ), carboplatin, paclitaxel, gemcitabine, G-FLIP (irinotecan, gemcitabine, 5-fluorouracil, leucovorin, and cisplatin), erlotinib, mFOLFOX6, CHASER regimen, and radiotherapy.
Five clinical examples of IVC improving effectiveness of chemo/radiation for advanced and metastatic cancer patients:
Phase I clinical trial that included 16 patients with advanced pancreatic cancer. High dose intravenous vitamin C (IVC) was administered with fractionated radiotherapy and gemcitabine, the combination was synergistic.
Following treatment with IVC, two patients tumor shrank enough to become eligible for surgery to remove the tumor. Including IVC in the cancer therapy delivered an overall median survival rate that doubled historical median rates of the same treatment without IVC.
Additionally, the authors state that IVC offers “protection from radiation damage in normal surrounding tissue, making it an optimal agent for potentially improving locally advanced pancreatic adenocarcinoma.”. (63) The researchers proceeded to a phase II trial.
A phase I trial included stage IV pancreatic cancer patients receiving IVC, gemcitabine, and erlotinib. After 8 weeks of treatment, 88% of the patients experienced a decrease in primary tumor size. The researchers noted these are incredible results that are superior to “gemcitabine alone or gemcitabine plus erlotinib”. (64) The researchers request a phase II trial.
14 patients with glioblastoma participated in a Phase I clinical trial. They were treated with high dose intravenous vitamin C (IVC), temozolomide (TMZ), and radiation therapy. The authors reported that IVC improved “radiotherapy and TMZ effectiveness in glioblastoma patients, improving both progression free survival and overall survival” and also “proved to be safe when combined with radiotherapy and TMZ”.
The data shows IVC improves results by “sensitizing cancer cells to radiation and chemotherapy” and “protect against radiation and chemotherapy-induced toxicity”. (65) The positive results have led to a Phase 2 clinical trial.
An ongoing phase II clinical trial includes stage IIIB and IV non-small cell lung cancer (NSCLC) patients receiving IVC, paclitaxel, and carboplatin. The published evidence shows that IVC massively improves the disease control rate to 93%; historically paclitaxel and carboplatin without IVC delivered only 40% disease control rate.
The authors summarize their findings by stating “we demonstrate that pharmacological ascorbate (vitamin C) represents an easily implementable and non-toxic agent that may increase treatment efficacy when combined with standard-of-care radio-chemotherapy in NSCLC”.(66) The study is expected to conclude December 2024.
A Phase I/IIa randomized clinical trial compared results of a group of patients with ovarian cancer that were given high dose vitamin C (IVC) with carboplatin and paclitaxel, vs a group only administered carboplatin and paclitaxel.
The results showed that the group that received IVC had longer progression free survival , overall survival, and experienced substantially decreased toxicities from the chemo.
The researchers noted IVC has “an outstanding safety profile”, is capable of “killing cancer cells without harming normal tissues” and proved to “enhance chemosensitivity of ovarian cancer and reduce toxicity of chemotherapy”. (67)
Ongoing clinical trials studying how vitamin C improves chemo and/or radiation cancer treatment results
The promising evidence recorded in numerous preclinical and clinical studies has encouraged many more clinical trials to be launched. Currently there are 19 clinical trials underway ranging from phase I to III. Cancer hospitals using high dose vitamin C for cancer treatment include Mayo Clinic, Johns Hopkins Comprehensive Cancer Center, University of Iowa Holden Comprehensive Cancer Center, Cornell University Weill Medical College, and Kansas Medical Center.
Which cancer types is high dose vitamin C effective against?
Studies prove high doses of vitamin C can kill cancers cells and improve the capability of chemo, targeted, radio, and hormonal therapy against the following cancer cell types:
Lung
Breast
Colorectal
Prostate
Pancreatic
Ovarian
Glioblastoma
Leukemia
Lymphoma
Melanoma
Gastric
Multiple myeloma
Myelodysplastic syndrome
Head and neck
Oral squamous
Sarcoma
Cervical
How does high doses of vitamin C kill cancer cells?
High doses of Vitamin C has been widely shown to impose oxidative stress and cause DNA damage to cancer cells, but evidence from recent preclinical and clinical studies show that vitamin C has many more mechanisms of action that make it selectively destructive to cancer cells. In total, researchers have observed 14 ways VitC damages cancer cells. This variety of “attack angles” is believed to be the reason VitC is effective against many cancer types.
*Prepare yourself: this next section is the most technical part of the guide. It should help the reader understand how VitC actually works to kill cancer cells. For those interested, many of the links in this guide go into far more detail of the pharmacology of vitamin C as a cancer treatment.
Primary Action: Vitamin C damages cancer cell DNA
High concentrations of vitamin C acts as a pro-oxidant in cancer cells; this means vitamin C generates a lot of reactive oxygen species (ROS) which is destructive to cancer cells. Additionally, it also prevents the cancer cell from protecting itself from ROS. This imbalance that vitamin C creates is known as oxidative stress. This is the reason IVC improves the capability of chemo and radiation; those treatments generally seek to cause cell death (apoptosis) via oxidative stress.
IVC selectively acts as a pro-oxidant to cancer cells because tumors generally prefer to maintain increased levels of iron in and around their cells. (68) When large amounts of Vitamin C come into contact with the iron, it triggers something known as the Fenton reaction; this is a multi-step chemical reaction that creates an ongoing cycle that generates hydrogen peroxide (H202) and hydroxyl radicals (OH). (69) Both H2O2 and OH are destructive to cancer cells.
High dose Vitamin C damaging cancer DNA
Attacking cancer cells from the outside and inside.
High doses of intravenous vitamin C lead to “increased steady-state levels of H2O2” (70). The H2O2 wreaks havoc on the cancer cell from the outside by generating large amounts of the highly damaging hydroxyl radical (OH). H2O2 also enters the cancer cell to generate OH internally. This oxidative stress attack from the inside and outside damages the cancer cell DNA, proteins, and lipids. This damage alone often leads to cancer cell death, but also softens/sensitizes the cancer cell so the chemo and/or radiation therapy can be far more effective.
Vitamin C creates a cancer cell energy crisis.
Furthermore, the Fenton reaction causes VitC (ascorbic acid) to convert into dehydroascorbic acid (DHA). DHA can enter many tumor cells through something called a glucose transporter (71). But DHA is an unwanted guest of the cancer cell, so it sacrifices key substances to process it out. This effort leads to an energy crisis that results in cancer cell damage or death.
Is high dose vitamin C safe for cancer patients?
High dose vitamin C is regarded as having an “outstanding safety profile” (72). Published clinical studies reported that high dose intravenous vitamin C is well tolerated by patients and no significant adverse events can be directly attributed to VitC.
Reducing chemo and radiotherapy side effects with vitamin C infusions.
Standard treatments like chemo and radiation commonly have a myriad of long term side effects associated with their use. Both treatments damage the DNA of normal cells which can result in issues with fatigue, nausea, brain fog, increased risk of infections, and mouth sores. For survivors, they sometimes struggle with long term side effects like cognitive problems, nerve damage, heart impairments, fertility issues, and a greater risk of secondary cancers. Reducing these side effects is often a priority for patients.
Many studies show that VitC helps to reduce the toxic affects of chemotherapy and radiation therapy. NIH published researchers described IVC’s ”ability to decrease chemotherapy-induced adverse effects should already make it a very valuable addition to chemotherapeutic regimens” (73) and that including it with chemo/radio treatments can help “avoid standard 20-40% rates of severe toxicities” (74).
Contraindications of IVC
Unfortunately, high-dose IVC is not an appropriate treatment for everyone, there is a small population of people that can have adverse reactions. Those with renal insufficiency may develop kidney stones because the body is not capable of expelling the additional VitC. Red cell glucose-6-phosphate dehydrogenase deficient (G6PD) patients receiving high-dose VitC may develop hemolytic anemia. Before starting a high dose vitamin C treatment, a blood test is used to determine if a patient has either of these conditions.
Why hasn’t my oncologist recommended to include high dose IVC in my cancer treatment?
Review IVC fact sheet with doctor
It is very likely that your Oncologist has not read the studies published over the last 7 years, recent systematic reviews, or meta-analysis that lays out the substantial evidence that high dose IVC can be a potent anti-cancer agent and reduce the toxic effects of chemo and radiation. The digital fact sheet available below can help you and your doctor explore how IVC can be incorporated in the treatment plan.
Your Doctor should be receptive to the information even though IVC is not yet FDA approved to treat cancer. The National Cancer Institute points out that “off-label use of drugs is very common in cancer treatment”. Doctors can review evidence published in medical journals, and can choose to include treatments that have shown to be safe and beneficial. IVC checks both of those boxes.
When will high dose vitamin C be an FDA approved cancer treatment?
A few hurdles must be cleared for High dose intravenous vitamin C to progress from being labeled as an “alternative or complementary cancer treatment” to becoming a part of the “standard care tool kit”. The fact that a pharmaceutical company can’t patent vitamin C, means there is no financial incentive to get approval quickly.
It costs approximately $37.8 million dollars to progress a cancer treatment from Phase 1 clinical trials through Phase 3. Since large pharmaceutical companies have no financial benefit to invest in FDA approval, we need to rely on government grants and private donations to progress these studies through the required trials.
Currently there are 12 Phase 2 clinical trials (this includes a large trial led by the Mayo Clinic and National Cancer Institute) and one Phase 3, so there is hope that it will get across the “FDA approved” finish line in approximately ten years. However, this means for those that want to use high dose vitamin C to treat their cancer now, they will likely have to pay out-of-pocket for IVC.
How to get high dose vitamin C infusion treatment for cancer?
For those who live and work in Maryland, Personalized Medicine can provide high dose vitamin C Infusion therapy at your home/work. We help those in Montgomery County, Frederick County, Carroll County, Howard County, Washington County and Baltimore City/County. We are also in the process of opening a new clinic in Rockville, MD.
It can be difficult to find a clinic or practitioner that has clinical experience administering the treatment, that has researched the latest clinical studies, and understands the protocol that is required to safely achieve sustained high ascorbate plasma concentrations.
High dose vitamin C treatments require appropriate lab screening, medical history and biometric analysis to determine dosage, and periodic monitoring of lab samples to ensure the treatment is effective. For these reasons, businesses like “IV Bars” and “Med Spas” should be avoided. We suggest discussing the option with your Oncologist to see if they can administer the treatment or can recommend a local provider. If they are unable, speak with your primary care practitioner to see if they can recommend options.
How much does high dose IVC cost?
Cost is dependent on the dose administered and the amount of IV treatments. Dosing is based on a number of factors, and generally patients should seek to receive a minimum of 2-3 treatments per week. Those seeking to aggressively treat their cancer can seek daily treatments.
An example cost for an 8 week at home/work treatment can range between $9,000 to $12,000 depending on dosage and amount of treatments per week. Costs are less for IVC administered in our clinic. Medical financing options are available for those that need it.
Is high dose IVC used for palliative care?
Many studies show that high dose VitC is a safe and effective option for patients seeking palliative care. Vitamin C infusions improve wellbeing and quality of life. Studies (76, 77) report IVC improves appetite, aids sleep while reducing pain, fatigue, and depression. Many studies referenced in this article observed much higher overall survival time for those receiving high dose VitC.
Take the next step to develop a care plan
Research funded by the National Cancer Institute, carried out by the best comprehensive cancer centers in the country are publishing clear evidence that an additional safe and effective tool is available to beat cancer. Some Oncologists may be waiting for the progression to FDA approval to be finalized, but many patients don’t have 10+ years to wait for that to happen.
If you are fighting for your life, you should be able to use every safe treatment that is available. The High Dose IVC fact sheet found here should be shared with your doctor so you can discuss how IVC can be included in your cancer treatment. Those seeking high dose vitamin C infusion treatment in Maryland can schedule a no cost consultation with Personalized Medicine.
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