By Marie McCullough
Is mainstream medical science ignoring an inexpensive, painless, readily available cure for cancer? US government nutrition researcher Mark Levine wonders about this.
He has published new evidence that suggests vitamin C can work like chemotherapy – in some ways better. But so far, he hasn’t been able to interest cancer experts in conducting the kind of conclusive studies that would advance treatment.
“If vitamin C is useful in cancer treatment, that’s wonderful- if it’s not, or if it’s harmful, that’s fine, too,” said Levine, a Harvard-educated physician at the National Institute of Diabetes and Digestive and Kidney Diseases. “The goal is: find what’s true. Either way, the public wins, clinicians win, and patients win.”
If Linus Pauling, the two-time Nobel laureate-turned-vitamin C zealot, had taken an equally dispassionate stance 30 years ago who knows where the vitamin would be in oncology today? Surely not where it is: a dubious alternative on the fringes of medicine, despite links to remissions and cures.
This is not about popping supplements. It’s about putting high-dose vitamin C, ascorbic acid, into a vein. The distinction between oral and intravenous is crucial.
Levine’s lab has shown that, at high concentrations, the vitamin is toxic to many types of cancer cells in lab dishes. But the body automatically gets rid of extra C through urine, so to get that much C into the body before it’s eliminated, it must be put directly into the blood.
This may explain the defining setback of Pauling’s crusade. He and his collaborator, Scottish surgeon Ewan Cameron, gave C intravenously and orally and claimed many of their cancer patients lived surprisingly long and well. In the 1970s two rigorous government studies intended to test their claims gave only pills – and found no benefits.
How could so many smart people, including Pauling, ignore a variable as basic as the body’s ability to absorb and clear a drug?
“I don’t want to impugn anyone,” Levine said. “It’s one of these things where somebody didn’t ask the right questions.”
Can intravenous vitamin C do what even the costliest, most targeted, most effective therapies cannot: kill cancer cells without harming healthy ones?
Loretta Hill, 43, of New Jersey, sits at a faux granite table, facing a TV, chatting with two other cancer patients in the office suite of family physician Vivienne Matalon. Each patient is tethered to an intravenous bag of vitamin C and other nutrients that will take 40 minutes to deliver. The fee, not usually covered by health insurance, is $US110.
Hill can’t prove that vitamin C saved her from colon cancer, but she fervently believes it has. She was diagnosed in 2001, at age 38. She had surgery, radiation and two courses of chemotherapy. Six months later the cancer was back – but had spread to both lungs.
After those tumors were cut out, her oncologist offered irinotecan, which costs about $US9500 a week. But, she says, he held out little hope.
By then, Hill could barely function, much to the anguish of her husband and 9-year-old daughter. When she heard about Matalon’s ascorbate infusions, she thought: “If this doesn’t work, at least I’ll be in a better position for more chemo.”
Now, almost four years later, Hill is in college part time, plays soccer, and has no signs of cancer. Her weekly vitamin C dosage has been cut to 30 grams – equivalent to about 500 oranges – but she has no plans to quit because her only side effects are “fabulous hair and skin”.
Bill Nath, 69, a Kansas businessman, is an even more provocative case. In 1996 blood in his urine led to a diagnosis of bladder cancer. Tumours were invading the organ and surrounding muscle. Nath consulted experts at four major cancer centres. All recommended chemotherapy, radiation, and removal of all or part of the bladder. Total removal would include the prostate, adding risks of incontinence and impotence.
Nath ultimately made a choice that seemed suicidal to his wife, friends, and doctors: to keep part of his bladder and forgo chemotherapy and radiation.
Instead, he got 30 grams of vitamin C twice a week for three months, then every month or two for four years at the Centre for the improvement of Human Functioning in Wichita. It was founded by Hugh Riordan, a physician and friend of Pauling’s now deceased. A decade after his diagnosis, Nath is cancer-free.
Levine, in collaboration with National Cancer Institute pathologists, re-examined, then published Nath’s case and two others from Riordan’s centre. While such case reports prove nothing, Levine hoped they would stir interest in re-examining ascorbate in oncology.
But anecdotes and impressions don’t count. Scientists point out there’s no data to indicate the best dosages or treatment regimens, no basis for predicting how tumours will respond, and no data on the impact it has on survival.
“As far as I know, that kind of registry just doesn’t exist now, and it’s a huge weakness of the movement,” acknowledged Ron Hunninghake, chief medical officer at Riordan’s centre, which is starting a database.
But evidence or not, consumers are nevertheless interested in alternative therapies, and intravenous vitamin C is gaining fans among US patients. Reports of side effects are rare and risky patients – with kidney problems or blood disorders – are easily screened out. Interest is not growing, however, among, mainstream oncologists, judging by conferences, publications, and interviews with some of them. The National Cancer Institute, with a $US5-billion budget, is not sponsoring studies of intravenous C. Nor is the National Center For Complementary and Alternative Medicine – although it is paying for studies of the Noni extract herbal supplement and Reiki energy healing. The American Cancer Society and the American Association of Clinical Oncologists warn patients against high-dose vitamin C, as do leading cancer centres such as the University of Pennsylvania’s and Memorial Sloan-Kettering in New York.
Jeffrey White, director of the National Cancer Institute’s office of cancer complementary and alternative medicine, says that he’s tried to “generate awareness” of Levine’s research, and believes it justifies more studies in humans. But White acknowledges that the NCI has rejected “a few” proposals for such studies.
At the prestigious Mayo Clinic in Minnesota, oncologist Edward Creagan says the idea that intravenous levels is toxic to cancer but not oral levels is “an intriguing concept”. “However, my own belief is that the vitamin C story is really ancient history. It would be very difficult for patients and clinicians to mount a lot of enthusiasm for another vitamin C study.”
It was Creagan and his Mayo colleague, Charles Moertel, since deceased, who in the 1970s conducted the two National Cancer Institute funded clinical trials that showed vitamin C pills taken orally were no better than placebos. Pauling lobbied for a trial, then later contended that the Mayo researchers enrolled unsuitable patients. A second trial in response to Pauling’s criticism also bombed. Again he faulted the Mayo oncologists. He also threatened a libel suit against a Rochester newspaper for the headline “Pauling Wrong on Vitamin C for Cancer,” and accused the New England Journal of Medicine and the NCI of accepting a “Fraudulent” study, according to Australian medical historian Evelleen Richards. By then, Pauling advocated treating everything from the common cold to mental illness with vitamins and other substances he dubbed “orthomolecular”, meaning “right molecule”. To many colleagues, this genius and visionary, winner of the 1954 Nobel in chemistry and the 1962 Nobel Peace Prize for his antiwar work, had become a kook – “The Old Man and the C”.
Decades later, both sceptics and fans of vitamin C are wary about more trials.
“There’s tremendous resistance to even test this,” Levine said. “It’s very hard to revisit something like this without data. Information is diamonds.”
PRIVATE FUNDING GETS TWO STUDIES UNDER WAY
As the chief of the molecular and clinical nutrition section at the National Institute of Diabetes and Digestive and Kidney Diseases, Mark Levine discovered by accident some useful information that changed thinking. In the early 1990s his lab began looking at how the concentration of a nutrient affects its function, and how the body gets the proper concentration.
“As part of those studies, we looked at how vitamin C is absorbed in the intestine,” Levine said. By 2000, when that work led to an increase in the US recommended daily allowance of vitamin C, Levine had become an expert on ascorbate’s “pharmacokinetics” – what the body does to the drug.
Consumers and scientists already knew that ascorbate is an antioxidant, meaning it protects cells from reactive oxygen molecules – the same marauders that turn peeled apples brown and wet metal rusty.
Indeed, the reason the American Cancer Society and others discourage ascorbate megadoses is that a few studies of cells in dishes suggest vitamin C might protect cancer from oxidant damage. Chemotherapy and radiation work partly by intentionally unleashing this damage.
But Levine’s lab studies showed that ascorbate transforms from an antioxidant into just the opposite – an oxidant “promoter” – when it reaches high concentrations. At these levels vitamin C acts like a toxic drug by generating hydrogen peroxide, a powerful oxidant used as a bleaching agent.
Still, the biochemistry was puzzling. Putting pure peroxide in the bloodstream can be fatal. Levine’s experiments offered possible answers – vitamin C did not generate peroxide in blood, only in liquid such as found in body cavities. Thus, in the body, intravenous C must seep out of the blood to work.
Five out of nine types of cancer cells that were put in simulated body-cavity fluid died when concentrated ascorbate or peroxide was added to the dish. And the best part, this same lethal marinade had no effect on healthy cells. For some reason, cancer cells were vanquished by a mundane substance harmless to good guys.
Hugh Riordan had speculated that this was partly because an enzyme that neutralises peroxide is abundant inside normal cells, and scarce inside cancerous ones. But by inducing cells to take in vitamin C, Levine proved internal concentration doesn’t matter, malignant cells withered only when C surrounded them.
With this new evidence, a coterie of researchers – all associated with Pauling or his disciples – has recently obtained private funding for small trials of intravenous vitamin C. University of Kansas Medical Centre physician Jeanne Drisko has $US375,000 for a trial of 30 ovarian cancer patients. McGill University oncologist Wilson Miller has $US300,000 to find the maximum safe doses for treating various cancers.
Meanwhile, Levine is forging ahead with animal studies, trying to decipher the molecular magic of C’s selective toxicity. “Shouldn’t we investigate the potential of ascorbate as a drug? Let’s not guess any more. Let’s be motivated by the truth.”
From: the Australian, August 5th, 2006