High dose intravenous vitamin C (HDIVC) therapy protocol

High dose intravenous vitamin C ( HDIVC ) therapy as a tool for cancer treatment / adjunctive cancer care involves the slow infusion of vitamin C doses on the order of 0.4 to 1.4 grams ascorbate per kilogram of body weight. At the stated concentrations, which can only be safely achieved with IV infusions, vitamin C is preferentially toxic to cancer cells and inhibits the formation of new blood vessels. A variety of studies suggest that at high concentrations vitamin C does not interfere with chemotherapy or irradiation and may inhance efficacy in some situations. Several studies indicated that HDIVC therapy could increase survival times beyond expectation in cancer patients. In addition, HDIVC therapy significantly improves global quality of life scores, with benefits including less fatigue, improved appetite, reduction in nausea and vomiting, reductions in depression and sleep disorders.
HDIVC protocol:
1) Candidates include those who have failed standard treatments, those seeking to decrease the severity of side effects from cancer therapy, those attempting to prolong remission and those declining standard treatment
2) Patient must sign a consent-to-treat and should have no significant psychiatric disorder, end-stage CHF or other uncontrolled co-morbid conditions
3) Baseline and screening laboratory including but not limited to CBC with differential, quantitative G6PD test, serum chemistry profile and complete urinalysis must be obtained
4) In order to properly assess the patient’s response to HDIVC therapy patient records ( tumor type & staging, pathology reports, appropriate tumor markers, CT, MRI, Pet scans, prior cancer treatments etc. ) have to be obtained prior to the commencement of the therapy.
5) Having taken all the precautions and obtained informed consent from the patient the administering physician begins a series of three consecutive HDIVC infusions at the 15, 25, and 50 gram dosages followed by post HDIVC plasma vitamin C levels in order to determine the oxidative burden for that patient so that subsequent HDIVC treatments can be optimally dosed.
6) Following the first three HDIVC treatments the patient is scheduled to continue on a dose to reach the therapeutic range of 350-400 mg/dl ( at doctor’s discretion ) twice a week until a total course of 16 HDIVC treatments are completed.
7) Re-assessment of the patient is performed at the end of the HDIVC therapy using appropraite tumor markers, PET scans, CT / MRI and blood chemistry.

Umit Cetinkaya, M.D.
Internal Medicine

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