13 ms·

Vitamin C and Immuno-Oncology

154 points by daddylonglegs 7y ago

blackrock 7y ago
ELI5 please. So billions of dollars spent on cancer research, and the solution this entire time, is to simply spike the IV drip with some lemon juice?
british_india 7y ago
Fresca is packed with Vitamin C.
clumsysmurf 7y ago
I found this summary to be an easier read than the original research paper https://medicalxpress.com/news/2020-02-high-doses-vitamin-immunotherapy-combating.html https://medicalxpress.com/news/2020-02-high-doses-vitamin-im...
bastian 7y ago
This is an interesting link from the comments section of the article: https://clinicaltrials.gov/ct2/show/NCT04264533 https://clinicaltrials.gov/ct2/show/NCT04264533
1996 7y ago
TLDR: A team of researchers affiliated with multiple institutions in Italy has found that giving cancerous mice high doses of vitamin C (ascorbic acid) enhanced immunotherapy, resulting in slowed or stopped tumor growth. Maybe Linus Pauling was indeed on to something (https://en.wikipedia.org/wiki/Linus_Pauling https://en.wikipedia.org/wiki/Linus_Pauling ) with his idea of high dose IV vitamin C: skipping the article as it seems to take political positions ("But if this work makes some headlines of the “Linus Pauling was right” sort, don’t believe them") and using Wikipedia as a source instead: Pauling's work on vitamin C in his later years generated much controversy. He was first introduced to the concept of high-dose vitamin C by biochemist Irwin Stone in 1966. After becoming convinced of its worth, Pauling took 3 grams of vitamin C every day to prevent colds.[13] Excited by his own perceived results, he researched the clinical literature and published Vitamin C and the Common Cold in 1970. He began a long clinical collaboration with the British cancer surgeon Ewan Cameron in 1971 on the use of intravenous and oral vitamin C as cancer therapy for terminal patients.[143] Cameron and Pauling wrote many technical papers and a popular book, Cancer and Vitamin C, that discussed their observations. Pauling made vitamin C popular with the public[144] and eventually published two studies of a group of 100 allegedly terminal patients that claimed vitamin C increased survival by as much as four times compared to untreated patients (...) medical establishment concluded that his claims that vitamin C could prevent colds or treat cancer were quackery.[13][151] Pauling denounced the conclusions of these studies and handling of the final study as "fraud and deliberate misrepresentation",[152][153] and criticized the studies for using oral, rather than intravenous vitamin C[154] (which was the dosing method used for the first ten days of Pauling's original study
- SAI_Peregrinus 7y ago
  I wouldn't say that "But if this work makes some headlines of the “Linus Pauling was right” sort, don’t believe them" is a political position. Pauling was wrong: he didn't say "High dose IV vitamin C is helpful", he said (paraphrased) "High dose IV vitamin C is helpful because it is an antioxidant". But it's not an antioxidant, as this paper shows, it's an oxidant! It's helpful, but for exactly the wrong reason, and low-dose vitamin C is an antioxidant, which is harmful! So if Pauling were correct you'd expect other antioxidants to help, but they also cause harm (in oncology).
  - agumonkey 7y ago
    I've been curious about balancing [anti]oxydants, do you know good texts on this ?
  - 1996 7y ago
    So basically this guy who said vitamin C IV in high doses fights cancer was wrong and should be never rehabilitated , because the hypothetised mechanism was the other way around? (anti oxidant -> oxidant) I think we are forgetting the most important result there: vitamin C IV in high doses fights cancer.
    - SAI_Peregrinus 7y ago
      > I think we are forgetting the most important result there: vitamin C IV in high doses fights cancer. No, that's wrong. Vitamin C IV in high doses makes certain chemotherapy work better to fight cancer. And does so in a way that Pauling wouldn't have been able to predict, his mechanism of action would imply that it would reduce the effectiveness of the chemotherapy.
- starchild_3001 7y ago
  Not sure who downvoted you, but thanks for sharing this important snippet of history. Without pioneers (who often don't get it fully right), there'd no discoveries or progress.
pazimzadeh 7y ago
Here's the original article: High-dose vitamin C enhances cancer immunotherapy https://stm.sciencemag.org/content/12/532/eaay8707/ https://stm.sciencemag.org/content/12/532/eaay8707/ Takeaways: Oral Vitamin C and intravenous Vitamin C have vastly different pharmacokinetics and effects on cancer. - Low dose vitamin C (oral) is anti-oxidant and may attenuate chemotherapy: Chemosensitizing effect of vitamin C in combination with 5-fluorouracil in vitro https://www.ncbi.nlm.nih.gov/pubmed/12929582 https://www.ncbi.nlm.nih.gov/pubmed/12929582 "only a high concentration of vitamin C increased the cytotoxicity of 5-FU" Ascorbic acid attenuates antineoplastic drug 5-fluorouracil induced gastrointestinal toxicity in rats by modulating the expression of inflammatory mediators https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5598240/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5598240/ - High dose vitamin C (intravenous) is pro-oxidant - High dose vitamin C (intravenous) alone slows tumor growth - High dose vitamin C (intravenous) combined with immunotherapy has a synergistic effect High dose vitamin C (intravenous) also synergizes with chemotherapy and spares healthy cells https://stm.sciencemag.org/content/6/222/222ra18 https://stm.sciencemag.org/content/6/222/222ra18 If you are in chemotherapy or immunotherapy, stay away from low doses of oral anti-oxidant supplements such as Vitamin C.
- tomlue 7y ago
  We did a data extraction project for 81 trials using oral or intravenous IV as a cancer therapy! You can see the whole project at https://sysrev.com/p/6737 https://sysrev.com/p/6737. Basically we imported 81 VitC trials from clinicaltrials.gov and extracted dose levels, administration methods, placebo usage, and some other data. You can see all the oral studies here: https://shorturl.at/mvxy4 https://shorturl.at/mvxy4 You can see all the IV studies here: https://shorturl.at/bn019 https://shorturl.at/bn019 The results of the research will be published soon...
  - tomlue 7y ago
    Those links are broken and should be You can see all the oral studies here: https://bit.ly/3ct2q4u https://bit.ly/3ct2q4u You can see all the IV studies here: https://bit.ly/2Th9ud5 https://bit.ly/2Th9ud5
- 7y ago
pstuart 7y ago
Shooting up C doesn't sound appealing, but I wonder if liposomal C might be worth exploring after all.
KWxIUElW8Xt0tD9 7y ago
look up papers by Dr. Klenner on the use of intravenous vitamin C see also "living proof" a New Zealand 60-minutes segment
chrisco255 7y ago
Worth noting that clinical trials are underway for studying the effect of vitamin C infusions on 2019-nCov: https://clinicaltrials.gov/ct2/show/NCT04264533 https://clinicaltrials.gov/ct2/show/NCT04264533
- deleted 7y ago
  [deleted]
jcims 7y ago
Pursuing this as an adjunct therapy for my wife's cancer treatment showed me a side of healthcare that I hadn't really considered before. Fear. Not fear of a calculated risk going the wrong way healthwise, but profound fear of stepping anywhere outside the brightly lit path of 'standard of care'. There's this phase change in the doctor's expression that you can see visually when you enter into conversations such as this (the other one being management of hyperglycemia). There's a certain slackening of facial expression and straightening of posture. The vocabulary becomes smaller, blinking more regular, tone flatter and the conversation becomes more circular. It took me a little while to sort it out, but I've come to the conclusion that these (mostly young) doctors are so incredibly leveraged in their position by student loans and sunk cost into their education that they simply cannot risk anything outside of the prescribed approach to care for a patient...particularly one where there is generally a foregone conclusion as to the outcome. I initially raged against them individually, but now I see them as scared children and my hatred is directed towards the system that creates this fear. Should I encounter this situation again, my first goal will be to find a doctor with a terminal illness themselves and see if we can't forge a new path together.
- appleiigs 7y ago
  Without scientific evidence the young doctors would be guessing and that would not be responsible of them. Without scientific evidence, you are guessing too.
  - jcims 7y ago
    Philosophically there's nothing wrong with what you're saying, but it's not particularly applicable. None of the 'standard of care' therapies for, in our case, ovarian cancer are guaranteed to be effective...they simply have hazard ratios that are more favorable than the rest. So, quite literally, doctors are already guessing as to what to do next once you are in a recurrent cancer setting (even before, really). On top of that there is a mountain of clinical evidence that high dose intravenous vitamin C (IVC) has an incredibly low risk of adverse events in healthy patients and there have been clinical trials and case studies indicating that it improves quality of life in cancer patients undergoing chemotherapy. Evidence that IVC actually has a therapeutic benefit in killing cancer is starting to emerge, but definitely needs work to meet the standard of testing that is generally mandated for something to become standard of care. So now we're in this weird local minima of scientific interest in a potential therapy. Nobody that I've seen is seriously suggesting that IVC is an effective monotherapy against any kind of cancer. But there is growing evidence that it is a safe and effective adjunct therapy to increase quality of life and potential outcomes for many patients. Unfortunately, clinical trials are expensive and most oncology teams are not interested in results that haven't specifically tested the cancer that they specialize in. So you are left with waiting for someone to explore the enormous graph of specific cancer treatment settings and apply this trial. In other words, it's not coming to a theater near you any time soon. Meanwhile people are dying because the current treatments are not working, and finding a doctor with the guts to explore these options with a willing and educated patient is, in my personal experience, next to impossible.
kaikai 7y ago
Very high doses of vitamin C are also an abortifacient, although it's not as reliable as other medical methods. If you think you might be pregnant or are trying to become pregnant think twice about using vitamin C to treat another other conditions.
piinthesky 7y ago
Timing is everything when money is involved. https://www.dailymail.co.uk/health/article-8067189/Chinas-doctors-racing-Vitamin-C-beat-coronavirus.html https://www.dailymail.co.uk/health/article-8067189/Chinas-do...
y0ssar1an 7y ago
Don't waste my time with this stuff. - single study - on mice - hasn't been replicated - purely speculative mechanism of action (How exactly is Vitamin C helping? They don't know!) I guess I have to remind everyone that most published research is false: https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.0020124 https://journals.plos.org/plosmedicine/article?id=10.1371/jo...
- ksaun 7y ago
  I appreciate and believe I understand your perspective. I do not refute your criticisms of the research. I have a different perspective, however. As someone who is expected to die of cancer within a few years, even early/flawed research is of interest. Especially with the cognitive impairments I feel from chemotherapy, I find it challenging to wade through all of the ideas and opinions to get to information that's useful in guiding decisions about my treatment. In particular, this thread acquainted me with jcims's life experiences. I take his statements at face value and believe that he's indeed spent countless hours researching various treatment possibilities. That he is left with the belief that vitamin C has promise as a treatment option gives me cause to further explore the relevant science. I lack the time, energy, and knowledge to investigate the plethora of options/speculation, so I greatly appreciate when another credible person points me in a direction that's worthy of greater attention. This doesn't mean I'm planning to ask my oncologist about vitamin C or pursue this as a treatment option at this time. :) It just gives me a promising area of further exploration and I'll see where it leads me. From this thread, I also gained reinforcement (in part through pazimzadeh's summary, below) of my understanding that taking vitamin C oral supplements during chemotherapy is ill-advised. I'd come across this guidance before, but have been reminded of it by this article and this discussion. So, my request to you is to please not discourage posts such as this article here on Hacker News. If you prefer to not have your "time wasted [by] this stuff" then please don't click on such articles or please suffer in silence. Or, better yet, post your summary of the research's limitations, as you've done here. (That is, your summary is useful, but your first line saddened me, as I appreciated having my time "wasted" by this article and the subsequent discussion. I hope others here do not heed your request.) Edit: minor editing to simplify. (I realize this post is still rather wordy, please forgive.)
watertom 7y ago
Mice do not equal Humans for one simple fact. Mice produce l-Ascoribic Acid already, where humans cannot. I would argue that guinea pigs would be a much better model, because guinea pigs, like humans don't manufacture their own vitamin C. I would argue that testing any vitamin C therapy on animals that product their own l-ascorbic acid is a waste of time.

154 points by daddylonglegs 7y ago

ELI5 please. So billions of dollars spent on cancer research, and the solution this entire time, is to simply spike the IV drip with some lemon juice?

british_india 7y ago

Fresca is packed with Vitamin C.

clumsysmurf 7y ago

I found this summary to be an easier read than the original research paper https://medicalxpress.com/news/2020-02-high-doses-vitamin-immunotherapy-combating.html https://medicalxpress.com/news/2020-02-high-doses-vitamin-im...

bastian 7y ago

This is an interesting link from the comments section of the article: https://clinicaltrials.gov/ct2/show/NCT04264533 https://clinicaltrials.gov/ct2/show/NCT04264533

1996 7y ago

TLDR: A team of researchers affiliated with multiple institutions in Italy has found that giving cancerous mice high doses of vitamin C (ascorbic acid) enhanced immunotherapy, resulting in slowed or stopped tumor growth. Maybe Linus Pauling was indeed on to something (https://en.wikipedia.org/wiki/Linus_Pauling https://en.wikipedia.org/wiki/Linus_Pauling ) with his idea of high dose IV vitamin C: skipping the article as it seems to take political positions ("But if this work makes some headlines of the “Linus Pauling was right” sort, don’t believe them") and using Wikipedia as a source instead: Pauling's work on vitamin C in his later years generated much controversy. He was first introduced to the concept of high-dose vitamin C by biochemist Irwin Stone in 1966. After becoming convinced of its worth, Pauling took 3 grams of vitamin C every day to prevent colds.[13] Excited by his own perceived results, he researched the clinical literature and published Vitamin C and the Common Cold in 1970. He began a long clinical collaboration with the British cancer surgeon Ewan Cameron in 1971 on the use of intravenous and oral vitamin C as cancer therapy for terminal patients.[143] Cameron and Pauling wrote many technical papers and a popular book, Cancer and Vitamin C, that discussed their observations. Pauling made vitamin C popular with the public[144] and eventually published two studies of a group of 100 allegedly terminal patients that claimed vitamin C increased survival by as much as four times compared to untreated patients (...) medical establishment concluded that his claims that vitamin C could prevent colds or treat cancer were quackery.[13][151] Pauling denounced the conclusions of these studies and handling of the final study as "fraud and deliberate misrepresentation",[152][153] and criticized the studies for using oral, rather than intravenous vitamin C[154] (which was the dosing method used for the first ten days of Pauling's original study

SAI_Peregrinus 7y ago
I wouldn't say that "But if this work makes some headlines of the “Linus Pauling was right” sort, don’t believe them" is a political position. Pauling was wrong: he didn't say "High dose IV vitamin C is helpful", he said (paraphrased) "High dose IV vitamin C is helpful because it is an antioxidant". But it's not an antioxidant, as this paper shows, it's an oxidant! It's helpful, but for exactly the wrong reason, and low-dose vitamin C is an antioxidant, which is harmful! So if Pauling were correct you'd expect other antioxidants to help, but they also cause harm (in oncology).
- agumonkey 7y ago
  I've been curious about balancing [anti]oxydants, do you know good texts on this ?
- 1996 7y ago
  So basically this guy who said vitamin C IV in high doses fights cancer was wrong and should be never rehabilitated , because the hypothetised mechanism was the other way around? (anti oxidant -> oxidant) I think we are forgetting the most important result there: vitamin C IV in high doses fights cancer.
  - SAI_Peregrinus 7y ago
    > I think we are forgetting the most important result there: vitamin C IV in high doses fights cancer. No, that's wrong. Vitamin C IV in high doses makes certain chemotherapy work better to fight cancer. And does so in a way that Pauling wouldn't have been able to predict, his mechanism of action would imply that it would reduce the effectiveness of the chemotherapy.
starchild_3001 7y ago
Not sure who downvoted you, but thanks for sharing this important snippet of history. Without pioneers (who often don't get it fully right), there'd no discoveries or progress.

pazimzadeh 7y ago

Here's the original article: High-dose vitamin C enhances cancer immunotherapy https://stm.sciencemag.org/content/12/532/eaay8707/ https://stm.sciencemag.org/content/12/532/eaay8707/ Takeaways: Oral Vitamin C and intravenous Vitamin C have vastly different pharmacokinetics and effects on cancer. - Low dose vitamin C (oral) is anti-oxidant and may attenuate chemotherapy: Chemosensitizing effect of vitamin C in combination with 5-fluorouracil in vitro https://www.ncbi.nlm.nih.gov/pubmed/12929582 https://www.ncbi.nlm.nih.gov/pubmed/12929582 "only a high concentration of vitamin C increased the cytotoxicity of 5-FU" Ascorbic acid attenuates antineoplastic drug 5-fluorouracil induced gastrointestinal toxicity in rats by modulating the expression of inflammatory mediators https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5598240/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5598240/ - High dose vitamin C (intravenous) is pro-oxidant - High dose vitamin C (intravenous) alone slows tumor growth - High dose vitamin C (intravenous) combined with immunotherapy has a synergistic effect High dose vitamin C (intravenous) also synergizes with chemotherapy and spares healthy cells https://stm.sciencemag.org/content/6/222/222ra18 https://stm.sciencemag.org/content/6/222/222ra18 If you are in chemotherapy or immunotherapy, stay away from low doses of oral anti-oxidant supplements such as Vitamin C.

tomlue 7y ago
We did a data extraction project for 81 trials using oral or intravenous IV as a cancer therapy! You can see the whole project at https://sysrev.com/p/6737 https://sysrev.com/p/6737. Basically we imported 81 VitC trials from clinicaltrials.gov and extracted dose levels, administration methods, placebo usage, and some other data. You can see all the oral studies here: https://shorturl.at/mvxy4 https://shorturl.at/mvxy4 You can see all the IV studies here: https://shorturl.at/bn019 https://shorturl.at/bn019 The results of the research will be published soon...
- tomlue 7y ago
  Those links are broken and should be You can see all the oral studies here: https://bit.ly/3ct2q4u https://bit.ly/3ct2q4u You can see all the IV studies here: https://bit.ly/2Th9ud5 https://bit.ly/2Th9ud5
7y ago

pstuart 7y ago

Shooting up C doesn't sound appealing, but I wonder if liposomal C might be worth exploring after all.

KWxIUElW8Xt0tD9 7y ago

look up papers by Dr. Klenner on the use of intravenous vitamin C see also "living proof" a New Zealand 60-minutes segment

chrisco255 7y ago

Worth noting that clinical trials are underway for studying the effect of vitamin C infusions on 2019-nCov: https://clinicaltrials.gov/ct2/show/NCT04264533 https://clinicaltrials.gov/ct2/show/NCT04264533

deleted 7y ago
[deleted]

jcims 7y ago

Pursuing this as an adjunct therapy for my wife's cancer treatment showed me a side of healthcare that I hadn't really considered before. Fear. Not fear of a calculated risk going the wrong way healthwise, but profound fear of stepping anywhere outside the brightly lit path of 'standard of care'. There's this phase change in the doctor's expression that you can see visually when you enter into conversations such as this (the other one being management of hyperglycemia). There's a certain slackening of facial expression and straightening of posture. The vocabulary becomes smaller, blinking more regular, tone flatter and the conversation becomes more circular. It took me a little while to sort it out, but I've come to the conclusion that these (mostly young) doctors are so incredibly leveraged in their position by student loans and sunk cost into their education that they simply cannot risk anything outside of the prescribed approach to care for a patient...particularly one where there is generally a foregone conclusion as to the outcome. I initially raged against them individually, but now I see them as scared children and my hatred is directed towards the system that creates this fear. Should I encounter this situation again, my first goal will be to find a doctor with a terminal illness themselves and see if we can't forge a new path together.

appleiigs 7y ago
Without scientific evidence the young doctors would be guessing and that would not be responsible of them. Without scientific evidence, you are guessing too.
- jcims 7y ago
  Philosophically there's nothing wrong with what you're saying, but it's not particularly applicable. None of the 'standard of care' therapies for, in our case, ovarian cancer are guaranteed to be effective...they simply have hazard ratios that are more favorable than the rest. So, quite literally, doctors are already guessing as to what to do next once you are in a recurrent cancer setting (even before, really). On top of that there is a mountain of clinical evidence that high dose intravenous vitamin C (IVC) has an incredibly low risk of adverse events in healthy patients and there have been clinical trials and case studies indicating that it improves quality of life in cancer patients undergoing chemotherapy. Evidence that IVC actually has a therapeutic benefit in killing cancer is starting to emerge, but definitely needs work to meet the standard of testing that is generally mandated for something to become standard of care. So now we're in this weird local minima of scientific interest in a potential therapy. Nobody that I've seen is seriously suggesting that IVC is an effective monotherapy against any kind of cancer. But there is growing evidence that it is a safe and effective adjunct therapy to increase quality of life and potential outcomes for many patients. Unfortunately, clinical trials are expensive and most oncology teams are not interested in results that haven't specifically tested the cancer that they specialize in. So you are left with waiting for someone to explore the enormous graph of specific cancer treatment settings and apply this trial. In other words, it's not coming to a theater near you any time soon. Meanwhile people are dying because the current treatments are not working, and finding a doctor with the guts to explore these options with a willing and educated patient is, in my personal experience, next to impossible.

kaikai 7y ago

Very high doses of vitamin C are also an abortifacient, although it's not as reliable as other medical methods. If you think you might be pregnant or are trying to become pregnant think twice about using vitamin C to treat another other conditions.

piinthesky 7y ago

Timing is everything when money is involved. https://www.dailymail.co.uk/health/article-8067189/Chinas-doctors-racing-Vitamin-C-beat-coronavirus.html https://www.dailymail.co.uk/health/article-8067189/Chinas-do...

y0ssar1an 7y ago

Don't waste my time with this stuff. - single study - on mice - hasn't been replicated - purely speculative mechanism of action (How exactly is Vitamin C helping? They don't know!) I guess I have to remind everyone that most published research is false: https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.0020124 https://journals.plos.org/plosmedicine/article?id=10.1371/jo...

ksaun 7y ago
I appreciate and believe I understand your perspective. I do not refute your criticisms of the research. I have a different perspective, however. As someone who is expected to die of cancer within a few years, even early/flawed research is of interest. Especially with the cognitive impairments I feel from chemotherapy, I find it challenging to wade through all of the ideas and opinions to get to information that's useful in guiding decisions about my treatment. In particular, this thread acquainted me with jcims's life experiences. I take his statements at face value and believe that he's indeed spent countless hours researching various treatment possibilities. That he is left with the belief that vitamin C has promise as a treatment option gives me cause to further explore the relevant science. I lack the time, energy, and knowledge to investigate the plethora of options/speculation, so I greatly appreciate when another credible person points me in a direction that's worthy of greater attention. This doesn't mean I'm planning to ask my oncologist about vitamin C or pursue this as a treatment option at this time. :) It just gives me a promising area of further exploration and I'll see where it leads me. From this thread, I also gained reinforcement (in part through pazimzadeh's summary, below) of my understanding that taking vitamin C oral supplements during chemotherapy is ill-advised. I'd come across this guidance before, but have been reminded of it by this article and this discussion. So, my request to you is to please not discourage posts such as this article here on Hacker News. If you prefer to not have your "time wasted [by] this stuff" then please don't click on such articles or please suffer in silence. Or, better yet, post your summary of the research's limitations, as you've done here. (That is, your summary is useful, but your first line saddened me, as I appreciated having my time "wasted" by this article and the subsequent discussion. I hope others here do not heed your request.) Edit: minor editing to simplify. (I realize this post is still rather wordy, please forgive.)

watertom 7y ago

Mice do not equal Humans for one simple fact. Mice produce l-Ascoribic Acid already, where humans cannot. I would argue that guinea pigs would be a much better model, because guinea pigs, like humans don't manufacture their own vitamin C. I would argue that testing any vitamin C therapy on animals that product their own l-ascorbic acid is a waste of time.