I have recently been invited to attend a session on a novel integrative cancer treatment approach but found out the main player of the session was actually practicing naturopathic medicine even though he appeared to smudge the very clear distinction between orthodox oncology and naturopathic medicine. With due respect to all naturopathic medicine practitioners, I personally believe that such a plot to sell high-dose intravenous vitamin C (HDIVC) so that it may appear to be a panacea remedy for cancer could be inappropriate as HDIVC by itself has never been an alternative to orthodox modalities of treatments, e.g., surgery, radiotherapy and chemotherapy.

I am not saying that HDIVC has no role for cancer therapy. In fact, a book that I am guest editing for Nova Science Publishers has a couple of chapters on the very interesting history of vitamin C – from its discovery in the 1930s to its very early usage for saving a countless number of scurvy patients to eradicating viral infections by then (when anti-viral agents were unheard of) to its use for end-stage cancer patients to its unfortunate and outright rejection due apparently to conflict of interest. Perhaps, the large pharmaceutical companies would very much prefer to develop more and more novel agents for treatment of both microorganisms and cancer but it so happened that the off-patent HDIVC not only has pleiotropic effects but is also safe and readily available, let alone being eminently affordable especially when compared with their hefty novel products.

It is right and proper for all pharmaceutical companies to make a profit. However, to deprive patients of the usefulness of such a pleiotropic and eminently affordable drug as HDIVC may not be appropriate. I used to work for years as a senior radiation oncologist for a flagship general hospital but had found out that a senior medical oncologist had attempted to influence the local Ministry of Health to ban the use of HDIVC. His rationale was that HDIVC never had any evidence at all for its therapeutic effects. In that case, even those desperate cancer patients running out of all viable options would never have any chance to try HDIVC even on compassionate grounds. This would be just like passing an immediate “death sentence” to those end-stage cancer patients.

Importantly, the addition of HDIVC on top of previously “ineffective” oncology modalities of treatments may well have good results unexpectedly. Even though HDIVC on its own may not be sufficient for eradication of cancers unless it is administered as an adjunct. This was what had happened in the 1970s when Linus Pauling (a Nobel laurate) and colleagues administered HDIVC to end-stage cancer patients and achieved longer survivals, let alone a better quality of life. Most probably, their belated HDIVC administration had a retrospective adjuvant effect on top of all those ‘ineffective” oncology modalities of treatments but had now been rendered more effective upon the addition of HDIVC, albeit belated. I would personally believe in such a belated adjuvant effect as cancer patients were well documented to have “recall radiation reactions” when chemotherapy agents were administered even several weeks after irradiation, i.e., their previously irradiated regions would now begin to have another bout of radiation reaction upon the delivery of belated chemotherapy agents even though no more irradiation had ever been delivered.

In retrospect, it is merely conjecture, but, there are no other likely ways to explain why those end-stage cancer patients given HDIVC by Pauling et al could have longer survivals and better quality of life. There must be something in HDIVC especially as, currently, many scientists, e.g., Dr. Jihye Yun, Assistant Professor at the Department of Molecular and Human Genetics at Baylor College of Medicine, Houston, has been actively studying the scientific basis of the beneficial effects of HDIVC. Moreover, clinicians, e.g., Dr Paul Marik, Internal Medicine, Eastern Virginia Medical School, Norfolk, VA also believes that the early administration of HDIVC may well prevent the so-called “cytokine storms”: probably the cause of acute respiratory distress of chest infections, especially viral, including COVID-19. This indication is mostly based on the anti-inflammatory effects of HDIVC. There is also a prospect of adjunctive HDIVC reducing bacterial resistance to antibiotics. All of these could well be the saving grace for a lot of unfortunate patients, let alone the known pleiotropic properties of HDIVC may well enable its oncology adjunct role.

As of 2018, cancer research workers at the University of Iowa’s Holden Comprehensive Cancer Center had received a five-year, $9.7 million grant from the National Cancer Institute to study on the use of HDIVC for therapy purposes. This is very encouraging indeed as the off-patent HDIVC would hardly attract any financial assistance from the pharmaceutical industry. Hopefully, in the near future, the details of various clinical applications of HDIVC would be elucidated. All in all, although HDIVC is, without doubt, evidence based medicine, its exact role as an adjunct for both microorganism and cancer eradication has yet to be explored more fully. My own perspective is it has an excellent potential to be a good adjunctive oncology agent, let alone its time honored anti-microbial and anti-inflammatory properties. However, to hail it as a panacea of cancer therapy is, to me, inappropriate at this stage.

Shiu Y. Tsao, former Director of Radiotherapy, Department of Clinical Oncology, the Chinese University of Hong Kong, Hong Kong SAR, China.