In this issue of the Journal, we republish three papers from prior years to showcase the promise and potential efficacy of intravenous vitamin C (IVC), as well as the complexities related to its mechanism of action, suggested optimal dosing, and its impact upon normal and cancer cells. I urge our current and new readership to thoroughly review these articles. They are part of two dedicated issues covering various topics related to IVC and cancer in this inaugural 2017 year of having the Journal available in an online and open access format for all to freely enjoy.

I have a perspective on IVC that I would like to share with our readership. Let me begin by offering a short history lesson pertaining to pediatric oncology. In the 1950s, fewer than 10 percent of pediatric cancers were cured, but today almost 80 percent will survive their cancer diagnosis (CancerProgress.Net, 2016). How did this happen? An article by Shamberger (2013) outlines the history of pediatric oncology, including its evolution to the current cancer success rates of our present day. Pediatric oncologists addressed the poor success rates of pediatric cancers in the 1950s through a systematic evaluation of treatment outcomes and patient responses to particular chemotherapeutic agents. Cooperative group trials were initiated, in which all pediatric patients with cancer were enrolled in phase III studies that were overseen by multi-center and multidisciplinary collaborations across the United States. These collaborations helped to develop systematic and life-saving protocols, advanced treatment, and ensured that there was the needed discipline in treating pediatric cancers by removing the prior clinician-driven, individualist approach.

Unfortunately, the current state of IVC treatment continues to be mired in a clinician-driven approach. The typical cancer patient seeking IVC finds a clinician who can perform this treatment, and the clinician uses his/her knowledge of IVC to deliver adjunctive or primary cancer care. While this is admirable, it will inevitably fail many patients because at the present time there has been no systematic way that patients receiving IVC have been studied under an omnibus of multi-center and multidisciplinary collaborations across North America. This has resulted in much clinical confusion and uncertainty about the types of cancers most responsive to IVC, optimal dosing for specific cancers, whether IVC should be withheld and not offered to patients with specific cancers and, in general, an absence of protocols that have been vetted by the larger community of IVC clinicians who regularly provide this type of clinical care.

It is surprising that in our current era of data collection and analysis, this type of systematic approach that could advance IVC and cancer care has yet to happen, despite the popularity of the approach and the evolving numbers of publications on the topic. A simple Google search on February 22, 2017 revealed some 718,000 results in 0.61 seconds. A search on PubMed on the same day revealed some 880 citations, even though not all of them were related to cancer. I quickly scanned the more current publications about IVC and none of them have synthesized the concerns raised here. Much of the published data speaks of pharmacokinetics, the impact of IVC upon patients with advanced cancers, and the safety of IVC, but to my knowledge no protocols have been vetted and approved by larger organizations and experts to distil the many important facets of IVC and clinical cancer care that would improve patient outcomes.

My hope is that many in the field of IVC and cancer will read this editorial and become mobilized to change course and work more collaboratively and systematically. We need to know more specifics about this approach to cancer, so much so that unless things change the current state of IVC will remain mired in individualism and bias, with uncertain treatment outcomes and clinical efficacy. The field needs someone or some organization to work on systematizing all current and future data on this important treatment approach. Why can’t all adult patients that receive IVC be immediately enrolled in a phase III trial? Why can’t this information be uploaded somewhere in a format that can be authenticated and analyzed so that we can begin to answer these very important clinical questions, for our patients and for ourselves?

Jonathan E. Prousky, ND, MSc, MA, RP (Qualifying)

Editor

References

CancerProgress.Net (2016) Progress & Timeline, Pediatric Cancer, Retrieved from http://www.cancerprogress.net/timeline/pediatric-cancer

Shamberger, R. C. (2013) Cooperative Group Trials in Pediatric Oncology: The Surgeon’s Role, Journal of Pediatric Surgery, 48(1) 1-13.