Via bovenstaande organisatie en via deze website kunt u informatie vinden over het intraveneus toedienen van ascorbine zuur (vitamine C.) bij ongeneeslijke kankerpatiënten. Als extra waarschuwing ga hier nooit zelf aan beginnen, maar als u hier wat in ziet neem altijd contact op met een arts/oncoloog, die ook verstand heeft van voeding en biochemie. Zo weet ik dat dokter Valstar (en andere orthomoleculaire artsen) wel precies weet hoe dit werkt en hoe dit toe te dienen. Maar natuurlijk zullen ook oncologen in academische ziekenhuizen hier verstand van hebben. Maar neem dan een uitdraai mee voor uw oncoloog van het behandelingsprotocol die u kunt vinden op de betreffende website. En deze aanpak is nooit een aanpak op zich maar altijd een aanvulling op bestaande behandelingen. Ook is onze disclaimer hier nadrukkelijk van toepassing, zoals op alles wat op deze site wordt vermeld.

Wat me opvalt is dat ook bij de methylglyoxalformule (zie deze pagina voor alles over methylglyoxal incl. behandelingprotocol) ascorbinezuur (vitamine C. in ongeveer dezelfde dosis wordt toegevoegd aan de behandeling). Maar ik zal eens een arts vragen hier naar te kijken.

Ik plaats hier enkele citaten van de website over ascorbinezuur, maar voor volledige artikelen en informatie kunt u beter naar de website gaan. Of neem contact hierover op met uw orthomoleculair arts die meestal ook weten hoe dit toe te dienen en hoe dit werkt.

Op sommige plaatsen heb ik even wat in het Nederlands vertaald, maar het artikel is grotendeels in het Engels. Hoopgevend vind ik de beschrijving van twee gevallen waarbij ascorbinezuur als aanvulling in de behandeling bij twee ongeneeslijk verklaarde niercelkankerpatiënten voor een nooit meer gedacht effect zorgde.

Intravenous Ascorbate as a Chemotherapeutic and Biologic Response Modifying Agent

Introduction
For over 15 years we have studied high dose intravenous ascorbic acid (IAA) as an adjunctive therapy for cancer patients. Initially, doses of 15g per infusion were used, once or twice per week. These doses improved patients' sense of well being, reduced pain, and in many cases prolonged life beyond prognostications of oncologists.

Twelve years ago, we used infusions of 30 grams of IAA, twice per week, and found that metastatic lesions in the lung and liver of a man with a primary renal cell carcinoma disappeared in a matter of weeks (1). At that time we believed IAA was useful for patients with cancer solely through two biological response modifier mechanisms: increased production of extracellular collagen ("walling off" the tumor as proposed by Cameron and Pauling) and enhancement of immune function. We subsequently reported a case of resolution of bone metastases in a patient with primary breast cancer (1A) using infusions of 100 grams, once or twice per week (2).

In a recent publication (3) we presented evidence that ascorbic acid and its salts (AA) could be more than biological response modifiers. We found that AA is preferentially toxic to tumor cells - suggesting that it could be useful as a chemotherapeutic agent. Preferential toxicity occurred in vitro in multiple tumor cell types. We also presented data suggesting that plasma concentrations of ascorbate required for killing tumor cells were achievable in humans. Others have described in vivo toxicity in multiple tumor types and animal models (4-8).

Here we wish to summarize our experience using IAA for approximately 50 patients with cancer. We include our protocol, precautions, and case studies of two patients treated for metastatic renal cell carcinoma.

Treatment rationale
From our studies (3) we concluded that:

Tumor cells are more susceptible to the effects of high-dose, ascorbate-induced peroxidation products because of a relative catalase deficiency; and, 
Concentrations of ascorbate high enough to kill tumor cells likely can be achieved in humans. 
Subsequently we tested samples of human serum from patients receiving IAA, and confirmed that AA concentrations can reach levels that are cytotoxic to tumor cells in vitro. Using densely populated monolayers, three-dimensional hollow-fiber tumor models, and human serum as a growth medium to closely mimic what occurs in vivo, we found that an AA concentration of 400 mg/dL effectively kills most tumor cell types. Originally we reported that a concentration of 40 mg/dL was adequate (3). Those early data were generated from in vitro studies using sparsely populated cell monolayers and standard tissue culture medium.

Figure 1 shows the responses to increasing doses of ascorbate of four human tumour cell lines grown in dense monolayers in a medium of human serum. Zie deze websitepagina voor figuur 1 and figuur 2.

Figure 2 depicts plasma ascorbate levels of three representative patients given 65 grams of ascorbate over 65 minutes. 

Patient 1 was a 74-year-old male who had a diagnosis of non-metastatic prostate carcinoma, who had received 30 IAA infusions in the two years prior to the study. Patient 2 was a 50-year-old male with a diagnosis of non-Hodgkin's lymphoma who had received 16 IAA infusions prior to the study. Patient 3 was a 69-year-old male with a diagnosis of metastatic carcinoma of the jejunum who had received 16 IAA infusions prior to study.

From the data in both figures 1 and 2, one can see that the concentrations required to kill tumour cells can be achieved at least briefly in human plasma. Figure 2 suggests the need to measure post-IAA plasma ascorbate concentrations to determine if patients are achieving what we expect are adequate concentrations.

Hieronder de beschrijving van het  behandelingsprotocol, maar nogmaals neem altijd contact op met uw behandelend arts/oncoloog en/of orthomoleculair arts (zie adressen orthomoleculaire artsen op pagina nuttige adressen)bij toepassing van dit protocol. Zie ook onze disclaimer.

Infusion Protocol
Treatment choice
Treatment of cancer with IAA should never be considered to replace an effective, proven treatment. It should only be considered in: (De behandeling van kanker met IAA zal hiermee nooit in de plaats kunnen komen van effectieve bewezen andere behandelingen. Het kan alleen in overweging genomen worden in geval van):

Cases of treatment failure using proven methods (in gevallen van niet aanslaan van bewezen methoden) 
Cases with no known effective treatments (in gevallen waar geen effectieve behandelingen paraat lijken) 
Cases in which it is used as an adjunct to proven treatments. (in gevallen waar IAA als aanvullende behandeling kan worden gegeven.)
Because IAA treatment is experimental an appropriate informed consent form should be read, understood, and signed by the patient. (Omdat een IAA behandeling experimenteel is zal elke patiënt moeten tekenen dat alles goed is uitgelegd en begrepen

Precautions and side effects
The side effects of IAA in our experience are rare. However, there are contraindications and potential side effects to be considered. (Bijwerkingen bij IAA zijn zeldzaam althans naar de ervaringen van deze organisatie. Hoewel er wel een paar contra-indicaties zijn voor toediening. Lees deze goed)

Although it has been reported only once in the literature, tumor necrosis, hemorrhage and subsequent death after a single intravenous 10 gram dose of AA, as reported by Campbell and Jack (10), should be the highest priority concern for the safety of IAA for cancer patients. For this reason, we always begin with a small dose (see Infusion). 
Another report described acute oxalate nephropathy in a patient with bilateral ureteric obstruction and renal insufficiency who received 60 gram IAA (11). We have also heard one case report of a patient with colon carcinoma, receiving daily IAA, who developed nausea and vomiting and was hospitalized for dehydration (12). Both cases show the need to ensure that patients have adequate renal function, hydration, and urinary voiding capacity. To these ends, our baseline lab tests include a serum chemistry profile and urinalysis. 
Hemolysis can occur in patients with a red cell glucose-6-phosphate dehydrogenase (G6PD) deficiency. We therefore test G6PD on all patients before beginning IAA infusions. 
Localized pain at the infusion site can occur if the infusion rate is too high. This is usually corrected by slowing the rate. 
Because ascorbate is a chelating agent, some individuals may experience shaking due to low serum calcium. This is treated by a slow (1 cc per minute) intravenous push of 10 cc of calcium gluconate. 
Rivers (13) reported that high dose IAA is contraindicated in renal insufficiency, chronic hemodialysis patients, unusual forms of iron overload, and oxalate stone formers. However, oxalate stone formation may be considered a relative contraindication. Two groups of researchers (14,15) demonstrated that magnesium oxide (300 mg/d orally) and vitamin B6 (10 mg/d orally) inhibited oxalate stone formation in stone formers. 
Given the amount of fluid which is used as a vehicle for the ascorbate and the sodium hydroxide/sodium bicarbonate used to adjust the pH, any condition which could be adversely affected by increased fluid or sodium is relatively contraindicated. For example: congestive heart failure, ascites, edema, etc. 
As with any intravenous site, infiltration is always possible. 
Ascorbate should only be given by intravenous drip. It should never be given IV push, as the osmolality of high doses are capable of sclerosing peripheral veins, nor should it be given intramuscularly or subcutaneously. There is always a trade-off between fluid volume and osmolality. We have found an osmolality of less than 1200 milliOsmal to be tolerated well by most patients (Table 1). (Zie website voor table 1)

In high-dose ascorbate therapy, many intravenous solutions are hypertonic. This does not seem to present a problem as long as the infusion rate is low enough and the tonicity does not exceed 1200 milliOsmal (mOsm). We generally infuse AA mixed with Ringer's lactate (RL) solution for AA amounts up to 15 gram, and in sterile water for larger amounts of AA. We presently use a sodium ascorbate/ascorbic acid mixture containing 0.91 moles of sodium per mole of ascorbate (500 mg AA/mL, pH range 5.5-7.0, Merit Pharmaceuticals, Los Angeles, California, and Maclaskey Pharmaceuticals, Wichita, Kansas). Table 1 shows the osmolalities of commonly prepared solutions.

Infusion
As indicated in the precautions, a small starting dose of 15 gram AA in 250 mL RL over 1 hour is recommended. The patient is watched closely for any adverse effects. The dose can then be gradually increased over time. The infusion rate should not exceed 1 gram AA per minute; 0.5 gram/min is well tolerated by most patients. Although there is variability due to scheduling and tolerance, a typical protocol will consist of the following infusions:

Week 1: 1 x 15 g infusion per day, 2-3 per week 
Week 2: 1 x 30 g infusion per day, 2-3 per week 
Week 3: 1 x 65 g infusion per day, 2-3 per week 
The dose is then adjusted to achieve transient plasma concentrations of 400 mg/dL, 2-3 infusions per week.

According to our working hypothesis, the goal of the infusions is to raise plasma ascorbate concentration above the tumor-cytotoxic level for as long as possible. Because the ascorbate is so readily cleared by the kidney, the optimal infusion rate will result in tumor-cytotoxic plasma levels of ascorbate for the longest time periods - and hopefull, maximum tumor cell killing.

We advise patients to orally supplement with 4 grams ascorbate daily, especially on the days when no infusions are made, to help prevent a possible scorbutic "rebound effect".

Case histories
We have seen patients with almost every type of solid tumor in our clinic. Many of them have received IAA, with various degrees of success. Our cases include a patient with cancer of the head of the pancreas who lived for 3.5 years with IAA as sole therapy, resolution of bone metastases in patients with breast cancer, many patients with non-Hodgkin's lymphoma (none of whom have died from their disease), resolution of primary liver carcinoma tumors, resolution of and reduction in size of metastatic colon carcinoma lesions, and resolution of metastatic lesions and over 3-year survival in patients with widely metastatic ovarian carcinoma. We plan to present a full compilation of cases in another communication.

ascorbate, infusion, infusions, plasma, concentrations, intravenous, serum, resolution, sodium, renal

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