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IV Vitamin C: The Long Awaited Cancer Cure

When vitamin C was discovered in the early 1930’s by Hungarian and American researchers it was described as the anti-scurvy vitamin.  Vitamin C is required to make collagen.  Without vitamin C, collagen production stops and our tissues start to breakdown, causing scurvy.  Just a few years after it’s discovery, doctors argued that vitamin C’s ability to strengthen tissues and promote healing would make it the ideal anti-cancer agent.  The theory was that if a person were saturated with vitamin C, their tissues would be impenetrable to invading cancer cells.

It wasn’t until the 1970’s that medical researchers actually tested the effects of vitamin C on cancer patients.  In a famous study, doctors gave 100 cancer patients a combination intravenous (IV) and oral vitamin C and compared the outcomes to 1000 other similar cancer patients, who did not receive vitamin C.  The results were stunning.  Patients live longer with the combination of IV and oral vitamin C.  The conclusions were clear; vitamin C increases the life span of patients dealing with advanced cancers.

The medical community’s reaction was swift.  The studies were picked apart for methodological flaws and bias.  The lead researcher was essentially blacklisted from publishing medical research for the next 20 years.  Most impressively, in less than 5 year, preeminent researchers from the Mayo Clinic produced multiple studies that definitively demonstrated that oral vitamin C has no effect on cancer patient survival.  The combination of well designed studies and the Mayo Clinic’s prestige as one of the elite American medical institutions shut the door on research involving  vitamin C.

A handful of physicians continued to offer IV vitamin C to cancer patients, and they continued to publish case reports of the benefits of IV vitamin C.  They reported decreases in  fatigue, reductions in inflammation and pain, decreases in poor prognostic markers, and improvements in blood counts and immune functions.  Over the last 5 years, IV vitamin C has slowly made it’s way back into medical research, based on dozens of case reports that show patients benefit from this therapy.

The biggest revelation about vitamin C has been it’s ability to act as a labile antioxidant.  In normal concentrations, vitamin C acts as an antioxidant.  However, in high concentrations vitamin C can produce free radicals; it turns into an oxidant.  The body has sophisticated mechanisms to prevent this from ever happening under normal conditions.  Regardless of the amount of vitamin C a person consumes, the levels in the blood never rise above a set amount.  This is an example of the body’s innate wisdom.  IV vitamin C can bypass this safety mechanism and allows for the delivery of greater concentrations of vitamin C. into the blood

The initial studies, using 10 grams of IV vitamin C, were able to raise the level of vitamin C above normal levels, but the concentration never approached the levels needed to turn vitamin C into an oxidant.  At these doses in the initial studies, vitamin C acted as a nutrient.  Current research is focused on using massive doses of vitamin C (100-150 grams).  At these levels, vitamin C isn’t acting as a nutrient, but as a cytotoxic agent.  Modern research is focused on using vitamin C to kill cancer cells, in a similar way as chemotherapy.  The preliminary research in this area, vitamin C as chemotherapy, has not been promising; survival times have not improved over standard chemotherapy treatment.

Clinical experience shows that lower doses of IV vitamin C have the ability to improve energy and help prevent some of the most devastating effects of chemotherapy.  IV vitamin C as a nutritional therapy helps maintain blood counts and supports immune function.  The use of IV vitamin C as a nutritional therapy, helping people heal, improves the quality of life for cancer patients.

We are still waiting for solid evidence that IV vitamin C, as a nutritional therapy or as chemotherapy, can improve the quantity of life.   Finally, after 40 years, the medical community is starting to answer this question.  While we wait, a handful of physicians will continue to offer IV vitamin C to cancer patients to improve their quality of life as they struggle with this horrible disease.

What’s So Bad About Cholesterol?

Chances are you’ve heard someone say the phrase, “I need to lower my cholesterol.”  Most people would be hard pressed to explain what cholesterol actually is, what roles it plays in our bodies or just how lowering cholesterol improves our health.

Physically, cholesterol has a texture about halfway between butter and wax.  It’s categorized as a lipid, a type of fat, and it is essential to all animals.  Cholesterol is so important because of the role it plays in animal cells.  Every cell in our body has a lining, a cell membrane that separates the inside of the cell from the outside of the cell.  Cholesterol is essential to ensuring the stability of that lining.  Without cholesterol, animal cells would have a very hard time keeping the insides in and the outsides out.   The second important function of cholesterol is as a building block for many of our hormones.  All of our steroid hormones (estrogen, progesterone, testosterone, cortisol, aldosterone, and vitamin D) are made out of cholesterol.  Immune function and sexuality are just a two of the important processes these hormones regulate.

These things rarely get mentioned when we talk about cholesterol. Usually when we talk about cholesterol, we’re talking about heart disease.

Cholesterol needs to be in every cell of our body, but most cholesterol is either created by the liver or absorbed from the digestive tract.  This presents the problem of how to distribute a fatty wax substance through out our mostly water bodies.  To solve this problem, people have a very elaborate system from moving cholesterol around the body.  The two biggest parts of this system are High Density Lipoproteins (HDL) and Low Density Lipoproteins (LDL), which are respectively referred to as ‘good’ and ‘bad’ cholesterol.

At any given time, HDL and LDL can be found in the blood.  Cholesterol does a very good job of absorbing oxidants from the blood.  LDL cholesterol is easily oxidized when traveling through the blood.  Once LDL cholesterol is oxidized it becomes very sticky, sticky enough to hold onto the side of a blood vessel and form plaques.  When these plaques get large enough they can cause heart attacks, the deadliest forms of heart disease.

One of the most common approaches to preventing heart disease has to been to reduce LDL cholesterol.  Less LDL in the blood, means less cholesterol can get oxidized and form plaques.  The medications that are used to lower LDL cholesterol have saved countless lives and have reduced rates of heart disease.  However, these medications are not without risks, and every year a small portion of people are not able to tolerate the side effects of the medications.

However, there are multiple ways to address prevent the formation of plaques that do not artificially lower cholesterol.  Reducing oxidative stress, preventing the oxidation that turns cholesterol into plaques, and targeted nutritional therapies reduce the risk of heart disease.  Our diets are also profoundly powerful tools to regulate not only our intake of cholesterol but also our bodies production of cholesterol and oxidants.

Cholesterol does play an important factor in heart disease, but it is not the only factor.  And the simple view that ‘lower cholesterol is good for you,’ ignores all the important roles that cholesterol plays.

Ask the Doctor: Longer life without vitamin D?

I take vitamin D to help with Seasonal Affective Disorder, but I also heard that people with low vitamin D live longer.  Should I be taking vitamin D?

The study you’re referring to was a Dutch study published this past November. The researchers looked at 380 families with 2 siblings who lived into their 90s. Looking at vitamin D levels and three genes associated with vitamin D, they found a higher rate of a form of the gene CYP2R1, which predisposes individuals to low vitamin D.

This study was interesting because, we have dozens of studies that suggest higher levels of vitamin D are associated with lower levels of heart disease, cancer and other major diseases.  Now we have a study that suggests that a gene that affects vitamin D may be correlated with a longer than average life span.  Unfortunately, we don’t know how or why that correlation exists.

From a practical standpoint, the weight of the evidence suggests vitamin D helps reduce the risk of death from the major leading causes of disease; and if it is helping your Seasonal Affective Disorder, than it is certainly worth taking.

The Sunshine Vitamin and the Winter Blues

It’s a good time to start thinking about vitamin D, the sunshine vitamin.  Vitamin D is called the sunshine vitamin because the first step in making vitamin D involves ultraviolet light penetrating the deep layers of the skin. Cholesterol that is found in the deep layers of the skin absorbs a portion of ultraviolet light.   The light-soaked cholesterol then travels to the liver and is converted into an inactive form of vitamin D.  Inactive vitamin D eventually travels to the kidneys, where it is converted into active vitamin D.  Along the way, our bodies have the ability to finely control this process, but that initial sun exposure is needed to start the process.

For a long time, medicine thought that vitamin D only played a role in bone health.  Vitamin D is essential for maintaining healthy and dense bones.  Vitamin D tells the body to increase the density of bones, by adding more calcium to the bones.   Vitamin D deficiency, generally considered having below 25-30 nmol/L, has been linked to rickets in children; osteomalacia (soft bones) in adults and an increased risk of falls and fractures in people over 65.

However, in the last five years we’ve seen a flurry of activity that suggests vitamin D plays an important role in maintaining optimal function throughout the body.  Vitamin D has been linked to increased immune function and greater ability to fight off and recognize bacteria and viruses that cause disease.  Several population studies have even suggested that individuals with higher vitamin D levels are less likely to develop major diseases such as, multiple sclerosis and cancer, because of the effects of vitamin D on the immune system.  There’s even evidence that vitamin D’s effects on the immune system can help reduce acne.

Vitamin D has also been linked to improvements in athletic performance.  From shaving time off of a sprint to adding height to a basketball player’s jump, vitamin D appears to assist athletic ability through a combination improved muscular contraction, increased repair, and improved mental alertness.  Vitamin D doesn’t only help physical performance; improvements in concentration and overall mood have been associated with higher levels of vitamin D.  Some physicians have even begun using Vitamin D to help treat Seasonal Affective Disorder.

Unfortunately, for the next 6 months, most people living in Portland won’t be making vitamin D due to the lack of sunshine.  Supplementing is the most consistent way of ensuring adequate vitamin D over the next few months.  Most governmental regulatory bodies recommend between 400-800 IU of vitamin D to prevent disease and maintain current level.  People who are deficient may have to take doses closer to 5000-10,000 IU a day to raise their levels.  A simple non-fasting blood test can tell you what your vitamin D level is and can help direct you to the most appropriate dose of vitamin D to get you through the next few months without sunshine.

Sun Screening

Ultraviolet A (UVA) rays are the most abundant form of ultraviolet radiation in sunlight.  These rays are the longest and lowest energy form of ultraviolet radiation.  UVA rays pass through the atmosphere relatively easy.  Regardless of season or time of day, sunlight contains roughly the same amount of UVA rays.  These rays are also capable of penetrating the deeper layers of our skin, where it causes oxidative reactions.  This oxidative reaction causes the darkening of melanin, which most people recognize as tanning.  Unfortunately, oxidative reactions also cause photo-aging of the skin and increase the risk of melanoma, the deadliest form of skin cancer.  UVA does not cause sunburns.

Ultraviolet B (UVB) rays are the middle range of ultraviolet radiation.  Depending on the season and time of day, the atmosphere will absorb varying amounts of UVB.   Mid-day, during the summer months is the highest UVB exposure.  UVB rays do not travel as far into the skin, but unlike UVA, UVB rays can directly damage the DNA in our skin.  UVB rays are responsible for sunburns, and the most common forms of skin cancer.  UVB also stimulates the production of new melanin and vitamin D.

Sunscreens were originally developed to protect pilots from blistering sunburns during their flights.  As such, early sunscreens only protected against UVB, and to this day the majority of sunscreens only protect against UVB.  Sun Protection Factor or SPF is a multiplier for how much time an individual can be exposed to sunlight without developing a sunburn from UVB.  SPF 2 means that a person who would normally develop a sunburn in 20 minutes, can be outside for 40 minutes without developing a sunburn.  A sunscreen with SPF 10 means that same person could be outside for 200 minutes without a sunburn.  This multiplier starts to become less accurate around SPF 30-50. There is no corresponding scale for UVA protection, and unless specifically stated, users should assume that sunscreen does not protect against UVA.

UVB exposure is needed to make vitamin D, a crucial fat-soluble vitamin that plays a role in bone strength, immune response, mental health, and even cancer prevention.  Normal sun exposure is crucial for our bodies to make this vitamin.  Depending on skin tone, a person can produce 10,000 units of vitamin D with just 20 minutes of sun exposure.  However, sunscreens of SPF 8 and above prevent us from making any vitamin D.  To complicate matters, sunscreens of SPF 15 and higher are recommended for the prevention of the most common forms of skin cancer.

People with a personal or family history of melanoma should be sure to use a sunscreen that protects against both UVA and UVB, such as sunscreens containing titanium oxide or zinc dioxide.  Everyone who is going to get more than 20 minutes of sun exposure at a time, should use sunscreen with SPF 15 or higher to prevent the damaging effects of overexposure.  But for at least 20 minutes a day, let the sun soak in and enjoy the benefits of creating your very own vitamin D, with all of it’s health promoting effects.

 

Food Allergies, Sensitivities and Intolerances: Fat

Essential fatty acids, sometimes referred to as vitamin F, are two polyunsaturated fats that humans have to obtain through their diet.  The balance of these fats in the diet can increase or decrease the strength of the inflammatory response.  People dealing with diseases that have a strong inflammatory component (eg. acne, chronic prostatitis, rheumatoid arthrtitis, and asthma) experience more severe symptoms when they consume a diet high in the pro-inflammatory essential fatty acids.

This is because of a group of fatty acid derivatives called eicosinoids.  Eicosinoids are short-lived, hormone-like chemicals that our body makes from essential fatty acids in response to noxious stimuli (eg. trauma, infection, or irritants). These chemicals are responsible for the redness, pain, swelling and heat associated with inflammation.  Since these signals are made on demand, eicosanoids are made from the essential fatty acids that are stored in the body.   Interestingly, the specific eicosinoid that is made depends on which of the two essential fatty acids are used and not on what the stimuli is.

The first essential fatty acid is linoleic acid.  This omega-6 fatty acid is abundant in safflower, sunflower and corn oils.  Animals convert linoleic acid into another fat called arachidonic acid.  Arachidonic acid, also an omega-6 fatty acid, is then converted to a group of pro-inflammatory eicosinoids that cause inflammatory reactions such as blood vessel constriction, immune activation, muscular contraction and fever.

Alpha-linolenic acid, an omega-3 fatty acid, is the other essential fatty acid in the diet.  The highest concentrations of alpha-linolenic acid in food are found in chia and flax seeds. Walnut, hemp, canola and soybean oils all have some amount of alpha-linolenic acid.  Just as with linoleic acid, animals convert alpha-linolenic acid into a different omega-3 fat for storage: eicosapentaenoic acid (EPA) . EPA is considered the active ingredient in fish oil supplements.  The eicosanoids produced from omega-3 fatty acids are generally considered anti-inflammatory.

Omega-3

Fatty Acids

Omega-6

Fatty Acids

Essential Fatty Acid

Alpha-linolenic acid

Linoleic Acid

Sources

Flax, Chia, Walnut, Hemp, Canola, Soybean

Safflower, Sunflower, Corn

Animal Form

Eicosapentaenoic acid (EPA)

Arachidonic acid

Sources

Salmon, Cod, Mackerel, Anchovies

Grain-fed Beef and Dairy, Pork

Because these fats are stored in the cells of animals, they have the ability to travel up the food chain.  Animals that have a diet high in linoleic acid, such as animals raised on corn, will have higher amounts of arachidonic acid, compared to animals that have a diet high in alpha-linolenic acid.

Both omega-6 and omega-3 fatty acids are essential to our health.  However, for people who experience chronic inflammation reducing their intake of omega-6 fatty acids, while increasing their intake of omega-3 fatty acids has proven to be a useful way of reducing symptoms.

Shifting towards the digestive tract, fat intolerance is the generic term for difficulty digesting any dietary fats.  The gallbladder and the pancreas are responsible for mixing and breaking the fats we eat, while the small intestine is responsible for absorbing the digested fats.  If any of these organs are not working properly, the end result is undigested fats entering the colon.  Fats in the colon are broken down by colonic bacteria, which causes foul smelling, explosive diarrhea.  People with a fat intolerance will generally report that greasy food will fairly quickly elicit a trip to the bathroom.  Avoiding fatty and greasy foods is one way to manage a fat intolerance.  To address the underlying problem, the gallbladder, pancreas or small intestine dysfunction, a person should consult with a licensed healthcare provider.

Read more: Food Allergies, Sensitivities and Intolerances – Proteins

Ask the Doctor: Peyronie’s Disease

I have peyronie’s disease as a result of prostate surgery, and my urologist suggested that I wear a penis stretcher and do manual exercises to stretch my penis.  Other than jelqing, are there other exercises that I could be doing?.  If so, where do I find them?

Peyronie’s disease causes the formation of fibrous plaques, similar to scars, along the penis.  These plaques cause painful curvature and shortening of the penis during erection.

Manual stretching devices are typically recommended during the initial 3-6 months of peyronie’s disease, while the plaque of forming. In the few studies that have been performed patients didn’t report a significant change in curvature of their erections, but did notice modest gains in length.  Other studies have looked at the use of vacuum erection devices; typically patients reported improvements in their pain, reduction in the degree of curvature and increases in penile length with the use of vacuum devices.

To date, there is no evidence that jelqing or other exercises benefit or harm patients with peyronie’s disease.  The only concern I have regarding these techniques is the expense, time wise and financially in learning these techniques.  Other treatment options that have shown some benefit include oral medications, injections, topical medication and surgery.

Controlling Cerebral Edema

Cerebral edema is a potentially life-threatening form of inflammation in the brain.  Unlike other organs the brain is almost entirely surrounded by bone, because of this inflammation and swelling literally have nowhere to go.  Edema, the fluid associated with swelling, very quickly deforms the delicate structures of the brain and causes intracranial pressure to rise.  This in turn causes a host of severe symptoms including: headaches, nausea, seizures, focal paralysis, hallucinations and potentially death.

Causes of cerebral edema (eg. concussions, brain abscesses, poisoning  and strokes)  are typically medical emergencies in and of themselves.  Treating the underlying condition resolves the cerebral edema.  However, in the case of cerebral edema from brain tumors one of the main treatments, radiation therapy, can also cause lasting cerebral edema.

The standard treatment for cerebral edema is oral steroids, typically dexamethasone. Given the potentially life-threatening nature of cerebral edema, brain cancer patients are asked to tolerate the side-effects of dexamethasone (eg. immunosuppresion, muscle wasting, insulin resistance, personality changes, and osteoporosis).  Another unfortunate side-effect of oral steroids is ability to increase cancer cell’s resistance to radiation and chemotherapy.   This fact combined with the negative side-effect profile has caused some oncologists to begin looking for alternative treatments for cerebra edema.

One of the agents that is being studied is Boswellia serrata, commonly known as Indian Frankincense or Salai.  A botanical cousin of the Frankincense that is used in incense, Boswellia serrata has a long history of use in Ayurvedic medicine.  In Western medicine, boswellia has demonstrated strong actions as an anti-inflammatory, reducing inflammation in asthma, arthritis and several digestive diseases.

In 2001, a very small clinical trial treated 12 patients with progressive cerebral edema with boswellia.  Half of the patients in the trial had cerebral edema associated with a progressing brain tumor; for those patients, boswellia did not demonstrate a strong benefit.  The other half of the patients had cerebral edema secondary to their treatment.  Within four weeks of beginning supplementation with boswellia, these patients saw a reduction in their cerebral edema.  Most of the patients were able to discontinue their use of dexamethasone, while seeing a reduction in symptoms.

More recently, a second trial looked at the use of Boswellia serrata concurrently with whole brain radiation therapy.  This trial randomized 45 people to receive standard whole brain radiation therapy or standard whole brain radiation therapy with boswellia.  60% of the patients who received bowellia experienced a large (75% or greater) reduction in their cerebral edema compared to 26% of the patients who received standard radiation alone. No significant differences were noted between the two groups in terms of dexamethasone usage or quality of life.  Interestingly, the study reported that patient in the boswellia arm seemed to have a greater response to radiation therapy; unfortunately, the study was not designed to study changes in treatment response.

Boswellia serrata is a natural anti-inflammatory that appears to have a significant effect on controlling and reducing cerebral edema.  It appears to be fairly well tolerated, with minimal side-effects, and is compatible with radiation therapy and standard therapies for cerebral edema.  This promising plant will need to be studied further before it gains wide acceptance in the treatment of brain cancers and their sequlae.

Food Allergies, Sensitivities and Intolerances: Protein

Food allergies are the best-known negative reaction to food proteins. In classic food allergies, a protein in certain foods (eg. peanuts, shellfish or egg whites) interacts with an antibody, IgE. Once that reaction occurs, our immune system goes into high gear releasing histamine. Histamine causes an immediate response, and can trigger everything from a scratchy throat and hives to life-threatening swelling of the throat and heart. Because of the rapid and potentially severe response, people with food allergies are usually very aware of them. Repeated exposures to an allergen can also trigger stronger and stronger reactions, which is why it is generally recommended that people with allergies avoid exposure to the food as much as possible.

In food sensitivities, a different antibody, IgG, is involved. IgG activates a much larger and more sophisticated portion of our immune system, when compared to IgE, which causes a greater variety of symptoms, over a longer period of time. Most people with a food sensitivity have some type of digestive complaint, but not always. The classic picture of Irritable Bowel Syndrome – gas, bloating, diarrhea and constipation – can frequently be attributed to an underlying IgG reaction. Food sensitivities can also play a role in major digestive diseases, such as ulcerative colitis and Crohn’s disease. Because of the overall immune activation that happens in food sensitivities, body wide symptoms are also fairly common. Joint pains, difficulty breathing with exertion, and even migraines can all be associated with food sensitivities.

Unlike food allergies, symptoms of food sensitivities typically develop a few days after the exposure. The most common triggers (ie. milk, wheat, corn, soy and eggs) are also common in most diets. Together these facts make tracing food sensitivities more difficult. The two most effective methods for determining a food sensitivity are IgG testing, a blood test, and an elimination or hypoallergenic diet. After a period of avoidance, most people can consume the foods they are sensitive to on a limited basis.

Gluten, a protein in wheat, spelt, rye and some oats, is the culprit behind one of the most serious reactions people can have to protiens, celiac disease. In celiac disease, the antibodies that form in response to gluten also react to lining of the digestive tract. For people with celiac, an exposure to gluten triggers the immune system to attack their digestive tract, which leads to a host of severe digestive complaints. Celiac disease, can be screened for using a blood test for the specific anti-bodies, although a definitive diagnosis involves taking a piece of the small intestine and looking at it under the microscope for specific changes. The treatment for celiac disease is a life-long avoidance of gluten and all gluten containing foods.

The final way the proteins in our food can negatively effects our health is through our nervous system. Some proteins in foods are able to directly affect our nerves. Casein, a protein found in milk, and gluten are both classic examples. These proteins bind onto our endorphin receptors. For most people, eating the protein causes a slight sense of well-being and relaxation. For sensitive individuals, they cause constipation, irritability, mood swings and difficulty concentrating.

Modified Citrus Pectin

Modified Citrus Pectin (MCP) has been advertised as an alternative treatment for advance cancers since the late 1990’s.  Normal pectin, the kind found in apples, orange peels and jelly, is a complex carbohydrate.  The bacteria in our colons break down pectin into short chain fatty acids, which benefit the cells that line the colon.  MCP is a form of pectin that has been chemically broken down to produce a molecule that is about 50x smaller, and can be absorbed by the digestive tract.

The initial research on MCP showed that rats with colon cancer developed fewer liver metastases when MCP was included in their diet.  Because of MCP’s novel anti-metastatic properties, there has been a lot of advocacy for it use by patients with advanced cancer.  While MCP has had many advocates, it has not had much clinical research. To date only two human clinical trials have been performed.

In the first study, a small group of men with recurrent prostate cancer received MCP every day for a year.  70% of the men saw a positive change in their PSA doubling time, a tumor marker for prostate cancer.  Just under half of those men had their PSA doubling time rise above 10 months, which suggests they are less likely to develop metastatic cancer.

In the second trial, 49 people with advanced cancer, who had progressed through conventional cancer treatment, took MCP daily.  Just over 20% of the people in the trial saw their disease stabilize within 2 months.  Most of them continued to have stable disease for 6 months, when the trial finished.

The limited information suggests that 20-30% of MCP users may halt the progression of their cancer.  Unfortunately, we don’t know what separates the people who benefit from those who don’t.  At the same time, the benefit of MCP, stabilization of advanced or recurrent cancer, should be noticeable with 2 months of starting it.

MCP, like pectin, is considered a dietary fiber. Most of the reported side-effects: upset stomach, bowel habit changes, gas and nausea, are in line with what would be expected from suddenly increasing the amount of fiber in a diet.  The one unexpected side-effect is itchiness, which can be severe enough necessitate medical treatment.  All of the side-effects resolve shortly after discontinuing MCP.

Research on MCP continues to progress, and hopefully larger trials can help us identify just who it is that will benefit from MCP.  Till that time, individual trials of MCP for patients facing recurrent and metastatic cancer seems like a reasonable inclusion in a comprehensive cancer treatment plan.