For most forms of cancer there is a common pattern that is followed. A diagnosis is made, and a treatment plan is crafted. Frequently those treatments include surgery, radiation, and/or chemotherapy. Treatment is over a defined period after which the patient is discharged with a plan for intermittent monitoring for relapse. What comes next can be excruciating. A waiting game hoping that with each new blood test or new image nothing that would occur.

Five-year “cancer free” is not cancer free

The five-year disease-free interval is a useful tool for quantifying the effect of various therapies but does not fully reflect the state of the cancer. Cancer is a cellular disease. An individual who is tumor free of the five-year mark could well be harboring billions of cancer cells that are still in the process of dividing [1]. Every cancer has a doubling time. The doubling time varies depending on the cancer and its stage as well as a cell site. Breast cancer has been estimated have a doubling time between 90 and 200 days [2]. Colon and lung cancer have equally long doubling times. Adenocarcinoma of the lung has been estimated to have a doubling time of 72 days. At that rate of doubling a person diagnosed with a 1 cm nodule at age 55 would likely have had that cancer start at age 43 [3].

Achieving the five-year post treatment milestone without tumors is worth celebrating, but it can also impart false confidence. Cancer cells can still be doubling on a consistent basis. Evidence of this comes from studies looking at "distant metastases." Those are cancer recurrences that occur beyond five years. An article published in the New England Journal of Medicine evaluated the 20 risk of breast cancer recurrence. Among patients with stage T-I disease the risk of recurrence was 13% with no node involvement, and 20% if 1-3 nodes were involved. The risk increased to 34% if there were more than three nodes involved [4].

A study of men with a history of colon cancer published in the International Journal of Cancer showed a 1 in 12 chance of having the cancer reappear between years five and 10 despite being tumor free at 5 years [5].

Most cancer treatments are carcinogenic

In addition to late relapse, there is an increased risk of secondary cancers in people who have ever had a malignancy. Some of this risk may emanate from the factors that contributed to the original cancer. Exposure to toxins and lifestyle risks frequently persist. However, there is also evidence that radiation treatment increases the risk of leukemia, myelodysplastic syndromes, and solid tumors. Many chemotherapy drugs increase the risk for leukemias [6].

The challenge of stem cells

Even after tumors been fully wiped out, and the patient achieves the desired status of “no evidence of disease” (NED) stem cells can still be active. These cells are felt to be resilient to chemotherapy and other treatments. They can become a source of cancer cell reproduction leading to relapse [7].

The potential of high dose intravenous vitamin C (IVC)

Vitamin C has been studied for decades both in the lab, and in clinical settings. There are dozens of studies demonstrating the toxic effect of vitamin C on various cancer lines in vitro. The mechanism of action is felt to be from vitamin C producing high levels of hydrogen peroxide [8].   This free radical is destructive toward cancer cells, but easily neutralized by natural cells. Clinical safety of IVC has been well-established both through studies, and through decades of patient treatment [9]. There are small studies and innumerable case reports of positive outcomes however there is no absolute proof that adding vitamin C to conventional treatment can help delay progression of cancer [10]. Nevertheless, many patients seek vitamin C therapy after conventional treatments have failed, or the cancer is far advanced. It is conceivable that IVC would be much more efficacious in the early, cellular stages of disease before tumors have developed. It is theorized that when infused intravenously vitamin C has the potential to destroy cancer cells in their formative state when they are at the most vulnerable, cellular level. This occurs before the patient is aware that cancer is present.

Because IVC is safe for natural cells, this treatment can be applied, and may be most advantageous when there is no evidence of cancer present. If cancer cells are dividing and going through their doubling process, a ‘title wave’ of high dose vitamin C could reduce the total number of cells thus not allowing them to progress to the tumor stage of disease. The analogy would be a bit like cutting back vines, so they don't choke the forest. The forest can live with the vines as long as they do not overwhelm the trees. Since the doubling time for most cancers extends beyond 30 days, a rational interval of treatment is monthly. The goal is to periodically reduce the total volume of cancer cells in circulation. Another factor to consider with any secondary prevention recommendation is cost. Intravenous vitamin C ranges between $200 and $300 per infusion. This puts it at an affordable price range for a large segment of the population. Many patients spend this much on oral supplements trying to bolster their health after cancer. It is likely these funds would be better directed toward intravenous vitamin C.

Ease of access is also important. Any doctor, or nurse practitioner has the capability to deliver high dose vitamin C in their office without any expensive equipment or infrastructure changes. At our center we been using this approach for secondary prevention for the past seven years. Although our volume is too small to draw conclusions, we have been encouraged by the results. With sufficient funding, an organized network could be established to develop a population cohort of individuals receiving this therapy. They could be tracked over years so that results could be quantified. Given the magnitude of the problem that we face, and the potential for benefit, as well as its ease of implementation, such an initiative seems worth pursuing.