Artemisinin seems a good option to me.

Regarding Vitamin C. What data are you looking at to consider its use, instead of just oral vitamin C?

High-Dose IVC phase 1 clinical trial: No patient (0/17) demonstrated an objective antitumor response. 13 had progressive disease. link

Vitamin C and Cancer: Is There A Use For Oral Vitamin C? link

Unexpected Early Response in Oral Bioavailability of Ascorbic Acid link

Linus Pauling used oral vitamin C mainly. The results he achieved in his study in 1970 were with patients who had not had chemotherapy. 

Thanks Johan, I’ll consider what you wrote. I have read many stories of people who have reached Ned using the metabolic approach to cancer in conjunction with IVC. Also, Daniel and Jane McLelland are both proponents. This is actually the first time I have seen it suggested that oral might be better than IVC. She probably is going to do the IVC, so given that, do you have any thoughts on how to make it work best in her situation? Thank you.

@j

Also, she will be using artemisinin, piperlongumine, feverfew, Metformin, Atorvastatin, DHA (in Omega 3), butyrate (Tributyrin), HCA, and an antiparasitic. Those were all clear to me. It is the supplements I listed above that I am uncertain about. Thanks.

Posted by: @abidingtoday

Thanks Johan, I’ll consider what you wrote. I have read many stories of people who have reached Ned using the metabolic approach to cancer in conjunction with IVC. Also, Daniel and Jane McLelland are both proponents. This is actually the first time I have seen it suggested that oral might be better than IVC. She probably is going to do the IVC, so given that, do you have any thoughts on how to make it work best in her situation? Thank you.

If you go that route I would follow Daniel´s recommendations. @daniel I know you have some specific recommendations in case of IVC could you share them here?

Not sure if D is a proponent though...

Combination of standard ascorbic acid powder and liposomal vitamin C «Initial measurements suggest that liposomes and standard oral ascorbic acid are absorbed by independent mechanisms and that a combination of both can yield free molecule plasma levels at >800 µM/L. Importantly, such plasma levels can be sustained indefinitely using oral doses.»

My understanding is that for VIT C treatment to work it is important to keep high VIT C plasma levels high continuously. Doing so with IV C becomes very expensive. Whereas oral VIT C is cheap.

@j 

I thought Vit C levels were not supposed to be high continuously, but that C was only supposed to be at pro-oxidant level as a periodic kill phase. I’m very confused.

Posted by: @abidingtoday

@j 

I thought Vit C levels were not supposed to be high continuously, but that C was only supposed to be at pro-oxidant level as a periodic kill phase. I’m very confused.

I don´t think the mechanism of action is clear. Vitamin C seems to have biphasic effects and can have anti and pro-tumor effects. 

I am basing much of what I am saying on Daniel’s Yin and Yang article. I don’t know if you’ve read it, but that’s the premise I’m using at this time. I’m open to different views, but it’s a lot at once. I think for now, I’d like to try to base things on that article as I felt it was really excellent. I did get confused about some things, which I am hoping to address in this post.

@j but I do really appreciate your input. I’d prefer not to have her do IVC obviously, in terms of time and money and all of the things that come with it. But right now she doesn’t have any kill phases happening, and I think it’s important that she does have periodic kill phases so that she can beat this cancer. At least that is my understanding so far.

Posted by: @abidingtoday

@j but I do really appreciate your input. I’d prefer not to have her do IVC obviously, in terms of time and money and all of the things that come with it. But right now she doesn’t have any kill phases happening, and I think it’s important that she does have periodic kill phases so that she can beat this cancer. At least that is my understanding so far.

QUOTE, Unfortunately, the Mayo Clinic studies did not take into account the short half-life of high-dose vitamin C, so their studies were flawed in terms of the basic science (Hickey, Roberts, Cathcart, 2005). Ironically, proponents of vitamin C as chemotherapy suggest that the early positive trial results were just serendipity (Ohno, Ohno, Suzuki, et al. 2009; Padayatty, Levine, 2000). They claim that Pauling, arguably one of the greatest scientists in history, “may not have fully appreciated the critical difference between intravenous and oral administration.”(Padayatty, Levine, 2000) This odd suggestion is easily refuted from Pauling’s writings and those of his colleague Cameron (Cameron, Pauling, 1993) With some irony, we must point out that the suggestion that oral doses are ineffective is a fallacy. Firstly, however, we restate that Cameron and Pauling, and Murata and Morishige, used predominantly oral doses, with the stated aim of maintaining plasma levels. Furthermore, Hoffer also replicated the early trials, using oral vitamin C in cancer patients, and obtained similar positive results,33 as shown in Figure 3. REF

@j I get what you’re saying. Again, I’m reading a lot of work on the other side, including Daniel and Riordan Clinic and Jane McLelland. Maybe @daniel will be able to weigh in at some point. I do appreciate your help.

Posted by: @abidingtoday

@j I get what you’re saying. Again, I’m reading a lot of work on the other side, including Daniel and Riordan Clinic and Jane McLelland. Maybe @daniel will be able to weigh in at some point. I do appreciate your help.

A Clinic needs to make money, an important consideration IMHO. No money in oral VIT C. I just wanted you to share the insight from the scientists who did the original work on VIT C. That somehow became obscured. Look forward to @daniel input.

@abidingtoday You mention Jane M twice. I read Jane M´s book a while ago, wrote a review here. I really don't understand why so many people, cancer patients, blindly follow her advice. I´d carefully scrutinize the information from her book or other writings. 

Just adding my 2 cents 😊 

@j johan, I’ve been really considering what you are saying. I would still like to get my original question answered at some point, but let me ask you some questions.

What is the oral Vitamin C protocol you propose for a stage 4 NSCLC adenocarcinoma KRAS patient? What type of C should be taken, how much, and how often?

How do we test C levels to see if dosing is effective? Blood test? Glucose monitor? What are expected results?

Could this strategy along with off-label drugs and supplements (including statin, Metformin, Berberine, powerful anti-helminthics, curcumin, and many other wonderful things) be enough to get a patient to NED? Someone who is not currently doing chemo or radiation? Who is only doing Keytruda? What if that person quit Keytruda?

I’m sorry I didn’t engage your point more yesterday. I am overwhelmed, and the more info I get (especially when it says the opposite of previous info), the more overwhelmed I get. But I’m not going to give up. I’m just learning, and I want to learn from people like you who have immersed themselves in this for a long time. So I would love to hear more about what you have to say, and I thank you again for your time.

Posted by: @abidingtoday

@j johan, I’ve been really considering what you are saying. I would still like to get my original question answered at some point, but let me ask you some questions.

What is the oral Vitamin C protocol you propose for a stage 4 NSCLC adenocarcinoma KRAS patient? What type of C should be taken, how much, and how often?

How do we test C levels to see if dosing is effective? Blood test? Glucose monitor? What are expected results?

Could this strategy along with off-label drugs and supplements (including statin, Metformin, Berberine, powerful anti-helminthics, curcumin, and many other wonderful things) be enough to get a patient to NED? Someone who is not currently doing chemo or radiation? Who is only doing Keytruda? What if that person quit Keytruda?

I’m sorry I didn’t engage your point more yesterday. I am overwhelmed, and the more info I get (especially when it says the opposite of previous info), the more overwhelmed I get. But I’m not going to give up. I’m just learning, and I want to learn from people like you who have immersed themselves in this for a long time. So I would love to hear more about what you have to say, and I thank you again for your time.

@abidingtoday

Your original question - is the goal of high-dose IVC always Ferroptosis? When Linus Pauling treated cancer patients with vitamin C, ferroptosis was not even known. It's a recent discovery. There are a lot of theories but that´s what they are - theories.

Btw, statins can interfere with iron metabolism, even chelate, much is not understood.

In the case of Vit C as ascorbic acid, we have the study from Pauling (increased survival time -4-fold- in Stage 4 cancer patients on high dose ascorbic acid). LINK

Considering the objective of maintaining plasma levels, VIT C treatment would need to be either orally or a combination of IVC and oral ascorbic acid. Linus Pauling himself took up to 18 grams of Vitamin C a day, although his regular dose was 12grams, which he took in just one dose. For active cancer, 3 x 6 grams would be a good dose to start. Titrate and monitor. You could do blood tests, but more importantly, I would closely monitor the cancer markers. If there is diarrhea the dose should be reduced.

Here is a review of 9 cases that included IVC https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5736057/#bibr7-1534735415622010

Note that IVC was just a part of the treatment ( For patients with active cancer, an initial recommendation of 21 days of daily IVC therapy was followed by continuing infusions every 2 to 3 days weekly.) BTW In this review, they mistakenly associate Linus Pauling as a proponent of IVC. 

For synergies with VIT C please check my page on ascorbic acid

What if that person quits Keytruda? A few days ago @dumbcritic, a contributor on this blog, posted results of a trial, Keytruda vs placebo. Keytruda extended life for about a month and a few weeks, on average.

Posted by: @abidingtoday

I’m sorry I didn’t engage your point more yesterday. I am overwhelmed, and the more info I get (especially when it says the opposite of previous info), the more overwhelmed I get. But I’m not going to give up. I’m just learning, and I want to learn from people like you who have immersed themselves in this for a long time. So I would love to hear more about what you have to say, and I thank you again for your time.

You are dealing with your mother´s stage 4 cancer. Jane M had stage 1 cancer and turned her experience into a best-selling book. Don't follow her advice. She is in no position to tell people they should treat cancer based on her little metro map. Every clear gain she achieved in her battle against cancer was when she had conventional treatment, chemo, and surgery.

Back in 2002/2003, I immersed myself for days on end in reading about glioblastoma. There was little time and my list of possible treatments was becoming endless. Treatments that appeared worth trying were very controversial. On a well-known brain cancer blog one day they interviewed a Nobel prize winner, I think in the field of mathematics. What would he do if he had Glioblastoma? His answer helped me a lot. He took the emotion and controversy out of it. He said that if he was faced with a death sentence he would evaluate alternative treatments based on clear evidence of their efficacy. The most promising ones he would then add to conventional treatment.

Note that even with his extraordinary intellectual capacity he would not try to figure out cancer himself.

@j

Thank you for your response. It really is helping me already.

I believe I have read that statins (as Glut1 inhibitors) should be avoided before IVC. So your comment on statins already rings true. Do you believe statins should also be avoided before medium-dose oral C? If so, would that mean never taking statins (if taking medium-dose C three times daily?)

As far as daily dose for C, we do things slow... would 3x2g be an effective place to start? 

Is there any brand of oral C you would recommend or any guidelines to help me pick one? Is liposomal any better than non-liposomal? And to confirm - you recommend ascorbic and not ascorbate?

As far as Keytruda, it seems ill-advised by so many people. Mom also has the option of pemetrexed. They would want to give her the full dose but I could fight for low-dose. I know this is kind of a loaded question, but if this were your mother, what would you advise her to do as far as these standard of care (or slightly modified SOC) therapies are concerned? Assuming she is going to do oral C, possibly pulsing with IVC, and is already doing a good deal of the wonderful off-label drugs and supplements outlined in this blog and on your synergies web page.

Posted by: @abidingtoday

@j

Thank you for your response. It really is helping me already.

I believe I have read that statins (as Glut1 inhibitors) should be avoided before IVC. So your comment on statins already rings true. Do you believe statins should also be avoided before medium-dose oral C? If so, would that mean never taking statins (if taking medium-dose C three times daily?)

As far as daily dose for C, we do things slow... would 3x2g be an effective place to start? 

Is there any brand of oral C you would recommend or any guidelines to help me pick one? Is liposomal any better than non-liposomal? And to confirm - you recommend ascorbic and not ascorbate?

As far as Keytruda, it seems ill-advised by so many people. Mom also has the option of pemetrexed. They would want to give her the full dose but I could fight for low-dose. I know this is kind of a loaded question, but if this were your mother, what would you advise her to do as far as these standard of care (or slightly modified SOC) therapies are concerned? Assuming she is going to do oral C, possibly pulsing with IVC, and is already doing a good deal of the wonderful off-label drugs and supplements outlined in this blog and on your synergies web page.

I don't know enough about statins to give you any recommendations. Not only should you check for interactions with supplements or repurposed drugs, but it should also be checked against the primary treatment. Designing treatments adjunct to primary cancer treatments often means a big leap into the unknown. 

Linus Pauling used plain and pure ascorbic acid, that is what I would use. Maybe add some liposomal, yes. You could dissolve 10 or 12 grams in 1,5 liters of water and have her drink it throughout the day. If this doesn't upset her stomach you could just start adding a few more grams.

"Clinical results using intravenous ascorbate as chemotherapy have not lived up to
the promise of the early trials. One reason for this is that IV administration produces
high but short-lived blood plasma levels. The assumption that a short sharp pulse of vitamin C
will be more effective than a lower level prolonged exposure is not supported by
the experimental data. As we have described, extending the exposure time more than
compensates for a reduction in concentration. Indeed, longer exposures can be orders
of magnitude more effective than short ones. The concentrations required to be cytotoxic
over longer periods are much lower. Oral intakes, particularly with combined use of
ascorbic acid and liposomal vitamin C, can easily achieve and maintain adequate levels
for selective cytotoxicity.

Finally, the use of vitamin C as a sole anticancer agent is not recommended, as its
anticancer actions are known to be greatly enhanced through use of synergistic supplements,
such as alpha-lipoic acid. In clinical trials, it might be appropriate to study vitamin C
in isolation, if the medical problem were to determine the details of its mechanism of action.

However, such mechanisms can be determined using animal and experimental studies. We therefore
see little reason to deprive patients of more optimal therapy, purely in an attempt to determine
the action of vitamin C in isolation. There is a more pressing and practical issue: the real
medical problem is to keep cancer patients alive and healthy, for as long as possible."

Keytruda is providing some life extension benefits, the thing with averages is they don't tell the whole story, sometimes many don´t benefit at all but a few do very well. 

Hence the need to pick the most promising additional treatments and do them right. Meaning dosage and length of treatment are crucial.

@j

Thank you so much for your thoughtful answer.

So no thoughts on Keytruda vs Pemetrexed? Have you seen better results / less side effects with one over the other? Yes, I’m grasping for straws here! This is hard, and I’m trying to pick every brain I can, haha.

Do you think 6g total oral vitamin C per day would be sufficient to start? Could there be adverse affects from starting too low?

Posted by: @abidingtoday

@j

Thank you so much for your thoughtful answer.

So no thoughts on Keytruda vs Pemetrexed? Have you seen better results / less side effects with one over the other? Yes, I’m grasping for straws here! This is hard, and I’m trying to pick every brain I can, haha.

Do you think 6g total oral vitamin C per day would be sufficient to start? Could there be adverse affects from starting too low?

It is hard indeed. The thing with cancer is that is so heterogeneous. Your mum's lung cancer is different than other patients with the same DX. Cancer cells are just cells with a defect. Normally these cells autodestruct. In cancer cells, they don't. Restoring that function would be the ideal and fastest fix. 

When these cancer cells start copying new cells, these again have defects of course, but as time goes by other defects occur, resulting in tumors with cancer cells that can have a wide range of defects. As you can see, treating early-stage cancer is much easier than later stages, not only because of the amount and different locations cancer can be, but also the diversity in the defects.

Pemetrexed can be very useful in reducing tumors, especially of the lungs. Your mother's oncologist will be able to make a decision as to which option is best at this time. You can always ask for a second opinion. 

If I would use ascorbic acid I would not use such a low dosage. Same for other supplements, if you go this route you need to try and establish and then commit to a dosage that has been proven some efficacy. Or else I would not bother using supplements. 

@j thank you, again. What is the lowest dosage of ascorbic acid you would advise to use per day? How low can we go?

@j I just don’t want to overwhelm her anymore than she is. It’s a lot of things to put in a body each day.

Posted by: @abidingtoday

@j I just don’t want to overwhelm her anymore than she is. It’s a lot of things to put in a body each day.

I know, compliance will be an issue. I took about 15 supplements when I got the C-flu, no problem, but I couldn't get my son to take any.

If a supplement is in the form of a powder, even if it is in a pill you can just mix it in fresh vegetable juice. That's a good way to take supplements, and vitamin C, I always have a bottle of water, it's a 2 liter bottle actually and I poor at least 12 grams in it. So then you take say curcumin with the water that has the ascorbic acid in it. 

I would prioritise, which are the supplements you think or feel are most valuable to help treat her cancer, and gradually introduce these, you can always startt a low dose initially to see if she doesn't have a bad reaction to it, and then either you stop or continue and start using a therapeutic dose.

Posted by: @abidingtoday

@j thank you, again. What is the lowest dosage of ascorbic acid you would advise to use per day? How low can we go?

12 grams pure ascorbic acid, divided in 4 doses, or as mentioned in water and drink continuously during the day.

@j Thanks : )

Assuming IVC is happening, would do this on IVC day as well, or skip that day?

And - if she is doing oral C 12g+ daily, is IVC a waste? I know we’re back to the beginning here, and you are not a huge fan, but did say it can be done as part of a strategy. Would you do the IVC to pack some extra punch to the oral vitamin C for a stage 4 cancer?

Thanks for your patience with all of these questions, and for taking the time to answer them for me.

Posted by: @abidingtoday

@j Thanks : )

Assuming IVC is happening, would do this on IVC day as well, or skip that day?

And - if she is doing oral C 12g+ daily, is IVC a waste? I know we’re back to the beginning here, and you are not a huge fan, but did say it can be done as part of a strategy. Would you do the IVC to pack some extra punch to the oral vitamin C for a stage 4 cancer?

Thanks for your patience with all of these questions, and for taking the time to answer them for me.

I think IVC and oral are interchangeable but oral ascorbic acid is so cheap, safe and easy to take. Of course if you've got an IVC assuming it is a high dose there's no need to take oral vitamin c that day. Note that IVC has risks https://pubmed.ncbi.nlm.nih.gov/26139164/.  

Dear @abidingtoday and @j

I am sorry I cannot join the discussion, but I am so extremely busy. This is why I could not read everything and cannot address all the points made. But,

- I discussed Vitamin C here https://www.cancertreatmentsresearch.com/high-dose-vitamin-c-cancer/
and the two different anti-cancer mechanisms that could be achieved with oral and IV. In my view, both make very much sense for different reasons discussed in the article, but it is important to understand they are different.

- as I understand, you feel a bit lost with info coming from all directions that may seem contradictory - if its a short question that requires short response, please write it here. If you have many questions that need to be addressed, we can have a call and go through the questions you have and see where I can help with info (no cost of course)

Kind regards,
Daniel

Posted by: @daniel

Dear @abidingtoday and @j

I am sorry I cannot join the discussion, but I am so extremely busy. This is why I could not read everything and cannot address all the points made. But,

- I discussed Vitamin C here https://www.cancertreatmentsresearch.com/high-dose-vitamin-c-cancer/
and the two different anti-cancer mechanisms that could be achieved with oral and IV. In my view, both make very much sense for different reasons discussed in the article, but it is important to understand they are different.

- as I understand, you feel a bit lost with info coming from all directions that may seem contradictory - if its a short question that requires short response, please write it here. If you have many questions that need to be addressed, we can have a call and go through the questions you have and see where I can help with info (no cost of course)

Kind regards,
Daniel

Thanks, D, hope things are going well.

In your article on Vit C, you conclude that in contrast to the approach in which Vit C is given at a very high dose a few times each week (IVC), as used today, the best anticancer action seems to be the one observed by Ewan Cameron and Linus Pauling, where patients were given a daily dose of about 10g or more (Ref.1, Ref.2). More specifically, they administered 10 g/d intravenous Vitamin C for approximately 10 days, followed by 10 g/d oral vitamin C thereafter. Their work showed significantly enhanced survival in these patients compared with two retrospective cohorts of 1,000 patients who did not receive vitamin C. (Ref.). Therefore, a lower dose (such as 10g/day) at a higher frequency of administration (i.e. daily) appears to be more beneficial based on the available studies.

That's basically the same as what I've written above, so I hope this helps @abidingtoday to make a decision. Note that Pauling himself later took 12 grams each day and started using higher oral doses in cancer treatment, using up to 18 grams himself to treat his own cancer. Pauling died at the age of 93 of prostate cancer but said he extended his own life through the use of oral ascorbic acid.

@j Thank you for asking. Things are going very well at MCS Formulas, as we have now some of the best products in the World in their category and will introduce soon some very nice one as well.

However, because I care about everything I do to make it as good as possible, I end up working every day until 3-4am and my body started to give me some important warning signs. So I now switched on a lot of supplements, diet and exercise.

We do add colleagues to help at MCS Formulas, but as the company is growing there is always more to do, next to the fact that i continue answering e-mails from people who need help.

Regarding Vit C, indeed I like both ways and when a pro-oxidant treatment is put together, it makes sense to use the IV as well. As we know, high dose IV Vitamin C is a good tool to push on the pro-oxidant strategy, and I do remember of people reporting positive results at oncology clinics. Not so many compared to how much Vit C is used in clinics, but there were reports, specifically when used in combo with DMSO.

The oral dosing is clearly helpful in so many areas of health, and I do think that IF someone
- would not do chemo and
- would need to choose between dosing Vit C at about 10g/day or do IV Vit C
I would choose the first.

BUT, if possible to do both, I would do both, specifically when on chemo or radio.

When used orally, I may stop it two days before chemo and two days after just to keep that time fame clean, but I do not see oral Vit C as a super anti-oxidant (as is the case for NAC, for example) and for that reason I would take it continuously.

As a side story, because of Vit C taken orally (and a few other supplements), at higher doses such as 6-8g/day when required, I had no more any flu since 2019 even if I came in contact with many people due to business travels. It has been actually recommended to me by Vikas from Emory Med. School a few years ago as he is using it in high dose for his family to counteract viral infections. Actually there was a clinical trial done on this some years ago showing positive results. My point with this story is that beyond theories and others reports, I felt the positive contribution of Vit C taken orally, and for that reason I have a lot of it at home. I avoid tablets, because those will not be absorbed well enough, and prefer e.g. one that dissolves in water, or is as powder in a capsule.

I hope you are doing well. 

Kind regards,
Daniel