Hoffer's Home Page -Orthomolecular Treatment of Cancer.

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Between 1978 and March, 1999 I have seen over 1040 patients suffering from cancer who came to me for nutritional and psychiatric counseling. This is no longer a surprising combination as it was when I first started to practice psychiatry in 1952. I attended my first annual meeting of the American Psychiatric Association in Los Angeles, in 1952. I did not meet another psychiatrist there with a PhD in Biochemistry. Since then many more scientists with the double degrees have become active in this field but of these very few actively pursue this particular combination. Orthomolecular theory and practice drives these two together. I have retained my interest in the biochemistry and clinical aspects of nutrition combining this with my education in medicine and later in psychiatry. The recovery of my first patient in 1960 from terminal bronchiogenic cancer of the lung arose from this coalescence of these two disciplines.

By 1960 my research group in Saskatchewan had discovered the first biochemical substance that was clearly related to the schizophrenias. Not knowing its structure we called it the mauve factor until it was later identified as kryptopyrrole. We tested thousands of patients and found that over 75% of all schizophrenic patients excreted this substance in their urine. It was also present in about 25% of other psychiatric groups, in about 10% of severely stressed physically ill patients and in about 5% of normal people but they were mostly first order relatives of schizophrenic patients. It disappeared with recovery of the patients no matter how they were treated. I was particularly interested in the fact that out of eight patients with cancer of the lung this factor was present in 5.

In 1960 a retired psychotic professor was admitted to our psychiatric department at University Hospital in Saskatoon. He had a bronchiogenic carcinoma of the lung and when he became psychotic it was concluded he had secondaries in his brain. He was placed on terminal care, expected to die in a month or so. Earlier he had been discharged to the care of his wife and a nurse but after several weeks had to be readmitted since they could not cope with his behavior. As soon as I discovered he was on our ward I had his urine collected and we tested it for the factor. He excreted copious quantities which we were able to use to help us identify the substance. I then advised his resident to start him on niacin 1 gram after each meal and on ascorbic acid 1 gram after each meal. By then I knew that this combination of vitamins used in megadoses was very helpful in treating any patient with this factor in their urine no matter what they were diagnosed. Fortunately for this patient the resident accepted my advice (the patient was not under my care but I was Director of Psychiatric Research at the hospital). He was started on the two vitamins on Friday afernoon and he was mentally normal by the following Monday.

I knew this patient before he became ill as I had treated his wife. After he had recovered I advised him to remain on these two vitamins. In 1960 our research unit was the only one in Canada, and perhaps in the world, where 500 mg tablets of these vitamins were available. They were specially made for us. If smaller tablets were used in these large doses they would make our patients sick because they contained so much filler. I told him that if he would pick up a supply each month I would give it to him free. This meant he had to see me each month and this gave me the opportunity of assessing his psychiatric state. I did not expect he would recover from his cancer. He had been told of his dismal prognosis and I did not contradict that. To my surprise he kept on coming back. About 12 months later I had lunch with the Director of the Cancer Clinic which had been following his case. He told me that the tumor had become less and less visable with each X ray every three months and that it was now no longer present. He lived about 30 months after he was diagnosed terminal. I had hoped that when he died he would be autopsied at University Hospital. Unfortunately he died at another hospital and I did not hear this until several days later. He did not die from his cancer.

Two years later a woman I had treated for depression several years earlier consulted me again. This time she was depressed because her 16-year-old daughter had Ewings tumor (a highly malignant sarcoma) in one arm and she was slated for surgery to amputate her arm. This was the standard treatment. I told her about the previous patient and his recovery and suggested that although there was no evidence it would help it could do no harm and might possibly be of some value. Her daughter agreed to take niacinamide 1 gram after each meal and ascorbic acid 1 gram after each meal. Her surgeon agreed to postpone surgery for a month. She recovered and the last time I heard from her family she was married and leading a normal productive life, with both arms. I concluded that vitamin B-3 was the most important component and that the vitamin C was helpful. In Saskatchewan under my direction we did the first double blind controlled therapeutic trials in Psychiatry, completing six by 1960. Therefore I was aware of the powerful influence of placebo. However when two terminal patients recovered on the vitamins it became powerful evidence that there was more than placebo at work.

I did not see any more cancer patients until 1977 after I had established my practice in Victoria, BC. In British Columbia specialists will not accept patients until they have been referred by their general practitioners. As a psychiatrist I saw patients referred with psychiatric problems but in most cases the referring physicians would not indicate why the referral had been made and I would only discover the reason when I finally saw my patient.

A.S.An elderly woman appeared and when I asked her why she had come she replied that she had cancer of the head of the pancrease. She had developed jaundice. Her surgeon discovered she had a large tumor in the head of the pancreas which occluded her bile duct. He promptly closed, created a by-pass, and when she recovered from the anesthesia advised her that she had about 3 to 6 months to live. She worked in a book store. She had read Norman Cousins book Anatomy of an Illness and thought that if he was able to take so much vitamin C with safety she could too and she began to take 10 grams each day. The next time she consulted her doctor she told him what she was doing. He referred her to me since he was familiar with my interest in megadoses of vitamins. I reviewed her program and increased her vitamin C to 4o grams daily trying to reach the sublaxative level. I had been using multi nutrients for my schizophrenic patients for many years and since I had no idea which, if any, of these vitamins might help I reasoned that she would have a much better chance if she also were to take more than one nutrient. I then added vitamin B-3, selenium, and zinc sulfate. Six months later she called me at home in great excitement. She had just had a CT scan. No tumor was visible. The CT scan was repeated by the incredulous radiologist. Her original bile duct had reopened and now she had two. She remained alive and well until she died February 19, 1999, nearly 22 years after she was told she would die.

Rarely patients make a major contribution to medicine by their interest in a disease and their willingness to try innovative approaches. A.S's recovery changed my professional career and I believe will make a major contribution to the complementary treatment of all cancer patients. Last year at a public meeting I thanked her publicly when I discussed her case before a meeting of Cancer Victors. She added that I had changed her life as well. She has also changed the life of hundreds of cancer patients who became victors, not victims.

By telling her friends, relatives and customers about her recovery she changed the nature of my practice. That first year another five patients were referred. The second case was a man with a sarcoma of the prostate which was invading his pelvic bone. He was advised no treatment was available. His doctor referred him to me and I started him on a similar program. But he was only able to take about 10 grams of vitamin C daily. I asked his doctor if he would mind injecting him with 10 grams of vitamin C twice weekly. After six months his doctor wanted to know how much longer would he need to receive his vitamin C. He told me that the tumor was gone. He stopped the injection. He lived another 9 years and died at age 80, but not from his cancer.

More patients were referred to me each year. At first almost all of them were patient-generated and often it took remarkable persuasive powers for the patient to obtain the necessary referral. After assessing their physical and mental state I would talk to them about the therapeutic regimen. I outlined the program in detail describing each nutrient and why I thought they might be helpful. I added that there was no guarantee that the vitamins would be helpful but gave them hope by describing the cases who had had a dramatic response. I added that the vitamin mineral program would decrease the toxicity of the xenobiotic treatment and would increase the efficacy of the xenobiotic program. If they needed surgery they would heal faster afterwards. If they needed chemotherapy the program would make it more tolerable and less painful and if they needed radiation the program would decrease the intensity of the side effects of the radiation and increase its efficacy. These comments were based on the literature which was developing rapidly. The program was designed to assist the body in controlling the cancer and was not a direct assault on the tumor. The attack on the tumor was carried out by the other physicians including their family doctor, the surgeons, the radiologist and oncologists. The diagnosis of the cancer and the xenobiotic treatment used was left entirely to the patient and their other doctors. I did not advise them whether or not they should take any other treatment. Very few did not receive xenobiotic therapy. After describing the program I would arrange to see them once more unless they were very depressed and anxious, in which case I would see them more often. A few of the patients had been under my care before they developed their cancer and I continued to see them. I then sent a consultation report to each referring physician. After the second interview they were returned to the care of their family physicians. I had not planned on doing any follow up but after several years when I had treated about 50 patients I became aware that the patients who had followed the regimen consistently for at least two months lived much longer than the patients who did not start the program or did not take it for at least two months.

About this time I went to a Festchrift for Dr. Arthur Sackler at Woods Hole, Mass. We met in 1951 when I was starting our research program. He and his brothers were practicing in mid-Manhatten. They were probably the first orthomolecular psychiatrists in the United States. They were treating schizophrenic patients by injecting them with histamine. After I returnd home I repeated their studies and found that their observations were correct. Out of twelve patients I treated using their regimen 8 became normal. The treatment was difficult since they had to be given increasing amounts of subcutaneous histamine until their diastolic pressure decreased to 0. It was amazing to see how comfortable they could be with that low blood pressure. Treatments were givern daily on week days until the series was completed. I did not continue this series because by this time I was using megadoses of vitamin B-3 which was much easier to administer and equally effective. The histamine flush was identical with the niacin flush. At that meeting Dr. Linus Pauling delivered a vigorous and careful critique of the Mayo Clinic's attempt to repeat the studies he had done with Dr. Ewan Cameron in Scotland. The Mayo group claimed they had exactly repeated these studies but it was clear on reading their paper that they had not. Dr. Pauling did not object to their negatives findings. He objected to their statement that their conclusions resulting from a different method of administering the vitamin C were used to condemn his and Camerons findings. In other words no scientist can claim to confirm or deny any study unless they really have repeated the original work as described by the original authors.

The next morning, after breakfast, I visited Linus Pauling who was staying in the room next to mine. When I walked in he was busy with a hand calculator. He told me he was working out the electron orbitals saying that he did not understand them unless he did the calculations himself. I told him that on the basis of my fifty patients I had concluded that he and Cameron were right, that vitamin C in large doses did improve enormously the outcome of treatment for cancer. Linus asked me if I intended to publish the data. I replied that I did not. I added that in my opinion there was little point in trying to do so since it wold be impossible to gain entry into any medical journal, that they would not accept any paper that dealt favorably with megadose vitamin therapy. The New England Journal of Medicine, which had published the Mayo Clinic attack on Pauling, refused to publish his rebuttal. Linus urged me to do a complete follow up study of every patient I had treated. I was flattered and agreed that I would. He said that he would see that the material would be published. But when I returned home I decided not to do the follow up. It would have meant an enormous amount of work. I thought tht Dr. Pauling was being kind to me. Two years later I received a letter from Linus in which he said bluntly "Abram where is the study". I decided that he was serious about it. By then I had seen 134 patients. I apologized and promised to start the follow up immediately. I traced every patient and determined whether they were alive, where they were, and what had happened to their lives. I contacted the patients, their famlies, their doctors, the cancer clinic where nearly all of them had been seen and treated. The Cancer Clinic in Victoria did a good job of investigation, diagnosis and treatment using only xenobiotic therapies.

Dr. Pauling developed an elegant method for determining the probable outcome of treatment using cohorts of patients who were or were not treated. After I had completed the follow up I sent the case histories, with identification of each patient removed, and the follow up study. We decided to use the duration of life as the only variable. This began when they first saw me and ended with the day of their death. There is increasing evidence that this hard measure of success is much more useful than trying to decide whether the tumor is slightly smaller or not. For patients have lived for a long time with slowly growing tumors. We agreed to publish as coauthors. I suggested that the first paper would be by Pauling and Hoffer. This was because it was his original idea to use megadoses of vitamin C and the work I had done was merely to test his conclusions. He was very firm that he would not consider this and insisted it would appear as Hoffer and Pauling. I think he felt that as a clinician who had done the clinical work I should be the senior author. He did not have an MD. Linus Pauling, in my opinion, was the most brilliant humanitarian scientist that ever lived. Over his life time in addition to his two Noble Prizes, he was awarded nearly 40 Honorary degrees, PHD's and DSc's. I am sorry he was never given an Honorary MD. His contribution to human health has surpassed that of most physicians. We wrote the paper using his method for analyzing the data and my clinical material. But the Proceedings of the National Academy of Sciences refused to accept the paper. One of the criticisms of our paper came from some rumour which had reached the critic that I had solicited patients to come to be seen implying I had selected only the best prognostic patients. On the contrary I had nothing to do with the selection and I included every patient who had been referred. Eventually we published in the Journal of Orthomolecular Medicine. I am the editor and I could not refuse to accept our work. That original paper was reprinted in the book by Ewan Cameron and Linus Pauling Cancer and Vitamin C. Updated and Expanded. Camino Books Inc, P.O. Box 59026, Philadelphia, PA 19102. 1993. Appendix IX is this report.

We began to write a book. My case load was building very quickly and I published a second paper with Dr. Pauling and several more after that on my own. We finshed most of the book except for much of the detailed clinical material but we could not find a publisher in the United States willing to publish it. The topic was still too controversial. I found a Canadian Publisher, Quarry Press, Kingston, ONT. A few months ago I sent him the completed manuscript. This contains all the original material Dr. Pauling had written dealing with each type of cancer and a presentation of my data based on nearly 800 patients. We concluded in our manuscript that the optimum treatment for cancer today is a combination of xenobiotic and orthomolecular therapy and that treatment must be started as soon as possible. This book will be available in about one year. Here are the early references.

Hoffer A & Pauling L: Hardin Jones biostatistical analysis of mortality data for cohorts of cancer patients with a large fraction surviving at the termination of the study and a comparison of survival times of cancer patients receiving large regular oral doses of vitamin C and other nutrients with similar patients not receiving those doses. J Orthomolecular Medicine 5:143-154, 1990. Reprinted in, Cancer and Vitamin C, Updated and Expanded E Cameron and L Pauling, Camino Books, Inc. P.O. Box 59026, Phil. PA, 19102, 1993.

Hoffer A & Pauling L: Hardin Jones biostatistical analysis of mortality data for a second set of cohorts of cancer patients with a large fraction surviving at the termination of the study and a comparison of survival times of cancer patients receiving large regular oral doses of vitamin C and other nutrients with similar patients not receiving these doses. J of Orthomolecular Medicine, 8:1547-167, 1993.

Hoffer A: Orthomolecular Oncology. In, Adjuvant Nutrition in Cancer Treatment, Ed. P Quillin & RM Williams. 1992 Symposium Proceedings, Sponsored by Cancer Treatment Research Foundation and American College of Nutrition. Cancer Treatment Research Foundation, 3455 Salt Creek Lane, Suite 200, Arlington Heights, IL 60005-1090, 331-362, 1994.

Hoffer,A. Orthomolecular Treatment of Cancer. In Nutrients in Cancer Prevention and Treatment. Ed. Prasad,KN, Santamaria,L & Williams RM. Pages 373-391, 1995, Humana Press, Totowa, New Jersey.

One Patient's Recovery From Lymphoma. Townsend Letter for Doctors and Patients. #160 , 50-51, 1996

A new book just arrived by Burton Goldberg, edited by W.John Diamond, W.Lee Cowden with Burton Goldberg, Alternative Medicine Definitive Guide to Cancer. Future Medicine Publishing, Inc. Tiburon, California.1997.In this valuable book 37 physicians including myself, describe the alternative methods they use with clinical descriptions of some of the results they have obtained. I prefer the term complementary to alternative and expect that soon all medicine will be complmentary and that physicians using only xenobiotic methods will be the exception.

Review of Previous Reports and Present Summary.

The use of large doses of nutrients for the treatment of cancer has not yet entered the mainstream of medicine, not in the Universities, nor in the medical journals, or in the wards, halls and corridors of hospitals. But it is beginning to do so, largely due to the persistance and dedication of Professor Linus Pauling. He needed forums in which to outline his views and these were provided for him by the physicians and other interested individuals. The Canadian Schizophrenia Foundation was honored to host Linus Pauling on three separate occasions, in Toronto and in Vancouver. About the same time the National Cancer Institute held a meeting in September 1990. This was not a clinical meeting. No one presented clinical data showing what nutrients might do. At this meeting Dr. Linus Pauling and two associates presented their findings. Dr. Pauling commented at that meeting "It is very interesting to be here since, for some ten years or so, you have refused every request of mine for research grants on vitamin C". The Proceedings, National Academy of Sciences (US) refused to publish any clinical papers authored by Dr. Linus Pauling. The first paper, by Hoffer and Pauling, was rejected.

During May 10-12, (1991) Jay Patrick, President, Alacer Corporation, hosted a meeting- the Second World Congress on Vitamin C and The Immune System, in San Diego, Bahia Resort Hotel. He had hosted the First World Congress on Vitamin C in 1978 in Palm Springs. That one was addressed by Dr. Szent-Gyorgyi who won the Noble Prize for his work on vitamin C and intermediary metabolism, by Dr. Linus Pauling, and by Dr. Fred Klenner, the first physician to use megadoses of vitamin C. The Second World Congress brought together a distinguished group of vitamin researchers and clinicians including Dr. E. Cheraskin, Dr. C.A.B. Clemetson, Dr. E. Ginter, Dr. J. Priestly, and others. Their papers were published in the Journal of Orthomolecular Medicine Volume 6, 1991. I also presented a report on the clinical procedures I was then using in treating the terminally ill cancer patients with Vitamin C. Dr. Linus Pauling presented an excellent outline of his research into vitamin C and Cancer but his presentation was not published. Dr. Pauling was an excellent speaker, very honest, and very blunt. The following quotation from his paper will convey some of the flavour of his presentations. "When Irvine Stone wrote to me in 1965, after having heard me give a talk in which I said that I would like to live 25 years longer in order to enjoy reading about the new discoveries about the nature of the world that no doubt would be made by scientists during these 25 years and said if I were to take three grams a day of Vitamin C, I would perhaps not only live the 25 years but even 50 years. And that was when I increased my uptake ot ascorbate fifty fold to 3,000 milligrams a day, then later to a hundredfold, 6000, then to two hundredfold, then to three hundredfold and I'm still not sure what the optimum intake is. There is a practical reason why I stopped at three hundredfold at 18,000. Well, I think that's pretty important. I read a statement by physicians that they should tell their patients not to worry about being constipated. I think they should worry about being constipated, its so harmful to carry waste toxic materials around an unnecessarily long period of time. So,it was Irwin Stone that got me interested in Vitamin C and of course, it was that scoundrel Victor Herbert who was responsible for my having begun writing books about vitamins". So the other day I got a book published by the National Academy of Sciences on control of diseases. It mentions practically nothing about vitamins and their usefullness but it does have something about common colds. A statement that 16 control trials have been turned out, every one of which showed that Vitamin C has no value in controlling the common cold, preventing or controlling the common cold. They didn't listen, but I'm sure they're the 16 control trials that I discuss in my books, where I give the amount of decrease in illness. Every one of these shows that Vitamin C has value, not that it doesn't have value. That's perhaps a minor misrepresentation. A couple of years ago, I got two or three letters from people who sent me clippings from a magazine. One of them said he had stopped taking his Vitamin C because of the statement in this magazine. It was a quotation from the Professor of Medicine at Yale University Medical School. I had mentioned, three or four weeks ago, while speaking in Yale University Medical School, his statement that you shouldn't take as much as even one gram of Vitamin C per day because it will damage the liver. So I wrote to him and said that I read the literature on Vitamin C to the extent that I can, and there are a couple of thousand new papers published every year about Vitamin C, but I missed the meal. Would you please send me the references to the work done on the damage done to the liver. Well, he was a gentleman, which you'd expect at Yale Medical School and often when I write letters like that I don't get an answer from them. He wrote back saying oh, that was just a mistake. That was the end of that. So far as I know he didn't write to the magazine and say that was a mistake, but he did say it to me. And there are lots of mistakes of this sort about vitamins that perhaps sometimes intentionally misrepresent the facts. For some perhaps there is a reason an economic, financial reason, that there is so msuch opposition in the medical establishment against improving your health by taking vitamins."

This first symposium which included laboratory and medical scientists was one of the first with this mix of clinical and preclinical data. The number attending was not very large but they made up in quality for the lack of numbers. There I met Dr. Patrick Quillin, Vice President of Nutrition, Cancer Treatment Centers of America. He was thinking about organizing a conference to consider the connection between nutrition and cancer. I thought it was an excelllent idea and encouraged him to do so. The first symposium was held in Tulsa, Oklahoma, November 6 to 8, 1992. The title of the meeting was Adjuvent Nutrition in Cancer Treatment. Over 300 physicians and others attended. Participating were seven Universities, more than 6 cancer institutes. The last half day of the symposium was taken up by clinical studies including my report, and a report from Prof Rudy Falk, University of Toronto Medical School. This was the first meeting were both the academic physicians and orthomolecular physicians met in an amicable and interesting exchange of information. The meeting was co- sponsored by the Cancer Treatment Research Foundation and the American College of Nutrition, and published as a proceedings.

In my presentation at the Tulsa Conference I described how I became involved in the treatment of patients with cancer. My preliminary data indicated that the addition of vitamin C in mega doses improved the outcome of treatment substantially. I described these findings to Linus Pauling. He urged me to follow up carefully every patient I had seen and offered to analyze the follow up data using the method he had developed. In our two recent studies, Hoffer and Pauling3 concluded that the addition of vitamin C improved the outcome of treatment for cancer significantly and substantially. In the first study 134 patients seen between August 1977 and March 1988 were followed until December 31, 1989. We concluded that orthomolecular treatment given to female related cancers had improved life expectancy about 20 times compared to our non random controls and 12 times for other cancers. In our second paper a second cohort of 170 patients seen between April 1988 to December 31, 1989 was followed to December 31, 1992. These results were about the same as those we had published earlier. We concluded that while vitamin C alone led to about 10 % excellent responders the addition of the other nutrients increased this to about 40 %.

Orthomolecular treatment improves the quality of life. It also decreases the side effects of radiation and chemotherapy. The program is palatable. The only patients who could not follow it were those who were getting chemotherapy and suffered severe nausea and vomiting or patients who could not swallow because of lesions in their throat. Orthomolecular therapy provides a step forward in the battle against cancer and must be fully explored. There can be no logical reason today why most of the research funds should go only toward the examination of more chemotherapy and more ways of giving radiation. There must be a major expansion into the use of orthomolecular therapy to sort out the variables and to determine how to improve the therapeutic outcome of treatment.

Hoffer A: Orthomolecular Medicine for Physicians. Keats Publising, New Canaan, CT, 1989.

Pauling,L: Biostatistical analysis of mortality data for cohorts of cancer patients. Proceedings National Academy Sciences, USA 86:3466-3488,1989.

Pauling, L and Herman, Z: Criteria for the validity of clinical trials of treatments of cohorts of cancer patients based on the Hardin Jones principle. Proceedings National Academy Science, USA 86:6835-6837,1989.

Anti Cancer Nutrition

A large number of special diets ranging from fasting (water only) to juice fasts to low fat and sugar free diets are used. Every one of the special diets have proponents who think they are very helpful, and patients who have been helped by them but no one has ever conducted an experiment to compare all the diets to determine which is the best. Perhaps there will never be a "best". Because of the individuality of people it may turn out that each person will have to determine what is their own best diet. In my book Hoffer"s Laws of Natural Nutrition Quarry Press,P.O.Box 1061, Kingston, Ontario K7L 4Y5. Almost all the diets used by complementary therapists are lower in animal proteins, much more vegetarian, with emphasis on vegetables rich in bioflavonoids and fruits. I advise my patients to obey three rules (1) To eliminate all junk food i.e,. food containing any added simple sugars like table sugar or glucose as in corn syrup. This simple rule, comprehensible even to children, will eliminate nearly 90% of the additives commonly added to processed foods. (2) To reduce fat levels, I think that dairy products are the chief villains. Nearly every study internationally has shown that countries with lower fat intake have fewer cases of cancer, particulary breast cancer. Milk is very rich in estrogens from the cow and in phytoestrogens from the grass that they eat.(3) To eliminate all foods they know they are allergic to. These rules allow the diet to be varied, palatable and interesting.

Vitamin Supplements

No one should take any supplements until they have become familiar with their properties and how to use them. It is advisable always to work with a knowledgeable physician. But if they can not find any physician or orthomolecular nutritionist they should go ahead on their own using the information now readily available on nutrition and vitamin supplements. They should advise their doctors what they are doing and which supplements they are using. By listing the vitamins and dose ranges I am not suggesting that every person need to take them all. This is an individual matter based on discussions with their doctor. The vitamin and mineral supplements are compatible with medication and with the diet.

Vitamin C. The dose range is anywhere from 3 to 40 grams daily in three divided doses. If the dose is too high it will not be absorbed by the intestines, will stay in the bowel and act like a laxative causing loose stools and gas. It is a good laxative. The best dose does not act like a laxative. Forms of vitamin C include the pure ascorbic acid (hydrogen ascorbate), and the mineral salts such as sodium ascorbate (slightly salty in taste), calcium ascorbate (slightly bitter), and other salts often found in combinations of the mineral ascorbates, In large doses it is best used as the powder dissolved in water or one of the juices. Do not use commercial grade vitamin C crystals of powders. Use CP grades as is found in drug stores or health food stores. Contrary to false rumours issued by some hostile critics of megadose vitamin use it does not cause kidney stones, does not cause pernicious anemia, does not cause sterility. A recent suggestion in a letter, to Nature, published in England concluded that more than 500 milligrams of vitamin C daily could cause DNA damage. This was based on one of a possible 20 markers that could have been used which showed no damage and a 21st marker which is seriously questioned. Some of the key scientists in this field criticized these conclusions. My only comment is that if they were correct why do my patients who take large doses of vitamin C live so much longer.

Vitamin B-3. There are two forms. Niacin lowers cholesterol, elevates high density lipoprotein cholesterol and reduces the ravages of heart disease, but causes flushing when it is first taken. The flushing reaction dissipates in time and in most cases is gone or very minor within a matter of weeks. Niacinamide, the other form, has no effect on blood fats (lipids) but is not a vasodilator. There have been 7 international conferences on the theme niacin and cancer. This vitamin is an essential component of the enzyme systems that repair broken DNA molecules. The dose ranges from 100 milligrams three times daily to 1000 milligrams three times daily. Several studies in Detroit have found that the response rate of cancer around the head and neck was 10% on radiation alone but increased to 80% when patients were given large doses of niacinamide. Very rarely niacin will cause obstructive jaundice which clears when the niacin is stopped. For details see my book Orthomolecular Medicine for Physicians.

Vitamin E (d alpha tocopherol succinate). This water soluble form has the greated efficacy in controlling cancer cell growth in the test tube and is the one I recommend should be used. The dose ranges from 400 to 1200 International Units daily. Vitamin E is the major fat soluble anti- oxidant in the body and plays a role by decreasing the concentration of free radicals which are thought to be involved in the creation of the cancer. It also decreases the risk of heart disease, thus confirming what was found over fifty years in Ontario by Drs. Wilfrid and Evan Shute.

The Carotenoids. Most people have heard of beta carotene but this is only one of a large number of carotenoids which are present in colored vegetables and fruits such as carrots, beets, tomatos and greens. The evidence is very powerful that these mixed carotenoids as found in these foods will decrease the incidence of cancer but there is a question about the efficacy of the pure beta carotene. There is still a vigorous debate about this. I prefer carrot juice to the beta carotene. Generally it is better to have a large variety of these natural anti cancer factors. Beta carotene is very safe. The only question is whether it is the best form. Only a small portion is converted into vitamin A.

Folic acid. Several studies have found this important vitamin has anti cancer properties, for cancer of the cervix and of the lung in lung smokers. This does not mean it is safe to smoke. It does mean that smokers should take it and immediately start their campaign to stop smoking. Women should take ample amounts to prevent neural tube disorders such as spina bifida. The US government plans to add it to flour. Canada is still thinking about it. The dose range is from 1 to 30 milligrams daily. It can be taken only on prescription.

Coenzyme Q 10. Dr. Karl Folkers discovered this substance, also called ubiquinone; toward the end of his long and distinguished career he regretted that he had not called it a vitamin. It is an odd vitamin since young people are able to make enough from the lower numbered ubiquinones such as Q 6 or Q 8 whereas older people and anyone ill is not able to make enough. It thus becomes a vitamin later in llife and when onc becomes ill. A few clinical studies have shown that in large doses it has anticancer properties especially for breast cancer. These range from 300 milligrams to 600 milligrams daily.

Mineral supplements

Selenium. The presence or absense of this trace element has the clearest relationship to the presence of cancer. People living on soils that are rich in selenium have a lower incidence. I recommend between 200 to 1000 micrograms daily. One of my patients took 2000 with no side effects.

Calcium and magnesium. These are generally very useful to take to maintain calcium levels in bones and blood. They have been found helpful in cases of bowel cancer. Women should receive 1500 milligrams of calcium daily from their food and supplements and half as much magnesium. There are several forms of these minerals available. Usually a person will absorb into their body anywhere between 25 and 50% of the calcium.

Zinc and copper. There is a reciprocal connection between these two. If blood zinc levels are too high the copper levels will be too low. Because zinc can shrnik enlarged prostate glands and may be helpful in the treatment of this cancer. I have been using it routinely. Also, people in Victoria tend to be low in zinc levels because our water is soft, and dissolves copper more easily from copper plumbing.

Other Substances Found in Plants.

A large number of these preparations are being used for the treatment of cancer. They include bioflavonoids, preparations from soy bean, and from mushrooms. Vaccines are also being used. Coley's vaccine originated over 100 years ago. I will not discuss these, nor other treatments such as 714-X, Ukrain, Iscador, Cartilage, Carnivora, Amygdalin (Laetril), Esiac, and many herbs. These are described in the book by Diamond, Cowden and Goldberg.

Most of the speakers at the 26th Annual International Conference on Nutritional Medicine Today, Toronto, April 1997, discussed various topics dealing with the principlea and pracice of orthomolecular medicine. Dr. C.Simone spoke on "Breast Cancer: Nutritional and Lifestyle Modification to Augment Oncology Care". Dr. Somone is well known for his work in researching complementary treatment of cancer.. He is an Internist, Medical Oncologist, Immunologist and Radiation Oncologist and has published several valuable books including Cancer and Nutrition and A Ten Point Plan to Reduce Your Risk of Getting Cancer. Optimum nutrition, avoiding toxic substances in food and water, and other lifestyle changes will materially reduce the risk of developing cancer.

Here is his ten point plan (1) Nutrition: calories slightly below average to maintain a weight just below the average weight. Should be high in fiber, rich in fish, fruits, and vegetables and with vitamin and mineral suplements. Eliminate additives and salt. (2) Avoid tobacco. (3) Avoid alcohol (one drink per week allowed). (4) Avoid radiation. Take X-ray only when necessary and avoid excessive exposure to sun. (5) Keep environment, air, water,and work place clean. (6) Avoid promiscuity, hormones and any unnecessary drugs.(7). Learn early warning signs like a lump in the breast. (8) Exercise and relax regularly. (9) Take a yearly physical. (10) Read his book for a self test of risk factors and symptoms that may indicate cancer or heart disease. See the report by Esteve,J. et all. Diet and cancers of the larynx and hypopharynx: the IARC multi-center study in southwestern Europe. In Cancer Causes and Control 7:240-252,1996.

These ten points should be part of every treatment program as well. The main difference is that in treatment the first point becomes even more important and the doses of supplements are much greater. The sicker a person is the more nutrients are needed in optimum doses to help the bodies reparative mechanisms. Treatment must be started as soon as the diagnosis is suspected and made, and should be concurrent with any other treatment recommended by oncologists and cancer specialists. Eventually all cancer specialists will be using these orthomolecular techniques. Supplements must be maintained while chemotherapy or radiation are being used. Studies have shown that these supplements enhance the toxic effect of the treatment on the lesion and decrease the toxic effects on the body. Patients do not suffer as much from the side effects and recover much more quickly when the treatment series is completed. They enhance the quality of life during and after treatment.

In Saskatoon, Saskatchewan, where I conducted my research which helped lead to orthomolecular oncology, Tyrell Dueck, age 13, was forced to undergo chemotherapy for an osteogenic sarcoma of his leg and amputation of that leg. Neither Tyrell nor his parents wanted him to undergo this treatment and instead, having already had two sessions of chemotherapy, Tyrell wanted to get alternative treatment from a clinic outside of Canada. The problem was that Tyrell ass not an adult. If he were, there would be no problem and no one could force him to receive treatment he did not want. His pediatric oncologist testified that the cancer could be spreading and that if chemotherapy did not start soon surgical options would be limited. He added that he would accept Tyrells wishes if he were certain that Tyrell had all the available information. Three professionnals, one a psychiatrist, testified that Tyrell was competent to make such a decision. The judge ruled that, even so, Tyrell had been unduly swayed by his parents and that he had not been given the necessary information.

The keywords are "necessary information" so that all the legal requirements for informed consent were met. I would be surprised if Tyrell had not been informed what might happen to him with or without standard treatment. The outlook for this lesion is dismal and even amputation of the leg would not ensure that other limbs might not have to be amputated later. I think Tyrell was informed about the possible benefits and risks of alternative treatment as well. Most patients study their options very carefully before they make these very serious decisions. But I also am convinced that the pediatric oncologist and the judge and the government department that ordered the treatment against Tyrell's wishes were the most ill informed. Treatment with high doses ascorbic acid either by mouth or intravenously or both carries no risk and does provide substantial advantages over chemotherapy and surgery used as the sole treatment. Between 1980 and 1995 four patients with sarcoma followed my treatment protocol (a combination of orthodox and orthomolecular treatment). The first seen in Victoria, had a prostate sarcoma invading his pelvic bones. The cancer clinic could not treat him and he was declared untreatable. He responded to the regimen and died 9 years later at age 80 clear of cancer. One is alive after ten years. One is still alive after five years. The last one, an abdominal liposarcoma died in his sixth year. Counting the first young patient I saw in 1962 who was still well several years ago, five of six responded either to the vitamin regimen alone or to the combination treatment.

I think there is a misunderstanding on both parties of this dispute. There is no reason in the world why any oncologist should not allow vitamin treatment in combination with chemotherapy. This would enhance the therapeutic effect of the chemotherapy and decrease its toxicity. It could possibly have saved this young boys leg and his life. He died soon after returning home. On the other side, if the oncologist had been more open Tyrell might have agreed to more chemotherapy if he were assured he could also take the vitamins by mouth or by intravenous administration. There were doctors in Saskatoon willing to use orthomolecular treatment. More knowledge and more comon sense could have avoided this terrible dilemma forced on Tyrell and to a lesser degree on the physicians who advised Tyrell and his family. The family appealed the decision to the superior court and enforced chemotherapy was put on hold. March 20. 1999

The final solution is that every one lost. Tyrell has metastases to his lungs and was therefore no longer treatable by the cancer clinic. They no longer objected to Tyrell receiving vitamin therapy. He did go to Mexico. Tyrell also lost months in obtaining orthomolecular treatment which may have destroyed his chance for recovery. The court lost because the decision was repellant and will generate massive controversy. December 26, 1999.

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A.Hoffer PhD MD FRCP(C)

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