1. Research Problem: Vitamin C deficiency occurs in cancer patients, resulting in poor quality of health. However, the safety of administration of intravenous vitamin C (IV C) for the improvement of QOL is of concern (Klimant et al., 2018).
2. Purpose: The purpose of the research is to determine whether deficiency of vitamin C in cancer patients is associated with exacerbation of tumor, and to evaluate the safety of administration of IV C in cancer patients independently or in combination with oral vitamin C as supportive care.
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3. Literature Review: Vitamin C deficiency is prevalent in cancer patients due to inflammation, reduced oral intake, medical interventions such as surgery, radiation, and chemotherapy, disease process and infections. The use of IV C or IV C in combination with oral vitamin C in oncology care has demonstrated amelioration of the patient condition and improved QOL (Klimant et al., 2018).
4. Theoretical framework. The use of IV C in cancer supportive care can be a safe way of enhancing the QOL in patients.
5. Research Question: How safe and effective is the use of IV C alone or in combination with oral vitamin C in cancer support care in reducing the disease processes and complications related to an antioxidant deficiency?
6. Research Design: Systematic Review
7. Sample type and size: The sample used was studies on the safety and efficacy of vitamin C therapy in cancer patients published in Medline between April 2018 and October 2016. I42 studies were identified and screened, and only 14 studies were included in the research.
8. Legal-ethical issues: None.
9. Instruments: The OVID platform of Medline was used to conduct the study searches.
10: Validity and reliability: The study conclusion and rationale and supported by other previous studies on the use of IV C therapy in cancer supportive care. This makes the research findings valid. However, further research has to be conducted on the safety and effectiveness of IV C therapy to enhance the reliability of the research findings.
11: Data Collection Procedure: A Medline search using the Ovid platform was conducted for all the studies published regarding the pharmacokinetics of vitamin C, deficiency in cancer patients, and the safety of the therapy. Keywords such as “oncology”, “ascorbic acid”, “intravenous vitamin c”, and “neoplasm” were used in the search. All articles that met the search criteria were reviewed and included in the study, from which the research data was collected.
12: Data Analysis: Statistical averages and the p-values of the blood vitamin C levels of each study evaluated were determined.
13. Results: Vitamin C is essential for the synthesis of neurotransmitters and collagen. The prevalence of vitamin C deficiency is higher in patients with chronic diseases, inflammation, and oxidative stress. Most studies reported the benefits of vitamin C administration in improving the QOL (Klimant et al., 2018).
14: Discussion of findings and new findings: Deficiency in vitamin c in cancer patients as a result of reduced intake or pathophysiological mechanisms may cause complications that might be corrected by the administration of IV C. IV C is a safe therapy in cancer supportive care of patients. Concomitant administration of antioxidant therapy for cancer treatment and IV C might reduce the efficacy of the therapy. The two therapies have to be administered interchangeably (Klimant et al., 2018).
15: Implications, limitations, and recommendations: IV C is safe and should, therefore, be used in supportive therapy. However, there is a concern for the interaction between the pro-oxidant and IV C anti-oxidant therapy. The study also fails to demonstrate a placebo effect. Further studies are warranted to explore the biomarkers and the duration of IV C treatment in patients (Klimant et al., 2018).
Cancer and the Use of Intravenous Glutathione and Vitamin C
1. Research problem: The use of glutathione (GSH) in cancer treatment is controversial as it is not clear whether GSH causes patient benefits or an improved quality of life (QOL) (Dettman & Meakins, 2017).
2. Purpose: The purpose of the study is to determine whether the use of intravenous GSH alone or in combination with IV C in cancer patients has significant positive effects on the patient outcome.
3. Literature review: High intracellular levels of GSH potentially increase the resistance of some cancer cell lines to some chemotherapy agents used. Higher GHS levels also improve the prognosis of some cancer cells. In most of the studies evaluating the role of GSH in cancer cell survival, a consistent relationship between the survival of the tumor and GSH levels have not been identified (Dettman & Meakins, 2017).
4. Theoretical framework: The use of intravenous GSH and vitamin C in cancer patients could potentially enhance the effectiveness of chemo drugs by reducing the survival of the cancer cells, thereby improving the QOL.
5. Research question: Is the use of intravenous GSH and vitamin C effective in the treatment of cancer patients undergoing chemotherapy?
6. Research design: Systematic review
7. Sample type and size: Clinical trials, animal trials, and in-vitro studies on the use of a combination of GSH and chemotherapy in the treatment of cancer patients were evaluated.
8. Legal-ethical issues: Patient confidentially and ethical clearance has to be ensured when using the data from the clinical trials, as these data involve real patient information.
9. Instruments: The study failed to demonstrate the instruments used in their analysis.
10. Validity and reliability: The research conclusions are consistent with the studies that were reviewed. However, the reliability of the research findings is in question as only a very small number of trials and studies were reviewed.
11. Data Collection Procedure: Both quantitative and qualitative data were extracted from the studies that were reviewed. The data was extracted through a critical evaluation of the findings in the included studies and trials, with a particular focus on the response of the subject groups to the interventions (GSH + Vit C).
12. Data Analysis: Statistical analysis was not conducted on the data. The data from each trial or study group was independently analyzed. The analysis involved comparing the blood levels of GSH and Vit C with the outcome of the intervention groups.
13. Results: Despite the potential effectiveness of the use of GSH and Vit C in the treatment of cancer patients, it is still quite unclear if the intervention can effectively be adopted in real patient situations. No successful clinical trials have been conducted, and the credibility of in vitro studies is affected by external factors (Dettman & Meakins, 2017).
14. Discussion of findings and new findings: GSH and Vit C have been used in combination therapy in many cases. The efficacy of GSH in the therapy is however unclear because most of the cases usually involved a high dose of Vit C and low doses of GSH. The use of these combination therapies has proven beneficial in some cases, with GSH demonstrating patient benefits and improved QOL (Dettman & Meakins, 2017).
15. Implication, limitations, and recommendations:
There is a need to conduct further in vivo studies and clinical trials to determine the effectiveness of GSH in the management of cancer. The fact that various studies support its use and the lack of evidence to demonstrate detrimental effects in patients means that the GSH +Vit C therapy may be adopted in the treatment of patients.
References
Dettman, I. & Meakin, C. (2017). Cancer and the use of intravenous Glutathione and Vitamin C. Journal of the Australasian College of Nutritional and Environmental Medicine , 36 (1), 19.
Klimant, E., Wright, H., Rubin, D., Seely, D., & Markman, M. (2018). Intravenous vitamin C in the supportive care of cancer patients: a review and rational approach. Current oncology (Toronto, Ont.) , 25 (2), 139-148.
