Source: JNCI Journal of the National Cancer Institute, doi:10.1093
Authors: Jennifer Lin et al.

Background:
Observational studies suggested that a diet high in fruits and vegetables, both of which are rich with antioxidants, may prevent cancer development. However, findings from randomized trials of the association between antioxidant use and cancer risk have been mostly negative.

Methods:
From 8171 women who were randomly assigned in the Women’s Antioxidant Cardiovascular Study, a double-blind, placebo-controlled 2 x 2 x 2 factorial trial of vitamin C (500 mg of ascorbic acid daily), natural-source vitamin E (600 IU of {alpha}-tocopherol every other day), and beta carotene (50 mg every other day), 7627 women who were free of cancer before random assignment were selected for this study. Diagnoses and deaths from cancer at a specific site were confirmed by use of hospital reports and the National Death Index. Cox proportional hazards regression models were used to assess hazard ratios (represented as relative risks [RRs]) of common cancers associated with use of antioxidants, either individually or in combination. Subgroup analyses were conducted to determine if duration of use modified the association of supplement use with cancer risk. All statistical tests were two-sided.

Results:
During an average 9.4 years of treatment, 624 women developed incident invasive cancer and 176 women died from cancer. There were no statistically significant effects of use of any antioxidant on total cancer incidence. Compared with the placebo group, the RRs were 1.11 (95% confidence interval [CI] = 0.95 to 1.30) in the vitamin C group, 0.93 (95% CI = 0.79 to 1.09) in the vitamin E group, and 1.00 (95% CI = 0.85 to 1.17) in the beta carotene group. Similarly, no effects of these antioxidants were observed on cancer mortality. Compared with the placebo group, the RRs were 1.28 (95% CI = 0.95 to 1.73) in the vitamin C group, 0.87 (95% CI = 0.65 to 1.17) in the vitamin E group, and 0.84 (95% CI = 0.62 to 1.13) in the beta carotene group. Duration and combined use of the three antioxidants also had no effect on cancer incidence and cancer death.

Conclusions:
Supplementation with vitamin C, vitamin E, or beta carotene offers no overall benefits in the primary prevention of total cancer incidence or cancer mortality.

Authors:
Jennifer Lin, Nancy R. Cook, Christine Albert, Elaine Zaharris, J. Michael Gaziano, Martin Van Denburgh, Julie E. Buring, JoAnn E. Manson

Authors’ affiliations:
Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA (JL, NRC, CA, EZ, JMG, MVD, JEB, JAEM); Department of Epidemiology, Harvard School of Public Health, Boston, MA (NRC, JEB, JAEM); Cardiovascular Division (CA), Division of Aging (JMG), Department of Medicine, Brigham and Women’s Hospital; Department of Ambulatory Care and Prevention, Harvard Medical School, Boston, MA (JEB)

Source: New York Times (nytimes.com)
Author: Tara Parker-Pope

Many people gobble big doses of vitamin C in hopes of boosting their immune system and warding off illness. But new research shows that in people with cancer, the vitamin may do more harm than good.

Researchers at Memorial Sloan-Kettering Cancer Center in New York studied the effects of vitamin C on cancer cells. As it turns out, the vitamin seems to protect not just healthy cells, but cancer cells, too. The findings were published today in the journal Cancer Research.

“The use of vitamin C supplements could have the potential to reduce the ability of patients to respond to therapy,” said Dr. Mark Heaney, an associate attending physician at the cancer center.

Dr. Heaney and his colleagues tested five different chemotherapy drugs on cancer cells in the laboratory. Some of the cells were first treated with vitamin C. In every case, including a test of the powerful new cancer drug Gleevec, chemotherapy did not work as well if cells had been exposed to vitamin C. The chemotherapy agents killed 30 to 70 percent fewer cancer cells when the cells were treated with the vitamin.

A second set of experiments implanted cancer cells in mice. They found that the tumors grew more rapidly in mice that were given cancer cells pretreated with vitamin C.

The researchers found that just like healthy cells, cancer cells also benefit from vitamin C. The vitamin appeared to repair a cancer cell’s damaged mitochondria, the energy center of cells. When the mitochondria is injured, it sends signals that force the cell to die, but vitamin C interrupts that process.

“Vitamin C appears to protect the mitochondria from extensive damage, thus saving the cell,” Dr. Heaney said. “And whether directly or not, all anticancer drugs work to disrupt the mitochondria to push cell death.”

Dr. Heaney measured the buildup of vitamin C levels in cells and said that the levels of vitamin C used in the experiments were similar to those that would result if a patient took large doses of the vitamin in supplement form. Earlier research at the cancer center showed that vitamin C seems to accumulate within cancer cells more than in normal cells.

Patients should eat a healthy diet that includes foods rich in vitamin C, Dr. Heaney said, but it’s the large doses of vitamin C in tablet form that are worrisome.