Hyperglycemia is commonly manifested in cancer patients. Although high intakes of sugar and refined carbohydrates and elevated blood glucose are strongly associated with the risk of cancer, much less is known about their effects on survival after cancer diagnosis. There is evidence that high carbohydrate intake is associated with poorer survival after diagnosis for early breast cancer. We measured glycated hemoglobin in a group of cancer patients (some with active disease and some in remission) and found a statistically significant lower average blood glucose in those in remission. Glycated hemoglobin provides an indication of average blood glucose over 2 to 3 months. The authors discuss lifestyle changes including diet and physical activity that can reduce average blood glucose. Ascorbic acid (AA) supplementation as an adjunct to cancer therapy is also considered. Furthermore, they present a biologically plausible explanation for how hyperglycemia can impair the actions of AA and damage immune effectiveness and hinder cancer survival. One mechanism is likely a reduction in intracellular AA; high intracellular levels of AA are necessary for optimal activity of the hexose monophosphate shunt. This metabolic pathway is important for maintaining proper cellular antioxidant status in immune cells including lymphocytes involved in cell-mediated immunity.

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