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The Ketogenic diet 

A diet high in fat and low in carbohydrates (sugars) that causes the body to break down fat into molecules called ketones. Ketones circulate in the blood and become the main source of energy for many cells in the body. A ketogenic diet is used to treat some types of epilepsy and is being studied in the treatment of some types of cancer – National Cancer Institute.

At the University of Boston, Professor Thomas Seyfried has been leading research in this field for a number of years. In his groundbreaking book, Cancer as a Metabolic Disease: On the Origin, Management, and Prevention of Cancer (Wiley, 1st ed., 2012) Seyfried argues that cancer can be best defined as a mitochondrial metabolic disease rather than as a genetic disease and that by altering the body’s metabolic environment, molecular pathology can effectively be neutralised. In the case of cancer, his findings have shown that when the body is in a state of ketosis, cancer cells are targeted and neutralised or eradicated, while the physiological health of normal cells is enhanced.
Source: Veritalife

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This study, co-authored by Thomas Seyfried, concluded:
The simultaneous restriction of glucose and glutamine, while under therapeutic ketosis, will deprive GBM [glioblastoma] cells of substrates for growth and energy production. This information should have value in the clinic.

This is a 2021 case report of a 32-year-old man diagnosed with Glioblastoma in 2014.

He refused standard of care and steroid medication after initial diagnosis, but started on a low-carbohydrate ketogenic diet consisting mostly of saturated fats, minimal vegetables, and a variety of meats.

The tumor continued to grow slowly until 2017, when he opted for surgical debulking. A pathology specimen confirmed IDH1-mutant GBM. Following surgery, he continued with a self-administered ketogenic diet. At the time of this report (May 2021), he remains alive with a good quality of life, except for occasional seizures. MRI continues to show slow interval progression of the tumor.

This 2019 study concluded:
No major advances have been made in improving overall survival for glioblastoma (GBM) in almost 100 years. The current standard of care (SOC) for GBM involves immediate surgical resection followed by radiotherapy with concomitant temozolomide chemotherapy. Corticosteroid (dexamethasone) is often prescribed to GBM patients to reduce tumor edema and inflammation. The SOC disrupts the glutamate–glutamine cycle thus increasing availability of glucose and glutamine in the tumor microenvironment. Glucose and glutamine are the prime fermentable fuels that underlie therapy resistance and drive GBM growth through substrate level phosphorylation in the cytoplasm and the mitochondria, respectively. Emerging evidence indicates that ketogenic metabolic therapy (KMT) can reduce glucose availability while elevating ketone bodies that are neuroprotective and non-fermentable. Information is presented from preclinical and case report studies showing how KMT could target tumor cells without causing neurochemical damage thus improving progression free and overall survival for patients with GBM.

Study (animal model): Glioblastoma (GBM) is an aggressive primary human brain tumour that has resisted effective therapy for decades. Although glucose and glutamine are the major fuels that drive GBM growth and invasion, few studies have targeted these fuels for therapeutic management. The glutamine antagonist, 6-diazo-5-oxo-L-norleucine (DON), was administered together with a calorically restricted ketogenic diet (KD-R) to treat late-stage orthotopic growth in two syngeneic GBM mouse models…The diet/drug therapeutic strategy killed tumour cells while reversing disease symptoms, and improving overall mouse survival. The therapeutic strategy also reduces edema, hemorrhage, and inflammation. Moreover, the KD-R diet facilitated DON delivery to the brain and allowed a lower dosage to achieve therapeutic effect. The findings support the importance of glucose and glutamine in driving GBM growth and provide a therapeutic strategy for non-toxic metabolic management.

See The glucose ketone index calculator: a simple tool to monitor therapeutic efficacy for metabolic management of brain cancer

This study of 45 women with ovarian or endometrial cancer concluded:
In women with ovarian or endometrial cancer, a KD results in selective loss of fat mass and retention of lean mass. Visceral fat mass and fasting serum insulin also are reduced by the KD, perhaps owing to enhanced insulin sensitivity. Elevated serum β-hydroxybutyrate may reflect a metabolic environment inhospitable to cancer proliferation.

This study says: We performed a case series study of a new ketogenic diet regimen in patients with different types of stage IV cancer. Carbohydrates were restricted to 10 g/day during week one, 20 g/day from week two for three months, and 30 g/day thereafter. A total of 55 patients participated in the study, and data from 37 patients administered the ketogenic diet for three months were analyzed. No severe adverse events associated with the diet were observed. Total ketone bodies increased significantly, and both fasting blood sugar and insulin levels were suppressed significantly for three months after completion of the study. Five patients showed a partial response on Positron emission tomography-computed tomography (PET-CT) at three months. Three and seven patients showed complete and partial responses, respectively at one year. Median survival was 32.2 (maximum: 80.1) months, and the three-year survival rate was 44.5%…Our ketogenic diet regimen is considered to be a promising support therapy for patients with different types of advanced cancer.

The 37 patients included eight colorectal cancer patients, six lung cancer patients, five breast cancer patients, four pancreatic cancer patients, and 19 other cancer patients (Table 1). Thirty-three patients (89.2%) received chemo-hormonal therapy.

This 2020 article Addressing the controversial role of ketogenic diets in cancer treatment published in Expert Review of Anticancer Therapy says:
I have argued that both fundamentalist and methodological skepticism about the clinical application of KDs for cancer patients should be rejected, so that the totality of evidence can be objectively evaluated. There is weak, yet positive evidence for improved efficacy of cancer treatments when KDs are used as complementary therapies. However, there is strong evidence for the safety of this approach, so that patients who want to support their treatment by a KD should not be discouraged, but ideally be supported by dieticians and oncologists that are well-trained in a systemic view of cancer and metabolism. 

Study of Modified Atkins Diet on 17 advanced cancer patients:
…survival improved in some melanoma and lung cancer patients…Notably, melanoma patients represented the three who benefitted most from this study. …Modified Atkins diets are safe and feasible in advanced cancer. Future studies should investigate the modified Atkins diet MAD or the ketogenic diet KD and their potential benefits to this type of cancer.
[Note: The Modified Atkins diet strongly encourages high-fat foods and restricts carbohydrate intake. It is similar to the ketogenic diet]

Literature review of 87 studies:
As elucidated in this review, the KD [ketogenic diet] seems to create an unfavorable metabolic environment for cancer cell proliferation and, thus, represents a promising adjuvant for a multifactorial patient-specific therapeutic regime. One clear benefit of the KD is its potential to increase the response to therapeutic drugs, which has been widely demonstrated in vitro and in vivo…The available scientific literature indicates that, based on controlled preclinical trials, strict KDs could be beneficial in a range of cancers. 

This study concluded:
There is suggestive and emerging evidence that carbohydrate restriction (i.e., ketogenesis) may help to disrupt cancer, without risk of adverse effects. 

This newly published Literature review found:
Although most preclinical studies indicate a therapeutic potential for ketogenic diets in cancer treatment, it is now becoming clear that not all tumors might respond positively. 

We can reduce the death rate by 50-percent if you view the tumor as a metabolic problem rather than a genetic problem.

Dr Thomas Seyfried, PhD, cancer researcher and professor of biology at Boston College.

The Ketogenic Diet may not be helpful in some types of cancer.

Blood and lymph cancers do not respond to Keto diet – Thomas Seyfried, PhD

Research says a glucose restricted diet for Colon cancer may yield to cellular sugar starvation.

All cancers love glucose, but breast, ovarian and prostate, for example, are more ’hormonally-driven’.

More info: Foundation For Metabolic Cancer Therapies 

Page updated 2024

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