Ketogenic diet, is it worth trying for patients with advanced cancer?

Dr. Clove has recommended two popular science articles related to ketogenic diet before. Is the legendary anti-cancer [ketogenic diet] really useful? > > and < < Ketogenic Therapy Can [Starve] Cancer Cells? > >, I happen to be engaged in relevant work and have some of my own ideas and experiences. I hope I can communicate with you.

First, ketogenic diet is effective in treating epilepsy.

Ketogenic diet, as one of the methods to treat refractory epilepsy, has been effective since it was invented in 1920s.

From 2007 to 2008, Dr. Liao Jianxiang of Shenzhen Children’s Hospital and the Second Affiliated Hospital of Guangzhou Medical University, where I am located, introduced this therapy into China. Our experience is: 1/3 patients can reduce 50% of attacks, 1/3 patients can reduce 90% of attacks, 10% patients can have no attacks at all, and some patients can reduce drug withdrawal [1].

There are also some patients who prefer ketogenic diet therapy without using any drugs, thus completely controlling the attack.

Second, ketogenic diet is being explored for the treatment of cancer.

Ketogenic diet was originally used to treat brain diseases epilepsy, so people first applied it to brain malignant tumors.

In animal experiments, people have successively found that ketogenic therapy can reduce tumor volume, prolong survival time and reduce metastasis for melanoma [2], breast tumor [3], colon cancer [4], prostate cancer [5], gastric adenocarcinoma [6], squamous cell carcinoma [7], etc.

The current research on ketogenic therapy for anti-cancer suggests that it may be an effective therapy. Of course, this is still a certain distance from becoming the standard [anti-cancer therapy], and more research is needed to confirm it.

There are 16 clinical trials registered on the US Clinical Trial Registration website (https://www.clinicaltrials.gov/) for ketogenic diet to treat tumors, including pancreatic cancer, lung cancer, breast cancer and head and neck cancer in addition to new and recurrent gliomas. Most of these are in the stage of patient recruitment.

Three, ketogenic diet to cooperate with calorie restriction

A large amount of evidence shows that caloric restriction may enhance the effect of tumor radiotherapy through various ways, and may enter the guidelines for future tumor treatment [8].

However, clinically, it is difficult to implement simple caloric restriction due to worries about weight loss, immune function damage and postoperative wound healing difficulties.

Some studies have found that Replacing carbohydrates with fat can prevent weight loss in cancer animals and patients [9, Therefore, the combination of calorie restriction and ketogenic diet may be more effective and avoid side effects. Animal studies have also found that ketogenic diet with calorie restriction has better inhibitory effect on tumors than non-calorie restriction [11], and found that this calorie restriction is between 30% and 40%, and will not produce obvious malnutrition.

Our initial experience is: Design a ketogenic diet therapy plan for the patient that originally requires 70% ~ 90% of the calories, The body weight of the patient can be maintained at a normal level, and the patient has no obvious malnutrition and other side effects. The blood sugar of adults is generally between 3 and 4 mmol/L, and hypoglycemia reaction rarely occurs, but children younger than 3 years old should be on guard. Foreign clinical studies also suggest that it is safe [12].

Four, advanced cancer patients can actively participate in clinical trials

Ketogenic therapy is a dietary therapy based on common food, which costs little. Especially for cancer that is difficult to treat by current methods, patients and their families should be encouraged to actively participate in clinical trials, communicate with doctors, find the most suitable treatment plan, and do not give up the last hope.

From an ethical point of view, any clinical trial is conducted on the basis of routine therapy, rather than giving up routine therapy. Some studies suggest that ketogenic diet may also enhance the effect of radiotherapy and chemotherapy [13, 14], and patients can completely add ketogenic diet on the basis of routine therapy.

The cost of ketogenic diet is mainly to give up some previous eating habits. Even if there is a little consultation fee, it is not an unreachable high cost.

We recommend that patients with advanced cancer actively try ketogenic diet therapy. Of course, this needs to be carried out under the guidance of experienced professional doctors. Don’t just search the Internet and start trying it at home, which may be harmful to patients.