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Many aggressive
cancers depend on anaerobic glycolysis for ATP production, as has been known
since first described by Otto Warburg in the 1920’s. The remarkable success of
modern PET scanning in the detection, staging and prognosis of many cancers
using F-18 Fluorodeoxyglucose (FDG) reflects this dependence. Very low
carbohydrate ketogenic (VLCK) diets have inhibited cancer growth in animal
studies and in a human case study. Ketone bodies in culture media have inhibited
cancer growth in cell culture studies [1], [5], [6].
While the mechanism of cancer inhibition is unlikely to be simple glucose
deprivation, several plausible mechanisms have been proposed. VLCK diets cause
tonic reductions in hormones that are supportive of tumor growth including
insulin, IGF7, IL6 and other inflammatory cytokines. Other metabolic effects
include apoptosis due to increased plasma fatty acids, and inhibition of fatty
acid synthase, a target of chemotherapeutic agents. While we actively explore
cellular and metabolic effects of ketone bodies themselves in our own
laboratories, we are also recruiting patients in a nutritional Clinical Trial of
carbohydrate restriction in collaboration between the Albert Einstein College of
Medicine and Downstate Medical Center. The two principle aims are to:
1) Determine safety and feasibility of a 28 day VLCK diet in 12 subjects with
FDG avid cancers.
2) Monitor change in PET FDG uptake between the beginning and end of the trial
as a surrogate marker for efficacy (as has been done in lymphoma, lung cancer,
breast cancer and other malignancies).
Five patients with metastatic cancer have completed four weeks of a VLCK diet
without adverse effects. We are looking to recruit another 7 patients. Please
take a look at our website for more information.
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