Can a ketogenic diet support recovery from brain cancer?
May 27, 2015 10:40 AM   Subscribe

A family member was very recently (last week) diagnosed with a glioblastoma. They had an apparently successful surgery this week. We're trying to come to grips with it and stay as positive as possible despite the typically poor prognosis. (Not sure yet what the deal is with our family member - apparently "all" of the tumour was removed, not sure of % removed or size of the tumour. The stats are obviously not great.) Of course, we're looking at anything that might help extend length and quality of life. There is some research that suggests "possibly", that staying away from glucose might starve any residual cells. At the same time, a restrictive diet may or may not be the best thing to inflict on someone who's been through this. There are probably many diets that cancer patients hear about; this is one we came across that seems to have some backing. Is there good evidence that a ketogenic diet can help? Is there a strong enough case for it to try it? Looking for answers from people with a knowledge base (or personal experience is welcome too), with respect to well-meaning others.

The family member, also, lives in another country. If the keto diet is to work, we've read, it has to happen asap after surgery, and we would have to communicate this idea to her care providers. Not sure if they'd be open to it.
posted by anonymous to Health & Fitness (5 answers total)

This post was deleted for the following reason: poster's request -- cortex

 
Is the family member open to it and in conversation with you about treatment strategies? To be honest, some people really don't want advice about their treatment, especially something as all-consuming as dietary restriction. It could help, but it is unlikely to be the difference in survival - and giving advice, however well-intentioned, can feel like critique, like you aren't fighting hard enough. This goes double for someone who is so far away - it would be one thing if you were available to prepare the meals, but without that, the work falls to the sick person, who is least able to manage it. Additionally, cancer and chemo (assuming that is happening) can change taste buds. It might be difficult for them to eat at all - only certain things may be at all palatable - therefore making food restrictions even more difficult.

I'm sorry that this doesn't answer your question, but have had a similar experience with another disease and think it needs to be said. It is hard to watch someone suffer and be powerless, but better to accept your own powerlessness than give that emotion to the sick person. If it seems right in the context of your relationship, you can broach the topic gently, but don't be surprised if the answer is no.
posted by decathexis at 11:07 AM on May 27, 2015 [6 favorites]


Having lost friends to glioblastoma, I know that it's utterly devastating to see someone close to you go from perfectly healthy to a shadow of their former self in just a few months. The urge to suggest something - anything - is very strong. Post-op medication usually destroys appetite, and it can be a fight to find any form of nutrition that can be held down, let alone some of the more challenging requirements of a keto diet. Current articles appear to be tainted by quackery, and while larger clinical trials are in progress, there aren't yet results.

While I know you want to help, it might be kinder to try to do something for your family member to help with their immediate care and comfort. Their quality of life has likely taken a huge hit, and they're having to deal with facing their own mortality. Can you ask their carers what they need right now?
posted by scruss at 11:22 AM on May 27, 2015 [7 favorites]


If glucose had anything to do with cancer, every diabetic would be riddled with cancer. All cells are fed by glucose, not just cancer cells.

As Julie Baker, Clinical Oncology Dietitian, explains it: “Our bodies use glucose, the simplest unit of carbohydrate, as their primary fuel. Without adequate carbohydrate intake, our bodies will obtain glucose, or fuel, from another source. Possibilities include the breakdown of proteins we eat or proteins stored in our body, which may ultimately lead to muscle loss and malnutrition.”
posted by Sophie1 at 11:54 AM on May 27, 2015 [1 favorite]


Mod note: This is a followup from the asker.
Thank you both for your answers. I appreciate that you are speaking from lived experience. Please rest assured that we are mindful of the concerns raised and are only trying to determine the possible merit of this diet, on the basis of evidence to date, so that we might at least present the evidence to both our family member and their medical care providers, as there may be differences in access to information / research cultures. Some of us are good googlers but we do not have a medical background. What we have seen looks promising (not for a cure. Obviously.)

We are not looking at Mercola, if that's what Google turned up. The keto diet has been recommended by the American Brain Tumor Association and is a serious subject of research (apologies for messy links, writing from phone):

http://www.medscape.com/viewarticle/749855

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4063533/

http://www.cancerandmetabolism.com/content/3/1/3

https://clinicaltrials.gov/ct2/show/NCT01865162

http://www.sciencedirect.com/science/article/pii/S2213231714000925

http://jcn.sagepub.com/content/28/8/1002.abstract

Thank you.
posted by cortex (staff) at 12:03 PM on May 27, 2015


This isn't all just quackery (and it is not correct that all diabetics would have cancer if it were true, but that is a bit out of scope here) but this diet probably not advisable at this time. There are multiple clinical trials looking specifically at a ketogenic diet for glioblastoma as an additional therapy.

The quality of life issue is definitely a big concern. In this 2011 study on the effects of a ketogenic diet on quality of life in advanced cancer patients, only 5 of the 16 patients enrolled were able to complete the study because it was so difficult to remain on the diet (two of the patients also passed away).

Previous peer-reviewed studies have shown that a ketogenic diet extends survival in animal models (e.g. mice, rats) of glioma, but there are few human studies at this time. As you might read in that link, most of the studies at this point are in Phase I, which means that they are being tested in small groups of people. Basically, Phase I studies are only to see whether the intervention is safe - they aren't done to test whether the intervention is effective. We really don't know yet if it's effective in humans. What we do know is that it negatively impacts quality of life. It can also cause kidney damage (although that is probably less of a concern).

So, I concur with others above: there probably isn't a strong enough case to try it at this point, based on the literature and on the negative impact this diet will likely have on quality of life. In practice, it's very difficult and requires a fair amount of monitoring, as this peer-reviewed 2015 article explains. Here's a table from that same article that shows the available data at this time on this particular therapy. It's limited at best.

I'm sorry about your family member. I agree with the suggestion to get in touch with their immediate carers to see what they need right now. A warm blanket, a call from a good friend, something tangible that reminds them that you love them - that is probably going to be a lot more helpful at this point in time.
posted by sockermom at 12:03 PM on May 27, 2015 [5 favorites]


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