Ketogenic Diet

[truckerbob]

Does anyone have any information on ketogenic diet helping advanced prostate cancer?

[ctarleton]

To my knowledge, there is very little science in humans concerning a ketogenic diet in the context of advanced prostate cancer.

There have been some studies in mice, dating back to a decade or so ago, often in regards to other cancers in mouse models. There was a small Phase I study, involving only 7 people who had histories of either a certain type of lung cancer, or pancreatic cancer, to see if such a diet over a 5-6 week period might improve the responsiveness to radiation & chemo treatments, but 4 of them couldn't stick to it that long and dropped out. There might have been someone else similarly looking at it in regards to brain tumor radiation.

Overall, if one searches PubMed for "ketogenic diet prostate cancer" or "carbohydrate restriction prostate cancer", there are very few entries over the past decade, compared to other topics.

More recently, however, you might be interested in this presentation, "Nutrition & Prostate Cancer", by "Greta Macaire, R.D., oncology dietitian with the UCSF Helen Diller Family Comprehensive Cancer Center. She helps patients with nutrition guidelines for specific cancers, supportive nutrition during treatment, and optimal healthy eating patterns to reduce the risk of cancer recurrence and maximize quality of life."

Charles

[Sisira in reply to ctarleton]

Thank you Charles for your excellent advice and the very informative link with the beautiful slides.

Sisira

[truckerbob in reply to ctarleton]

Yes, I have had the same lack of success in finding Keto/Advanced Prostate Cancer results. I have researched the work of Dr. Dominick D'agastino and Dr. Thomas Seyfried and others and have seen the evidence of a Keto Diet in starving the cancer cells for other cancers. Dietdoctor.com has a great article in their latest newsletter dietdoctor.com/low-carb/ket... about the 18 year old young man whose terminal cancer was abated by using a keto diet. Unfortunately prostate cancer does not feed on glucose like most other cancers. It feeds on androgen. I was diagnosed with advanced prostate cancer 2 & 1/2 years ago and have been treated with just ADT all that time. I am convinced that my obesity and diabetes were the cause of my cancer so I decided to try a keto diet to not help with a cure for my cancer but to treat the cause of my cancer. In the 4 months of being keto I have lost over 40 lbs, my A1C dropped from 7.8 to 6.0 and my bad cholesterol was reversed. I had an NMR lipid profile done and my results were so good my doctor removed my statin drug and I am now in the process of being weened of my BP meds. My bio markers have improved so much that I haven't felt this good since my 20's. Soon the only meds that I will be taking are my Lupron and Zytiga. I used to take 8-10 pills a day. So I know that a Keto/IF lifestyle won't cure my prostate cancer but it couldn't hurt. Attacking the cause of my cancer and improving my health is the one thing I can do to help myself. Now I need to start learning about my gut biome and immune system. Are any of the guys here on a keto/intermittent fasting lifestyle? I am brand new to Health Unlocked so I thought I would chip in with my APC experience.

[Tak-Druk]

Hi there. I worked with an MD who worked a lot beyond (or outside) conventional medicine who recommended a modified ketogenic diet soon after I first found out my cancer had metastasized. He spent a long time explaining the cellular biology behind the theory. It was fascinating.

With the help of a nutritionist, I followed it for 6 months but my PSA continued to rise. However during that time, I also lost about 5 lbs a month until I weighed the same as I was in high school; and I felt amazing! Normally I slow down a lot and feel like I need a nap in the afternoon, but on the keto diet my energy level and attention stayed very noticeably stable throughout the day.

I've thought a lot about going back to keto because I felt so good, but it's a real commitment and challenging to follow. Not much fun going out to eat. Also, I'm a cyclist and it seems even trickier with intense aerobic exercise in the mix.

[pjoshea13]

Bob,

Back in 2006, Steve Freedland asked:

"Is there a role for a low-carbohydrate ketogenic diet in the management of prostate cancer?" [1]

For $35.95 we can view the text of this ancient paper.

No need - in 2008 [2], Freedland conducted a mouse study ("injected with LAPC-4 cells"):

"despite consuming more calories, NCKD-fed mice {no-carbohydrate ketogenic diet } had significantly reduced tumor growth and prolonged survival relative to Western mice and was associated with favorable changes in serum insulin and IGF axis hormones relative to low-fat or Western diet."

IMO, this is an important study for two reasons:

a) Diabetics have more cancer risk of every type except PCa, where they have less risk. Pre-diabetics produce more insulin, but eventually, beta cells that secrete insulin fail to meet daily needs. Established diabetics have an enforced reduction of insulin levels. Meanwhile, the metabolic syndrome is the norm in non-diabetic PCa patients, with some degree of insulin resistance (& over-production).

b) A PubMed search for <Prostate "IGF-I"> currently returns 513 hits, which is indicative of the importance of the IGF axis in PCa proliferation. "IGF" is "insulin-like growth factor".

The NKCD would not be tolerated by most men. One could hardly have a clinical trial where adherence was expected to be near zero. But a low-carb ketogenic diet might be tolerated.

Here's Freedland again in 2009 (mice again) [3]. This time 3 diets:

- very high-fat/no-carbohydrate ketogenic diet (NCKD: 83% fat, 0% carbohydrate, 17% protein)

- low-fat/high-carbohydrate diet (LFD: 12% fat, 71% carbohydrate, 17% protein)

- high-fat/moderate-carbohydrate diet (MCD: 40% fat, 43% carbohydrate, 17% protein)

"Relative to MCD, survival was significantly prolonged for the ... NCKD groups (hazard ratio 0.59 ...). Median serum insulin, IGF-I, IGF-I/IGF binding protein-1 ratio, and IGF-I/IGF binding protein-3 ratio were significantly reduced in NCKD relative to MCD mice. Phospho-AKT/total AKT ratio and pathways associated with antiapoptosis, inflammation, insulin resistance, and obesity were also significantly reduced in NCKD relative to MCD tumors."

In 2013, Freedland asked [4]:

"Low-Carbohydrate Diets and Prostate Cancer: How Low Is “Low Enough”?"

"The results from this study show that mice consuming diets containing 10% to 20% kcal carbohydrates have similar tumor growth, overall survival, and IGF axis signaling as mice consuming NCKD. Given our previous results that NCKD slowed tumor growth versus a Western diet, this implies that survival benefits may be possible through the use of less-restrictive low-carbohydrate dietary interventions."

Note that the Mediterranean diet, which does reduce insulin resistance, is ~40% fat, but >40% carb. Reducing carb to 20% means eating a lot of nuts, I would think. Not so bad.

Freedland is heading up a trial:

clinicaltrials.gov/ct2/show...

Another trial (Atkins Diet) was terminated because of poor accrual:

clinicaltrials.gov/ct2/show...

-Patrick

[1] goldjournal.net/article/S00...

[2] ncbi.nlm.nih.gov/pmc/articl...

[3] ncbi.nlm.nih.gov/pmc/articl...

[4] ncbi.nlm.nih.gov/pmc/articl...

[truckerbob in reply to pjoshea13]

Thanks for that. I have no problem adhering to a strict KD. Most days I eat 0-5 grams carbs and protein 60 or less of protein. When I lose my last 20 lbs I will adjust my macros again. I can see why a lot of men would have a problem adjusting to a strict KD but as for me I have lost my cravings for carbage and will probably stay Keto for life.

[TrisC]

I think it depends on the person.