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Ketogenic Diet in the Treatment of Cancer - Where Do We Stand? This latest review article from Weber, Aminzadeh-Gohari, Tulipan et al, is *extremely* misleading IMO (disclaimer...I'm no expert so pls feel free to disagree, but bring facts & evidence). sciencedirect.com/science/articl… 
"Our aim was to summarize and critically evaluate human studies examining keto diets in the context of cancer" yet immediately state a claim that's simply untrue "...for triple negative breast cancer no effective standard therapy is available"👈Not accurate, invites scrutiny!🧐
"...only one randomized controlled trial is available to date"... glosses over critical fact that it's related to surrogate markers, feasibility, tolerability, QOL etc, which doesn't support conclusion that "ketogenic diet...can be regarded as a promising adjuvant ..."🤦♀️🧐🤦♀️
Table 2 lists "clinical studies in the context of ketogenic diet and cancer" that allegedly support overly optimistic hopes. Of 30 listed studies, ZERO show good robust evidence of it being a safe+effective cancer treatment, either alone or as adjunct. I'll look at each below.
Of note, I won't link to them and give more exposure but I'm happy to elaborate if needed. Also I don't claim expertise; I'm a cancer pt, not a researcher but eager to learn so please let me know if you see *factual* errors or want to discuss honestly.
"Metabolic management of glioblastoma multiforme using standard therapy together with a restricted ketogenic diet: Case Report" - a single pt, 2 months tmt...20% body wt reduction & biomarker changes; tumor recurrence 10 weeks after suspension of strict diet therapy. Not great.🙄
This case study, and why its author's conclusion was more than a bit confusing/misleading, discussed here: sciencebasedmedicine.org/ketogenic-diet…
Next up "ERGO: a pilot study of ketogenic diet in recurrent glioblastoma"... "Because of the small number of patients 🚨efficacy cannot be concluded by the results of the study🚨"
"...progression was documented in all of 17 patients on diet...limited # of pts, absence of randomization & lack of a control group in the study do not allow an unequivocal estimation of efficacy of the ketogenic diet."
"However it appears that single agent activity, if any, in these heavily pretreated patients was moderate at best. Although three patients achieved a stable disease at 6 weeks, median PFS was only 5 weeks, and PFS at 6 months was 0%" PROGRESSION FREE SURVIVAL AT 6 MONTHS WAS ZERO
Next study "Treatment of glioma patients with ketogenic diets: report of two cases treated with an IRB-approved energy-restricted ketogenic diet protocol and review of the literature." - TWO pts, "BOTH SHOWED TUMOR PROGRESSION while on the ERKD therapy"
Next "Efficacy of a ketogenic diet with concomitant intranasal perillyl alcohol as a novel strategy for the therapy of recurrent glioblastoma" published in Spandidos (predatory journal?). Only 9/17 pts survived and maintained compliance.
Next "Management of Glioblastoma Multiforme in a Patient Treated With Ketogenic Metabolic Therapy and Modified Standard of Care: A 24-Month Follow-Up"
Next "Targeting metabolism with a ketogenic diet during the treatment of glioblastoma multiforme" "Four of the six patients are alive at a median follow-up of 14 months. Time to recurrence/progression was 10.3 months...of remaining 4, three recurred."
Next one: "Changes in cerebral metabolism during ketogenic diet in patients with primary brain tumors: 1H-MRS study"
Next, "The Modified Ketogenic Diet in Adults with Glioblastoma: An Evaluation of Feasibility and Deliverability within the National Health Service" -only 4/6 pts completed 12 wk trial.
Trial "Glycemic modulation in neuro-oncology: experience and future directions using a modified Atkins diet for high-grade brain tumors: "...well tolerated without significant toxicity and although not statistically significant resulted in improvement in *seizure* control🙄
"Effects of a ketogenic diet on tumor metabolism and nutritional status in pediatric oncology patients: two case reports" - 1995 - one pt w/prenatal alcohol/drug exposure, below 5th% height/wt, showed improvement in MOOD and NEW SKILL DEVELOPMENT, no change in tumor margins.
Trial "Differential effects of patient-related factors on the outcome of radiation therapy for rectal cancer"
Next "Effects of Pre-surgical Vitamin D Supplementation and Ketogenic Diet in a Patient with Recurrent Breast Cancer" -ONE pt took oral Vit D+keto diet for 3 wks between diagnosis & surgery, HER2 changed from + to -. Relevance to outcome/survival?? 🤷♀️
Next "Efficacy of Metabolically Supported Chemotherapy Combined with Ketogenic Diet, Hyperthermia, and Hyperbaric Oxygen Therapy for Stage IV Triple Negative Breast Cancer" conflicted (undisclosed) researchers at predatory quack Chemothermia Clinic:
More on this egregiously misleading "TNBC cure" testimonial here: respectfulinsolence.com/2017/10/04/why…
And more on Chemothermia's predatory victimization of desperate dying cancer patients here: rte.ie/news/primetime…
Next "Glucose-based total parenteral nutrition does not stimulate glucose uptake by humans tumours" "... despite glucose being the preferred fuel for cancer cells...high uptake even in fasting conditions makes glucose consumption unable to be modulated by...glucose or lipid."
"Effect of energy substrate manipulation on tumour cell proliferation in parenterally fed cancer pts" "None of ...changes observed...were found to be statistically significant..."
"...Thus we FAILED TO PROVE that glucose consistently stimulates or lipids inhibit tumour proliferation despite a trend in this sense."
Next "Total nutritional manipulation in humans: report of a cancer patient" -Tolerance to regimen was good and body weight maintained....The tumour volume did not substantially change"🤷♀️
Next "The Potential Use of a Ketogenic Diet in Pancreatobiliary Cancer Patients After Pancreatectomy" Only 10/20 pts finished the study (6 refused the diet). "...pts who consumed KD had a higher energy intake and body cell mass" Relevance to survival or outcome?
Next "Consuming a Ketogenic Diet while Receiving Radiation and Chemotherapy for Locally Advanced Lung Cancer and Pancreatic Cancer: The University of Iowa Experience of Two Phase 1 Clinical Trials"
Next: "Feasibility study of metabolically supported chemotherapy with weekly carboplatin/paclitaxel combined with ketogenic diet, hyperthermia and hyperbaric oxygen therapy in metastatic non-small cell lung cancer" -another dodgy study from Chemothermia clinic in Istanbul Turkey
👆2018 Feasibility study, but interestingly the same author plus others (who own/work at the clinic and sell HBOT chambers, supplements, etc but do not disclose that?) published another study on the same group of pts the year BEFORE???
Next study: "Tumor growth in patients with tuberous sclerosis complex on the ketogenic diet" -3 of 5 pts, all children, had progression of a known tumor or tumors or the development of a new tumor while on the ketogenic diet."
"Conclusion: In this limited case series of five TSC patients, the ketogenic diet did not induce tumor regression or suppress the growth of TSC-related tumors."
Next "Favorable Effects of a Ketogenic Diet on Physical Function, Perceived Energy, and Food Cravings in Women with Ovarian or Endometrial Cancer: A Randomized, Controlled Trial"
Another write-up based on the same study "A Ketogenic Diet Reduces Central Obesity and Serum Insulin in Women with Ovarian or Endometrial Cancer" 😳??Is fat mass loss a desirable goal during active cancer treatment??
Next: "Decline of lactate in tumor tissue after ketogenic diet: in vivo microdialysis study in patients with head and neck cancer." 🤷♀️🤷♀️🤷♀️
Next:"A ketogenic diet exerts beneficial effects on body composition of cancer patients during radiotherapy: An interim analysis of the KETOCOMP study" - Patients "interested in taking self responsibility to support their therapy?!" 🙄🤦♀️🤬
Next "Cancer cachexia: influence of systemic ketosis on substrate levels and nitrogen metabolism" 🤷♀️
Next: "Effects of a ketogenic diet on the quality of life in 16 patients with advanced cancer: A pilot trial" ... I mean...⁉️⁉️
Next up:"Modified Atkins diet in advanced malignancies - final results of a safety and feasibility trial within the Veterans Affairs Pittsburgh Healthcare System" - I looked at this one way back when, and I was horrified--->>>
Next "Targeting insulin inhibition as a metabolic therapy in advanced cancer: a pilot safety and feasibility dietary trial in 10 patients" [RECHARGE] trial NCT00444054 - Safety & feasibility does not confirm EFFICACY. Only 5 of 10 patients completed the 28-day trial. Argh.
Next: "Impact of a ketogenic diet intervention during radiotherapy on body composition: I. Initial clinical experience with six prospectively studied patients" - another based on the KETOCOMP study. 6 patients. Relevance to survival? Disease status?
Next: "The development of tumours under a ketogenic diet in association with the novel tumour marker TKTL1: A case series in general practice" -Another Spandidos piece🙄. KD might be ok for someone ALREADY TREATED FOR THEIR CANCER?🤷♀️
So yeah, that's IT! 👆30 freaking studies cited, and not a single one that really supports their MAJOR CONCLUSION that a ketogenic diet "probably creates an unfavorable metabolic environment for cancer cells and thus can be regarded as a promising adjuvant..." 🤷♀️🤬🤦♀️⁉️
Yep, sure I'm angry. Yep, I'm pessimistic and a negative bully taking away hope, and silencing/censoring research and taking away a patient's right to choose their treatment, right? 🙄🤦♀️
In case you're wondering what the real deal is with ketogenic diet for cancer, this recent piece seems reasonable. "A systematic review of the use of ketogenic diets in adult patients with cancer." onlinelibrary.wiley.com/doi/10.1111/jh…
Here's what these authors found when they looked at the actual evidence for keto diets in cancer treatment.
Despite marketing hype, it's more RISK than BENEFIT. "The current studies demonstrated that patients on a KD lose weight. This is of concern for sarcopenic and malnourished patients because body composition and nutritional status have been shown to influence clinical outcomes"
