How to fight both COVID-19 and Cancer

March 25, 2022

CAN CANCER PATIENTS SURVIVE COVID-19?

Cancer patients are already in a fight to survive, and with COVID-19 taking over the spotlight, cancer patients wonder whether it is safe to receive chemotherapy as scheduled. I received a ton of questions from concerned patients and their families. I am sharing with you, some of my responses below.

What is COVID-19?

In case you are not up to speed with the news, COVID-19 stands for the Coronavirus- circa 2019. What started out as a viral infection in Wuhan province, China, has now spread to practically most of the countries in the world, threatening us now at our very doorsteps.

Can we continue chemotherapy under Covid-19?

- DAMNED IF YOU DON’T, DAMNED IF YOU DO…

I was excited and optimistic when 2020 arrived. But, for me and my patients, it's suddenly a battle between COVID-19 versus cancer. “Your timing is bad”, I jokingly told Mr. John (not his real name), my patient. “Your cancer is back, and we need to offer you more chemotherapy. “ Chemotherapy, as we know, can sometimes depress our bone marrows, and with that, a low white blood count will also lower our bacteria-fighting blood cells and make us less able to mount a response to infections. Mr. John’s eyes seemed to grow larger. He said, “If I delay chemotherapy, my cancer might grow. What if I receive chemotherapy? Might I become more vulnerable to catching the COVID-19 infection?”

Are we closing the clinic during the COVID-19 pandemic?

For cancer clinics, it is business as usual

In my line of work, COVID-19 hardly dampened the rates of cancer. In my hospital, it is business as usual. Essential services are still operational, if not getting even busier. Every week, new cancer cases continue to show up. Some of my patients in remission are now relapsing, while some of my now “stable” patients are wondering whether to continue chemotherapy or take a break.

WHAT QUESTIONS SHOULD I ASK MY ONCOLOGIST?

How fast is my cancer growing?

Is it the slow-growing type, or will it grow rapidly if chemo is postponed for months? The keyword here is “rapid” versus “indolent”. Do I have the luxury of watchful waiting until the next CT scan? Or is it better to go in and try to get as much chemo as possible? I don’t want to instill panic, but in an overabundance of caution, we foresee that in the event of a total lockdown, chemotherapy sessions might cease and postponements “could be” prolonged. If you only have one CT scan, you will need another one. One scan is only a snapshot of what your cancer is at this time. You need to compare two scans, spaced far enough apart, to get a sense of how fast, or slow, your cancer is growing.

Is there another way to detect the speed of my cancer growth, without using a scan?

Yes, for some cancers, there is a “tumor marker” blood test available for certain types of cancer. Aside from cat scans or PET scans, are we able to monitor the growth of my cancer via blood tests? Yes. Liver cancers can be monitored via a tumor marker blood test called “AFP or alpha-fetoprotein”. Colon cancers are followed via a CEA , also known as a carcinoembryonic antigen test. Pancreatic cancers use the Ca 19-9 test, and sometimes we also use the CEA test. For neuroendocrine tumors and carcinoid tumors, we follow serotonin levels and chromogranin. Ovarian cancers use the Ca-125 tumor marker. For prostate cancers, we follow the PSA or prostate-specific antigen test and testosterone. Although tumor markers can sometimes not correlate with tumor size ( some tumors are large and still have normal tumor marker levels, therefore are considered “non-secreting tumors’), we still find testing useful since this cuts down on the need to use ct scans and limit our exposure to radiation.

Does your clinic offer telemedicine? Can I see my oncologist via a virtual clinic instead of coming to the office?

In most cases, this can absolutely be done. If you have a computer, laptop, Ipad or smartphone, plus a good wifi connection and camera, you are probably all set. Your doctor can see you using one of the many telemedicine platforms that are now available. Or, in the case of some of my patients, just use the good old fashioned telephone. I had a 70-year-old patient of mine the other day, eagerly await his “virtual clinic” appointment. He had all the necessary equipment, and an email address to boot. But when the time of the virtual appointment came, he was unable to open his email to find my invitation link to the virtual consult. Several minutes later, we gave up, and I called him via phone and completed his visit the old-fashioned way! Not all clinics are willing to do this though. But in the past few days I see more and more clinics shifting to this option. be sure to ask your oncologist!

How about pre-chemotherapy blood draws?“Instead of going to the hospital lab, can I go to a clinic that is closer to my home, or can I “skip” blood draws for now?”

It depends on your cancer, and on the type of chemotherapy that you are receiving. How critical is it for your doctor to know your blood test results? Some biologics like targeted therapies need less monitoring than others. Especially if you have been taking a targeted therapy pill for several months now, AND, if you have had no side effects and no recent dose adjustments, then remote renewals COULD be an option for you. But if you are still experiencing side effects from your drug, or if your doctor is still adjusting your doses, then blood testing might still be required. Home health visiting nurses can sometimes come to your home, instead of you going to the lab. This might depend on your existing insurance coverage and on neighborhood availability. Ask your oncologist to be sure.

I am already on chemotherapy. Will my chemo depress the bone marrow for a very long period of time?

For newly diagnosed patients, if you have not yet experienced chemotherapy, ask your doctor how likely is it for your planned chemo to cause “neutropenia”. Not all chemotherapy are the same. As far as the ability to depress bone marrow, I would say that all chemo drugs will fall under one of the following classifications of “mild, moderate, or severely neutropenic”. This simply means that some chemotherapies are likely to cause low blood counts for prolonged periods of time. Recovery with some drugs might take weeks and sometimes months. During that critical time, we do not know if we will have enough ( or any) hospital beds available for cancer patients. Other chemotherapy drugs (under mild) might be available, that are less damaging to the bone marrow, and recovery can be expected in a matter of a week or two. However, it all depends on whether the choice of chemo is effective for you. Your oncologist is best suited to help you make that balanced decision. Stopping chemo altogether may be good for recovery, but might be very bad for your cancer control.

Am I a candidate for a growth factor injection to help my marrow recover more quickly?

Ask your doctor if you are a candidate for a growth factor injection (i.e. Neulasta or similar colony-stimulating factor). Will it be suitable for you, to help boost recovery after chemotherapy? THis may be an option for those of you with solid cancers. It might not be a good idea if you happen to have blood cancer.

Is there an oral equivalent / version for my chemotherapy?

Some chemotherapies can be switched to an oral or pill/capsule/tablet form. Tablets can be used instead of intravenous administration. Yes. this is certainly possible, however, very few chemotherapies actually have this option. Capecitabine tablets can take the place of 5FU. Some biologics are also in pill form. Several targeted agents are also given orally. Ask your doctor if your situation applies. If you have this option, it will allow you to hunker down at home much longer than if you had to get intravenous treatment.

Can I safely space out the frequency of my treatments?

If you are taking Leuprolide shots every 3 months for your prostate cancer, ask if you can get this every 6- months instead of three. If you receive monthly intravenous IVIG, or intravenous Zometa, can this be spaced out to every two or three months? Slow growing cancers may be a good candidate for this plan.

Do I have low immunity to bacterial infections? Do I have low immunoglobulin levels?

If I happen to catch a viral pneumonia, a bacterial infection on top of that will make matters really worse. Patients with CLL or chronic lymphocytic leukemia, and some lymphoma patients are at risk for catching a really bad bacterial infection on top of a viral pneumonia. This is because they may have low immunoglobulin (antibody) levels. When they do, they are classified as having hypogammaglobulinemia. Hypogammaglobulinemic patients who are already getting monthly intravenous immunoglobulins (IVIG) should check with their doctors to see if they need to replenish their IgG levels. If you are at risk of infections and have had at least two previous hospitalizations requiring treatment with intravenous antibiotics, then IVIG injections might be right for you. Not all patients will qualify, though (because the guidelines are pretty strict). But it doesn’t hurt to ask.

In case of a total COVID-19 lockdown, is there an accessible hotline or telephone number to call for cancer-related questions?

It is usually harder to contact your doctor than it is to call your congressman! Tip-Ask for the direct line to your chemotherapy nurse. They usually will have one. If the practice has telemedicine, or a patient “email or secure messaging system”, register for it and make sure that you use it. Do not rely only on the main clinic or hospital number. You will probably get the round around. Nowadays, doctors and nurses are so busy, they can barely call back patients via phone. Therefore, secure text and office message systems are the easiest ways to send them a message. You will likely get a quicker response this way.

I am afraid to leave my home, even for chemotherapy and bloodwork. Will I get infected?

No one really knows. But one thing is certain, the more people there are around you (a.k.a large gatherings and big families), the higher are the chances of a cancer patient to catch the COVID-19 infection. Wash your hands frequently, wipe down potentially infected surfaces, and use hand sanitizer whenever possible. Ask if your doctor can arrange home visiting nurses who can come and check on you, take your vital signs, and maybe even do your bloodwork. If you are elderly, or unable to move around much because you are on oxygen or in a wheelchair, then this could be a good option for you.

My dad is elderly. but is independently living by himself in a small town. Should he move in with my family during the COVID-19 crisis?

The fact that your dad is independent is great! In pandemic situations, isolation is the best protection. My only concern is if he runs out of food and supplies, especially if a quarantine is enforced for months on end. Will he have enough food, water, and paper supplies to go by? And if he does get infected, will he be able to seek medical attention? Keep in mind that right now, many hospitals have enforced a “no visitation” policy. So even if he gets admitted to a hospital in your hometown, for COVID-19 related reasons, you probably won’t be allowed to visit him. So living in the same town as you will not be much of an advantage as far as a social support during hospitalization. Do you have a large family? If he stays with you in the same household, there is the advantage of being with family support. But with more people under one roof, this means a higher risk of infection. If you have a large family under one roof, he might be able to stay with you but I suggest that he hunker down in a separate guest room or basement bedroom so that he still remains physically isolated, yet accessible to you at all times.

Should I use herbal supplements to fight COVID-19 with chemotherapy?

Because of the lack of a proven cure for COVID-19, the use of herbal supplements for cancer patients is getting some attention. Although most supplements are not FDA approved, they usually receive a designation called GRAS, which means - "Generally Regarded As Safe”. While they are totally legal to sell and use for general consumption, the FDA does not endorse these supplements as being able to cure, diagnose or treat medical conditions. Use your own discretion. Some supplements do interact with chemotherapy, and some may even "neutralize" the chemotherapy effects. Do check with your oncologist and pharmacist before you decide to take a certain supplement, to make sure that they don’t have any serious drug to drug interactions with your chemotherapy.

Will the ketogenic diet (Keto diet) protect cancer patients against COVID-19?

Good question. Since COVID-19 related cancer mortality is tied closely to an overwhelming inflammation, then yes, the keto diet’s anti-inflammatory effects might be helpful. Keto related groceries are less likely to sell out on store shelves. But it is good sense to try and stock up on some supplies before this all gets out of hand.

Above all, keep your distance, stay put at home as much as possible, and remember to wash your hands for 20 seconds with soap and water!

Stay safe, everyone!

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Exploring the Link Between Cancer and Weight Loss:

March 14, 2024

Breaking Down the Fear Ketogenic diets often result in weight loss. Cancer patients frequently lose weight. Does this mean that keto diets are harmful to use in cancer patients? Cancer and weight loss are two topics that often come hand in hand, yet the relationship between them can be complex and sometimes frightening. Weight loss, particularly unexplained or rapid, can evoke fear in many individuals, often signaling underlying severe health concerns. However, when it comes to cancer, weight loss can sometimes be one of the earliest signs of the disease. In today's blog, we delve into the connection between cancer and weight loss, unraveling why the latter often instills fear and how understanding this relationship can lead to better health outcomes. Understanding Cancer and Weight Loss: Cancer involves uncontrolled cell growth and abnormal spread of cells throughout the body. These invading cells affect various organs and systems and disrupt their normal function. Weight loss can be very subtle or profound depending on the type of organ invaded. As cancer takes root and establishes itself, it also spews out cytokines (unique inflammatory proteins) that also serve as signal messengers, signaling muscles to lose volume, resulting in a weight loss phenomenon known as cachexia. Cachexia is a complex syndrome. Inflammation is often at the root of this problem, of profound muscle wasting, generalized fatigue, and poor appetite, Why Are We Afraid of Weight Loss? Weight loss, in general, is often perceived negatively in society. There's a prevailing notion that thinness equates to health, beauty, and success, while weight loss may imply illness or a lack of control. However, when weight loss occurs without intentional dieting or exercise, it can be a red flag for underlying health issues, including cancer. In cancer, especially, the presence of weight loss is disturbing because we traditionally associate it with illness. Association with Illness: Unexplained weight loss is commonly associated with illness, particularly severe conditions like cancer. The fear of the unknown and the potential implications of such weight loss can be daunting for individuals. To be of "normal" weight is equated with health. Loss of Control: Weight loss, especially rapid or involuntary, can make individuals feel like they've lost control over their bodies. This loss of power can be unsettling and exacerbate feelings of anxiety or fear. Uncertainty: Weight loss without a clear cause can be perplexing and raise questions about what might happen within the body. The uncertainty surrounding the underlying cause can contribute to fear and anxiety. During chemotherapy, however, weight loss is inevitable because we are in a catabolic state. The active cancer is making us lose weight. The key is to control or snuff out the underlying cancer. Once you weaken the tumor, less cytokine release and less inflammation will follow. As this occurs, the "source" of the cytokine release will die, and weight gain should naturally recover. Therefore, loading up on carbohydrates to make us appear to be of "normal weight" is incorrect. Loading up on sugary treats will only strengthen the cancer and will only be counterproductive! Conclusion: The fear of weight loss, particularly in the context of cancer, is understandable, given the potential implications for health and well-being. However, by understanding the complex relationship between cancer and weight loss and challenging societal stigmas, we can accept some form of healthy weight loss during chemotherapy. We can learn to recognize unhealthy weight loss (loss of muscle mass) and differentiate it from healthy weight loss during a ketogenic diet (most of which is weight loss from fat and excess water). As long as one feels energetic, with normal blood parameters and no indication of significant liver or kidney failure, anemia, or marrow failure, then some healthy weight loss during chemotherapy or implementation of a ketogenic diet CAN be acceptable.

GINGER ALE DURING CHEMOTHERAPY

March 4, 2024

Are you still drinking "ginger ale" during your chemotherapy sessions? You know, those gleaming, chilled cans of sparkly soda that your cheerful chemotherapy nurse hands out along with your anti nausea pills? The scent and the taste of ginger help nausea stay away. But did you know that your "ginger ale" contains no ginger? Worse, the HFCS high fructose corn syrup, a highly processed sugar, can do you more harm than good. And making your cancer cells really happy. Next time you go for your chemo session, ask for water instead. Or better yet, bring your own ginger-infused drink from home. Here is some background about ginger. For centuries, ginger has been used as a remedy for nausea and digestive issues, and some scientific evidence supports its effectiveness. Here are some examples. Morning Sickness: Pregnant women often experience morning sickness, and ginger has been traditionally used to alleviate these symptoms. Several studies have shown that ginger can reduce nausea and vomiting during pregnancy. For example, a meta-analysis published in the Journal of Obstetrics and Gynaecology Research in 2014 concluded that ginger supplementation significantly reduced the severity of nausea and vomiting in pregnant women without any significant side effects. Motion Sickness: Ginger is effective in reducing motion sickness. A study published in Aviation, Space, and Environmental Medicine 1986 found that ginger was more effective than a placebo in reducing symptoms of motion sickness. Subsequent studies have supported these findings, suggesting ginger can alleviate symptoms like nausea, vomiting, and cold sweating associated with motion sickness. Chemotherapy-Induced Nausea: Cancer patients undergoing chemotherapy experience nausea and vomiting. The Journal of Alternative and Complementary Medicine 2009 published a review that analyzed several randomized controlled trials and found that ginger supplementation could reduce the severity of chemotherapy-induced nausea. Postoperative Nausea: Nausea and vomiting are common after surgery. A meta-analysis published in the journal Integrative Cancer Therapies in 2012 found that ginger effectively reduced postoperative nausea and vomiting compared to a placebo. However, we need more research to fully understand its mechanisms and best dosage. Everyone responds differently, but ginger, in its natural form, is usually safe to take during chemotherapy. Just make sure its the real thing! Photo credit Dan Sorum @ unsplash

Welcome to all our new members

January 30, 2023

Welcome to all our new members

Getting Started On A Keto Diet

May 17, 2022

Getting started on the keto diet usually sounds like someone is trying to lose weight? When you add cancer to that recipe, it becomes a whole new ball game. Do any of these thoughts sound familiar? “ I want to fight my cancer , and I heard that this diet can help me heal “ “ I’m confused because the keto diet will make me lose weight” “I’m afraid to lose more weight.” “I can’t afford to lose weight! “ “When is weight loss just right, and when is it too much? “ Is there real hope for me? Over the past two decades, I’ve seen my share of cancer patients. Yup, the whole package - diagnosis, anxiety, chemo, radiation, hair loss, weight loss, and, failures. But, I also saw many patients who achieve clean CT scans, remission, happy news, hair growth, and of course, the coveted weight gain. I have my own collection of patients with stage four cancers, a few have actually reached their ten to twelve year anniversary with me. Most of them have made it past five years and some are in complete remission. Yes, stage four to stage zero! How did they do it? You may have come to this website, searching for answers. I wish that I could tell you all that I know, in one sentence, but I can’t. It usually takes me several office visits to educate my patients. For now, you can stick around, and try to absorb the knowledge from current posts. Take time to read through my past blogs. Signup for a keto conference. There is one coming up very soon. The MHS 2022 in Santa Barbara California. May 5 to 8. Read books, and more books. You might be surprised. Not all books are the same. Some are full of dense material, while some are mostly fluff. But eventually, you will find the right book for you. Join me in one of my subgroups. But you need to fit the profile and be past the beginners stage when you join. Or you might get bored! I do show up there from time to time, to break the ice. And by the way, when you are stuck and can’t find the answers you are looking for...you need to make your voice heard and post your questions. What if my cancer doctor doesn’t approve? If your cancer doctor doesn’t know much about the keto lifestyle, or about metabolic approaches to cancer, don’t lose hope. Try to educate them, Share your knowledge. Even if they are at first resistant, with time, some will marvel at your progress and will notice that you are doing better than their average patients. Finally... the number one question that shows up on my blog.... What diet is best for me? I’m so CONFUSED! “ Dr. XXX on YouTube said that a keto diet and weight loss is good for cancer, but another doctor YYY said the opposite, that I should eat, healthy carbs, more plants, fruit , avoid fat and protein, try to gain weight. “ Dr. WWW advocates a vegan diet, but Dr ZZZ said do a carnivore diet.... , help!!!! Let me know your thoughts in the comments below!

New drug for relapsed Glioblastoma, a deadly form of brain cancer

March 30, 2022

There is exciting news on the horizon for glioblastoma, which is a deadly form of brain cancer. Have you heard of activated T cell therapy? It is similar to the car-T cell therapies that you often hear about for blood cancers. Well, this form of therapy is now available for patients with brain cancers. The catch is, you must enroll in a clinical trial. It is not yet available to the public. To qualify, one must have glioblastoma, a form of brain cancer , and cancer must have relapsed after the first diagnosis. Patients who are interested are now able to ask for information about enrolment at the Cedars Sinai Medical Centre in Los Angeles. This trial will be classified under a Phase one type of clinical trial. The drug company, Kairos pharma is the sponsor. This exciting new therapy, otherwise known as KROS 201, is a form of activated T cell therapy. The patient’s white blood cells are first harvested. Blood is removed by a simple intravenous blood draw, and then sent off to the lab to be processed in a cell culture. In the lab, the white blood cells are primed by exposing them to small protein substances called cytokines. This process will in turn activate the white blood cells, specifically the killer T cells. Once activated, these cells can now fight cancer by inactivating cancer stem cells. The T cells are returned to the patient’s body by intravenous infusion. The link for enrolment is not yet available but do keep checking on www.clinicaltrials.gov

Mistletoe plus chemotherapy in non small cell lung cancer

March 25, 2022

Iscador, a type of mistletoe preparation was tested by a medical team in Israel alongside conventional chemotherapy in the treatment of patients with advanced non small cell lung cancer. Although no improvement in survival or quality of life was noted,non hematological side effects from the chemotherapy and hospitalizations were less in the group which received the mistle toe preparation. Possible yet unproven mechanisms of action include improvement of immune function via increasing the number of NK natural killer cells as well as improve the function of Tumor Necrosis Factor Alpha. Fever which is also a noted side effect of this preparation has been described prior to spontaneous regression of certain cancers such as melanoma implying a possible role of immunotherapy in the fight against cancer. No randomized trials on cancer patients have yet been published.

Brain cancer – Challenges with the ketogenic diet

March 25, 2022

We made little progress in the way of survival in the treatment of malignant brain tumors, specifically the deadly glioblastoma multiform. Despite aggressive surgery followed by radiation therapy and precautionary chemotherapy, they relapse early and survival is measured in months. Patients rarely survive beyond a year. Alternative therapies abound with few successes. Some patients attempt to enroll in clinical trials in search of new drugs that might make a difference in their survival. There is a biologic treatment available. It is the monoclonal antibody called Bevacizumab. It supposedly controls the growth of blood vessels that supply nutrition to the brain tumor. Shrinking the blood supply supposedly starves the tumor. Very exciting, but nonetheless isn't a cure. Long term survivors still remain a rarity. There is mounting interest in metabolic basis of cancer development. In this respect, I do feel that ketogenic diets have potential benefit in brain cancer patients. The role of sugar and carbohydrates in the progression of brain tumors is interesting. Since most patients also are on steroids to improve brain swelling. It is also bad for them because this also increases their blood glucose. I wonder, if we are indeed adding fuel to the fire. A few case reports of brain tumor patients who were offered the ketogenic diet showed that some tumors stopped growing while others improved their survival. Notably, upon discontinuation of the diet, the tumor was noted to again progress, only to regain control upon reinitiation. Currently there are 4 clinical trials ongoing in the United States involving the ketogenic diet in the treatment of various forms of cancer. Another is ongoing in Germany. More clinical trial participation is desperately needed if we are going to move ahead and forge any progress with this deadly cancer. =

Lonsurf, newly approved colon cancer drug

March 25, 2022

Three weeks ago I got word that another new chemotherapy drug has been approved for the treatment of colorectal cancer. Ideal candidates for this drug are patients who failed previous chemotherapy involving one of the following drugs: 5-Fluorouracil, Oxaliplatin, Irinotecan, Cetuximab (also known as Erbitux) and Avastin ( also known as Bevacizumab).This new drug has two active components, trifluridine and tipiracil. Trifluridine is a new nucleoside analog. In other words, a nucleoside is a nitrogen containing biologic compound linked to a sugar, which when phosphorylated, turns into a nucleotide, which is a vital part of the DNA backbone. Trifluridine therefore is a nucleoside analog, meaning it isn't but acts like a nucleoside. It incorporates itself into the DNA structure and interferes with cell growth and proliferation. Tipiracil inhibits the enzyme thymidine phosphorylase, which catalyzes the degradation of Trifluridine, thus allowing it to last longer. Thymidine phosphorylase by itself has pro-angiogenic properties, meaning it promotes blood vessel formation and encourages better blood supply of tumors, so Tipiracil directly stops this advantage. Furthermore, Tipiracil by stopping thymidine phosphorylase, prevents the formation of thymine and 2-deoxy-alpha-D-ribose 1-phosphate. 2DARP is a strong reducing sugar product of thymidine catabolism and causes increased oxidative stress within tumors, promotes release of more tumor blood vessel promoting factors ( angiogenic growth factors) such as interleukin-8, vascular endothelial growth factors VEGF, and matrix metalloproteinase-1 an enzyme which breaks down collagen and extracelular matrix, which is key in promoting tumor metastases. This three mode action of tipiracil ( inhibits thymine production, thymidine phosphorylase VEGF activity, stops ROS and MMP-1 , VEGF and cytokine production)- makes it more attractive since it can potentiate the action of the common colorectal chemotherapy drug 5- fluorouracil whose main action is to inhibit formation of thymine. The RECOURSE trial, a international, randomized, double-blind, placebo-controlled study conducted in patients with previously treated metastatic colorectal cancer apparently resulted in statistically significant improvement in overall survival and progression free survival . The drug is given orally, twice a day, for two straight weeks, minus weekends, followed by a two week break. Side effects are listed as anemia, neutropenia, asthenia/fatigue, nausea, thrombocytopenia, decreased appetite, diarrhea,vomiting, abdominal pain,pyrexia. Since it is barely a month since FDA approval ( Sept. 24, 2015) it still has not hit our pharmacy shelves. I am however eager to try this. Will update you again in a few months.

Getting into ketosis

March 25, 2022

How long does it take to get into a state of clinical ketosis? By ketosis, I mean the levels of beta-hydroxybutyric acid reaching to above normal levels yet not high enough to bring you into a medical emergency such as ketoacidosis. As little as a day is all it takes. You an achieve this in different ways. The most common and sure fire method is to simply stop eating. If you fast and only limit your intake to water or sugarless herbal , which technically has ZERO calories, you will achieve a state of ketosis in no time. Another way is to try fasting for 15 hours a day, or roughly, just eat one full meal daily. this should bring you into ketosis too, though not all 24 hours are involved. If you try a ketogenic diet, that means, you will be limiting your carbohydrate intake to approximately 20% of your total daily intake, and take the rest in the form of fats ( 70-75%) and proteins (5 to 10%). Monitoring your progress will be helpful. A simple glucometer will suffice. Individual serum Ketone sticks, readily available from Amazon.com or special order through your pharmacy can be used to check your ketone levels throughout the week.

Update on clinical trials of the ketogenic diet in cancer

March 25, 2022

Several clinical trials are ongoing throughout the United States at the moment. The University of Iowa Department of Radiation Oncology is running a couple of Phase I trials on the use of the ketogenic diet plus radiation and chemotherapy in head and neck cancers, and they also have another which studies the ketogenic diet plus chemoradiation in non-small cell lung cancers and pancreatic cancer. Michigan State University has one which recruited brain cancers, also known as glioblastomas, a very deadly type of brain cancer. Duke University recently began a randomized trial studying the ketogenic diet plus androgen deprivation therapy in prostate cancer , using the ketogenic diet versus a control standard diet. Unfortunately per recent info posted on the clinicaltrials.gov website, the trial was terminated as of December 2015, due to lack of funding, and due to the principal investigator leaving . Closer to home, the Veterans Affairs Medical Center in Pittsburgh has their own trial which recently concluded in 2015. This trial recruited patients with advanced solid tumors across broad tumor types and patients dieted up to 16 weeks or until tolerated. The results have not yet been publicly released as it is currently under manuscript review.

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