Keto beginners guide for cancer patients

March 25, 2022

What to do when you don't know where to begin

What to do when you don’t know where to begin with keto?

(The following was a real conversation between myself and a cancer patient. Names have been changed to protect privacy.)

“Dr. Tan, what do I eat while on the keto diet?”

I looked up at my patient, Mr. Brown (not his real name). At age 65, he is overweight, diabetic, and basically a “meat and potatoes” type of guy. He also has cancer.

What is important to know about starting the “keto” lifestyle, is not so much what to eat, but what NOT to eat. People are always looking for a magic pill. In this case, the first impression people have about the keto (ketogenic- to generate or make ketones) diet, is that a certain type of food “might” help cancer. That isn’t really the case. The keto way of eating (WOE), is actually more than a diet. It is a lifestyle change. When you cut down on your carbohydrate intake, the body senses it and produces ketones to use as a back-up energy source. Cancers, fortunately, do not rely on ketones, and by following a keto diet, we hope it could help slow down cancer growth. Unfortunately, the evidence behind this is not yet substantial. We do know that this “keto” diet has anti-cancer properties in lab animals, and the human trials done so far seem to say that it is safe to use, even in advanced cancer patients.

Me: “Well Mr. Brown, I can give you a detailed list, a menu, plus a shopping list. We also have a cookbook that you can borrow. It’s over there by the chemotherapy nurses station.”

“Just remember, it is very important that we keep this process simple…. Just think of two letters--- S-S…!!!”

Mr. Brown: “S-S?? “

Me: “ Yes, no SUGAR, no STARCH!!!”

Mr. Brown: “Okay doc, but what about wheat bread?”

I shook my head, “ no, no, no… bread is bread. Bread has many names Wheat bread, gluten free bread, challah, tortillas, - they are all bread, and bread is made of starch!”

Mr. Brown: “Ok, how about pasta?”

Me: “Mr. Brown, pasta is usually made from semolina flour. Anything made out of flour automatically contains starch, and that’s not allowed.”

Mr. Brown: “Fruits? ”

I took a deep breath. “ No sir, fruits, including tomatoes, are high in carbohydrates and sugar.”

Mr. Brown: “But aren’t fruits supposed to be healthy for you?”

Me: Yes, for prevention, but once cancer develops, the anti-oxidant advantage gained by eating fruits gets smothered by the metabolic overactivity of the cancer.

Mr. Brown: “What about oatmeal?”

Me: “No, that’s still carbohydrate rich.”

Mr. Brown: ”Peanut butter?”

Me: Sigh.

I opened the side drawer next to my desk and pulled out a copy of our ketogenic diet handout. “Here you go, Mr. Brown. This is a list of the types of food that you can eat, and on this other list, are the prohibited foods. As you can see, there are literally hundreds of things that are allowed. You really won’t starve. “

Me: “Remember, don’t overdo it. A ketogenic diet, if taken in excess, is not good either. Just eat until you are no longer hungry. Don’t wait until you are full. And don’t forget to add fat.” “If you have time, I can introduce you to our nutritionist, and she can guide you further. “

This encounter with my patient made me realize that perhaps, a minimalist method towards the ketogenic diet, is good way to start if one is a novice.

GETTING KETO READY, THE MINIMALIST WAY

Baby steps!!! With practice, we will become experts in due time.

For beginners, my advice is, to KEEP IT SIMPLE.

Do not worry about checking your ketones or about buying a ketone meter. Right now, you just want to get your feet wet.

Begin with a blank slate. Empty your fridge and pantry.

Remove all the items that are on the “not allowed “ list.

Restock it only with keto-approved foods. Donate the rest to a local food pantry.

Start eliminating the OBVIOUS STARCHES: Flour, rice, bread, cereal, pasta, potatoes.

Next, remove the OBVIOUS SWEETS: candy, sugar, syrups, honey, jams, and regular soda drinks, fruits.

Now, there are the NOT-SO-OBVIOUS items which are popular for being healthy, but are high carb anyway – cow’s or goat’s milk, cottage cheese, non-fat yogurt, fruits. Avoid these.

If unsure, place the item in question in a box for future analysis.

Look up the rest of the remaining food items, using my chart.

BEWARE OF HIDDEN CARBS

For example, a lot of foods actually have starch and they are not called bread. For example, “ rice, wheat, oats, quinoa, tortillas, are all starchy. Some vegetables are healthy but are not keto-friendly. Examples include chickpeas, beans and potatoes. Did you know that carrots are also high in carbohydrates?

WHAT ABOUT TOMATOES AND AVOCADOES?

Tomatoes and avocadoes also add up quickly to your carb limit. A medium avocado actually contains around 16 grams of carbohydrates. If you are counting towards a 20-gram daily limit, that will easily kick you out of ketosis. So no, I would not recommend avocadoes for the beginner.

 

PEANUT BUTTER, SPICES, and CONDIMENTS

 

Peanut butter is protein rich, but unfortunately, the popular versions are usually loaded with sugar. But, there is good news. Peanut butter now comes in PLAIN versions. Look at the labels. Ingredients should say “peanuts and oil”. If sugar is listed, put it back on the shelf.

Spices can have hidden carbs. Again, look at the labels and search for “total carbs”. You will be surprised at what you will discover.

Ketchup, an American favorite, usually has sugar, or worse, high fructose corn syrup. Pasta sauce and marinara sauce, likewise can have a significant amount of added sugar.

Mayonnaise. Make sure it is indeed “pure mayo”. Mayonnaise is essentially just made up of eggs and oil, plus some spices. Lookout again for those with added sugar, glucose or corn syrup. Some might even have cornstarch to act as thickeners. Put those back on the shelf.

CLASSIFICATIONS

Now that you have a general idea of what to look for, you may now begin to arrange your newly emptied pantry and fridge into three categories.

Yes, only 3.  Make that 4 – for drinks.

Category 

  1. Protein : Are you a meat, poultry or seafood lover?

The foods under this category, should provide you with the needed PROTEIN. You can also add soy products like tofu, if you’d rather avoid meat. There is still some controversy about soy intake because they contain isoflavones , also known as plant estrogens. Some fear that it will fuel breast cancers. However, opposing research on soy intake of Chinese women show that if taken early on in life, that it could actually “protect” against breast cancer. Soy intake later on in life might not be as protective. Soy is available as tofu, edamame, and soy drinks. 1       Did you know that asparagus, supposedly anti cancer, also contains isoflavones? I think consuming soy products is okay, as long as you do so in moderation. Breast cancer patients who live in the western world, should probably avoid soy for now.

  1. Vegetables: Do you prefer Greens or Cauliflower?

Spinach, broccoli, lettuce, cabbage or brussel sprouts? Cauliflower is also a good choice.

  1. Fats

Most newbies forget to include fat in their meal plans. Remember, to make your meal ketogenic, FATS actually makes up the majority (60 to 75%) of a ketogenic diet? Butter, coconut oil, and olive oil are my three favorite fats. Also, include sour cream and heavy cream to your grocery list.

  1. Drinks – what’s wrong with water? Coffee, seltzer water, unflavored of course. Go easy on the caffeine. It can also result in glucose spikes. And be aware of soda drinks in the chemo suite. Just because the nurse hands you a can, doesn’t mean you have to drink it!

 

ASSEMBLING YOUR MEAL

 

By now, you got the idea. It’s day one. Meal planning for lunch and dinner is simple.

Visually cut your plate in half. Half is your choice of greens. I usually assemble half of my plate with broccoli, cauliflower, spinach or kale.

Then, choose your protein. Is today your day for beef steak? grilled chicken? or fried fish? Make sure they are “not breaded”. Remember that’s hidden carbs too ( the flour).

Don’t forget to add your FAT. Once you assemble your simple meal, top it off with a cube of butter, or a big dollop of heavy cream. Feel free to cook with these or drizzle some oil or melted butter over your assembled plate of food. Don’t forget to consider sour cream as garnish for your plate, and heavy cream for your soups and coffee.

Season with salt and pepper.

So that is my version of a keto-diet made simple:

Repeat daily with minor variations.

I know, it sounds boring.

But in reality, people do eat the same thing day in and day out. Usually, its cereal in the morning with milk, and meals usually have rice or pasta. All I am doing here is, I am eliminating the carbs and swapping them out for a keto-friendly alternative. Make some variety by changing the way you prepare the food. Bake one day, and steam or stir-fry the next meal, to make food interesting. The possibilities are actually endless. Simple preparation actually increases one’s chances of success.

ADDING VARIETY

Mushrooms, celery, tofu are good low carb add-ons. Once you become attuned to this diet, you can even venture back into desserts! But go easy on the sweeteners. Even sugar substitutes such as sugar alcohols (sorbitol, erythritol, etc.) can spike your glucose. At this point, you might even want to buy yourself a cookbook, to expand your meal variety. However, once you get the hang of what I am saying, buying a cookbook is really an optional step.

SUPPLEMENTAL KETONES

There’s a lot out of “ketone supplements” out there now. None of these are FDA approved, nor are any with enough scientific data to back their efficacy. But certainly, we hope that with future trials, we can learn more about keto-supplements and whether they are indeed worth their buck. One thing is for sure if you are not on the keto diet, to begin with, adding extra ketones to your diet in the form of a supplement will not really benefit you since you are still not depriving the cancer of glucose. Remember, it’s not what you can eat, but what you shouldn’t eat that is the main idea here.

As you get more attuned to the basics, you will gradually try other foods, and even start monitoring your blood sugars and ketones. You might also want to secure a phone app that helps you track carbs and even exercise. Even if you remain stuck in the beginner’s stage, you have already made a great step that will have a positive impact on your fight against cancer!

  1. Ziaei, S., & Halaby, R. (2017). Dietary Isoflavones and Breast Cancer Risk. Medicines (Basel, Switzerland), 4(2), 18. doi:10.3390/medicines4020018
  2. https://www.calorieking.com/us/en/foods/f/calories-in-fresh-fruits-avocados-average-all-varieties-raw/zU9a9g9oQ5W3RHKaVFtG7A

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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