Using FATS to fight cancer

March 25, 2022

Using FATS to fight cancer…

Hmmm, let me get this straight… you are telling ME to eat MORE fat in order to fight cancer???

The ketogenic diet is made up most mostly of fat, in fact, 70-75% of the daily allowance. Only 5-10 % is from carbohydrates and the rest is from protein. So isn’t there a danger in taking in too much fat? How about heart disease?!?!?

It may surprise you to know that a low carbohydrate, high fat diet if done properly, does not increase the risk of heart disease.

On the contrary, eating a high fat diet might actually decrease your risk of coronary artery disease.1,2

Not all fats are alike. There are good fats and bad. When we check our yearly fat (lipid) profile at the doctor’s office, we will see a breakdown of the numbers. The total cholesterol or TC. Then there is HDL or high density lipoproteins which are known as the good fat. LDL or low density lipoproteins are the bad fats, and the VLDL or very low density lipoproteins are the very, very bad fats. Triglycerides TG are another type of fat, which go up when we take in carbohydrates. Our doctor will tell us that we need more of the good fats (also known as HDL), and less of the bad fats LDL, VLDL and triglycerides.

For years, society has blamed cholesterol and saturated fats as the cause for heart disease and atherosclerosis. Saturated fats tend to be solid at room temperature, due to their chemical structure which has carbon atoms all strung together and attached to hydrogen atoms or other atoms without using any double bonds. As a result they are structurally very stable and are solid at ordinary room temperature.

For many years it was assumed that because this type of fat solidified quickly, it was natural to assume that saturated fats will just as quickly solidify within the body and clog our arteries.

The other incorrect assumption is that if you take in too much fat, you will naturally become fat!

Therefore it came to be that the popular health advice in the 1970s and 1980s consisted of promoting a high carbohydrate, low fat food as a “heart healthy” diet. Grocery shelves complied by increasing their stocks of low fat food items. People shunned whole milk and started buying skim or low fat milk products. Diets low in fat and heavy in carbohydrates and grains became popular and were felt to be the correct path to becoming healthy. Recently, it now is becoming clear that this was not the correct solution after all. Over the past half century many people lost weight, only to quickly regain it plus more. Ironically, we actually saw a RISE in heart disease, diabetes and cancer.

Why is the reason for this? These "heart healthy" low fat alternatives have fat removed and it their place manufacturers add fillers, usually in the form of starch and add loads of sugar to make up for the loss of palatability which is a consequence of the removal of the tasty fats. When one consumes ltoo much carbohydrate we easily gain weight, and also increase our levels of harmful CYTOKINES. Three of the most common cytokines are leptin, adiponectin (adipo means "fat") , and tumor necrosis factor-alpha (TNF-alpha). These proteins called CYTOKINES are found within and secreted by our white blood cells and also are found within the lining of blood vessels.

When excessive cytokines are released, inflammation rises. Inflammation is increasingly being linked to heart disease, diabetes, autoimmune disease and cancer.

How do atherosclerosis or blocked arteries develop? It Heart disease and blocked arteries first need inflammation to trigger damage to the blood vessel walls.

A good rule of thumb would be “ BREAD AND BUTTER SHOULD NOT MIX”. In other words, if you like to eat butter, better shy away from bread.

When you consume carbohydrates (starches, bread), they turn into glucose. When glucose levels become high, the inflammation in blood vessel walls increases. High blood glucose and carbohydrates also stimulate the liver to increase the production of certain fats called triglycerides and also to produce high levels of the bad fats. Bad fats (called LDL and VLDL) levels increase, and bring a rise in fatty acid production.

These bad fats VLDL (very low density lipoproteins) and LDL (low density lipoproteins) also contain cholesterol. When the blood vessel wall is attacked by high glucose and inflammation, the VLDL and LDL easily deposit their cholesterol into the wall of the blood vessels. Arteries become clogged and heart disease develops.

Emerging evidence now show that a low carbohydrate, high fat diet did better than a low fat, high carbohydrate diet in terms of improving cholesterol levels, and achieving overall weight loss. 3,4,5,6,7,8 Low-carbohydrate, high fat diets also were more effective in lowering inflammation. 7,8

Inflammation is blamed for the growing list of chronic medical diseases such as diabetes, arthritis and neurodegenerative diseases, and cancer.

Thanks to modern medicine, we can now measure inflammation in the blood. A blood test called CRP or C-reactive protein, we see levels increase when there is inflammation. Studies show that low carbohydrate diets decreased the concentration of C-reactive protein better than a conventional diet. Other markers of inflammation (leptin, adiponectin and tumor necrosis factor alpha) also decreased with a low carbohydrate diet. 9–11

I am not advocating that you can eat all the fat that you can. But do keep an eye out on the percentage of fat consumed, and choose fats wisely. The inuit Eskimos survive on a diet high in fat and barely have any cancer. Their fat is mostly of the omega-3 type, the kind which elevates your good HDL cholesterol and lowers your triglycerides. The younger Eskimos who live closer to town, eating the modern diet that we now are used to, are slowly acquiring the diseases of modern man.   http://discovermagazine.com/2004/oct/inuit-paradox.

When fat is consumed in the absence of carbohydrates, the body naturally has to use the existing fat and protein for energy and as a result, there is weight loss. Unlike the spiraling weight loss that is seen in very advanced cancer, this type of weight loss is controlled.

Which fat is better? Not all fats are alike.

Omega-6 versus Omega -3

Oils with high omega 6 fatty acids like safflower and corn oil can increase inflammation, and along with it, higher risks of heart disease and cancer.

Oils high in omega -3 fatty acids such as fish oil, can protect against these diseases.12–14

A study of human evolution reveals that humans began with a diet consisting of a ratio of omega-6 to omega-3 essential fatty acids of approximately 1:1. The Western diet now has a disproportionately abnormal ratio of 17:1.

Fast food and highly processed foods are the usual suspects. (Say goodbye to processed cupcakes!) This high omega-6/omega-3 ratio makes one more prone to developing the diseases of modern mankind, such as heart disease, autoimmune disorders, diabetes, and cancer.

Unsaturated versus saturated?

Saturated fats are made of chains of carbon atoms tied together by single bonds. Unsaturated fats have a chemical structure that consists of chains of carbon atoms © and some of these atoms are tied together by one or more double bonds. They may have less hydrogen atoms per carbon atom and as a result they have to use double bonds to keep their structure intact and are less stable than saturated fats. These areas where the carbon atom is replaced by a double bond are more prone to attack by free radical damage. When heat or radiation strikes, these become places where damage is inevitable. Examples of these vulnerable fats /oils are those that come from grains (corn oil, peanut oil, sunflower seed oil, and vegetable oil, etc.). I prefer to use saturated fats like coconut oil or good old butter. Olive oil has one double bond, so it too is prone to oxidative damage, but to a lesser degree than other unsaturated oils. I therefore prefer olive oils to vegetable oils such as corn, sunflower or peanut. If using olive oil, it is better to just drizzle it on salads, and if you have to cook with it, better to use only for light frying or baking, but avoid grilling or deep frying with it.

Do you prefer it steamed, boiled , grilled or fried?

The way we cook can also affect the damage to these oils and make them more pro-inflammatory. Cooking in high heat (deep frying or grilling and broiling) or cooking with acid can increase oxidation of unsaturated fats. Microwaving food can also cause oxidative damage to these fats. Better to cook using baking or steaming methods where the heat is not as sudden or high.

Why isn't the diet working?

Sometimes we find that a ketogenic diet is not always effective in cancer patients. This may be true, especially if one does not lose weight. Despite the lack of available sugar, persistent inflammation from other hidden sources may be still present. Patients with high amounts of body fat often have high amounts of leptin. Leptin was discovered in 1994. It is a hormone naturally found within fat tissue and plays an important role in appetite regulation and weight control. Leptin by itself is pro-inflammatory. High leptin levels are linked to increased breast cancer risk.15,16

  A commercially available leptin inhibitor is not yet in sight. However, decreasing the amount of body fat by way of low carb dieting is obviously one way to decrease leptin levels. Vitamin D , which brings down inflammation, is another way to decrease leptin levels.15 What other food have anti-inflammatory and anti-oxidant effects? Another topic for another day.

It all ties together, glucose--->fat--->inflammation. To be more effective in the fight against cancer, one must bring all three down.

 

  1. Seshadri P, Samaha FF, Stern L, et al. Adipocytokine changes caused by low-carbohydrate compared to conventional diets in obesity. Metab Syndr Relat Disord. 2005;3(1):66-74. doi:10.1089/met.2005.3.66.
  2. Rothstein WG. Dietary fat, coronary heart disease, and cancer: A historical review. Prev Med (Baltim). 2006;43(5):356-360. doi:10.1016/j.ypmed.2006.07.013.
  3. Vidali S, Aminzadeh S, Lambert B, et al. Mitochondria: The ketogenic diet - A metabolism-based therapy. Int J Biochem Cell Biol. 2015;63:55-59. doi:10.1016/j.biocel.2015.01.022.
  4. Garg a, Grundy SM, Unger RH. Comparison of effects of high and low carbohydrate diets on plasma lipoproteins and insulin sensitivity in patients with mild NIDDM. Diabetes. 1992;41(10):1278-1285. doi:10.2337/diabetes.41.10.1278.
  5. Hudgins LC. Effect of high-carbohydrate feeding on triglyceride and saturated fatty acid synthesis. In: Proceedings of the Society for Experimental Biology and Medicine. Vol 225. ; 2000:178-183. doi:10.1046/j.1525-1373.2000.22521.x.
  6. Halton TL, Willett WC, Liu S, et al. Low-carbohydrate-diet score and the risk of coronary heart disease in women. N Engl J Med. 2006;355(19):1991-2002. doi:10.1056/NEJMoa055317.
  7. Foster GD, Wyatt HR, Hill JO, et al. Weight and metabolic outcomes after 2 years on a low-carbohydrate versus low-fat diet: A randomized trial. Ann Intern Med. 2010;153(3):147-157. doi:10.7326/0003-4819-153-3-201008030-00005.
  8. Yancy WS, Olsen MK, Guyton JR, Bakst RP, Westman EC. A Low-Carbohydrate, Ketogenic Diet versus a Low-Fat Diet to Treat Obesity and Hyperlipidemia: A Randomized, Controlled Trial. Ann Intern Med. 2004;140(10):769-777+I. doi:10.1038/nm0603-677.
  9. Randomized a, Trial C. Annals of Internal Medicine Article A Low-Carbohydrate , Ketogenic Diet versus a Low-Fat Diet To Treat Obesity and Hyperlipidemia. Ann Intern Med. 2004;140:769-779. doi:10.1038/nm0603-677.
  10. Dupuis N, Curatolo N, Benoist JF, Auvin S. Ketogenic diet exhibits anti-inflammatory properties. Epilepsia. 2015;56(7):e95-e98. doi:10.1111/epi.13038.
  11. Ruskin DN, Kawamura M, Masino SA. Reduced pain and inflammation in juvenile and adult rats fed a ketogenic diet. PLoS One. 2009;4(12). doi:10.1371/journal.pone.0008349.
  12. Wall R, Ross RP, Fitzgerald GF, Stanton C. Fatty acids from fish: The anti-inflammatory potential of long-chain omega-3 fatty acids. Nutr Rev. 2010;68(5):280-289. doi:10.1111/j.1753-4887.2010.00287.x.
  13. Simopoulos AP. The importance of the omega-6/omega-3 fatty acid ratio in cardiovascular disease and other chronic diseases. Exp Biol Med (Maywood). 2008;233(6):674-688. doi:10.3181/0711-MR-311.
  14. Bagga D, Capone S, Wang HJ, et al. Dietary modulation of omega-3/omega-6 polyunsaturated fatty acid ratios in patients with breast cancer. J Natl Cancer Inst. 1997;89(15):1123-1131. doi:10.1093/jnci/89.15.1123.
  15. Menendez C, Lage M, Peino R, et al. Retinoic acid and vitamin D(3) powerfully inhibit in vitro leptin secretion by human adipose tissue. J Endocrinol. 2001;170(2):425-431.
  16. Gonzalez-Perez RR, Xu Y, Guo S, Watters A, Zhou W, Leibovich SJ. Leptin upregulates VEGF in breast cancer via canonic and non-canonical signalling pathways and NF??B/HIF-1?? activation. Cell Signal. 2010;22(9):1350-1362. doi:10.1016/j.cellsig.2010.05.003.

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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