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  "This case report gives hope that the KD might improve clinical outcomes for some patients with NSCLC. The tumor shrinkage, survival time, spectacular improvement in physical condition, and the restoration of daily attitudes are encouraging for further application of this therapeutic approach to larger numbers of patients."
Under "Case presentation" they call out that the patient is right handed... "A 54-year-old right-handed man presented with headache,"... is that a common thing to pay attention to in the type of research? I can see why they note he's a smoker, but seeing right-handed surprised me.
I mean depending on which side of the brain the tumour is, it could be relevant. Don't quote me on this (I'm not a doctor) but the right hemisphere controls the left side of the body (including left hand) and the left controls the right.
Handedness is important in neuroscience as there are functional asymmetries for things such as language. Pretty much all right-handed brains have language lateralized to the left side, whereas around 70% of left-handers also have language lateralized to the left side. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4219560/ So if a person is left-handed it's unknown if the lateralization of various functions in their brain is the same as a right-hander or if things are mapped in strange places. Left-handers also have higher rates of schizophrenia and other disorders.

I say this as a left-hander who is doing his PhD in neuroscience, haha.

Seems like a remarkably small sample group for a study like this. Maybe I am just not familiar with what is considered a significant sample size for cancer research.
A case report is exactly that, a case.
Case report studies kinda by definition are on one patient.
The epilepsy-level keto therapy (the one done in the study) can do wonders (80-90% of calories from fat, blood level GKI 1-2).

It didn't say what exactly happened with `However, dyslipidemia developed after this time which led to the discontinuation of the diet.`.

And if they consulted with a professional and recent research like "lean mass hyper responder".

> The KD was terminated 10 years after diet initiation (2018) as the patient developed dyslipidemia (cholesterol >280 mg/dL, triglycerides >300 mg/dL).

It looks like his LDL was "only" 140, but yeah trigs at 300 are no bueno.

I'm active in a community for a health condition. There's a very standard, very effective treatment which is mildly uncomfortable and time-consuming.

You can also do diet stuff. The diet stuff is about 20x less effective than the actual treatment, but that doesn't stop people from selling diets or not doing the treatment at all in favor of the diet.

That's what I worry about with studies like these. If you have a thing, do the actual treatment, don't mess around with diet. Diet impacts everything but that doesn't mean it can do anything. Do the treatment! Not the diet. This thinking can corrupt anyone, famously even Steve Jobs.

> You can also do diet stuff.

I don't know your health condition, but this is not "diet stuff". It's pretty specific. Look "ketogenic diet for epilepsy". If you break it, you have symptoms very quickly. It IS a medicine.

The grams of protein/fat/carbs were pretty extreme, it's not just "low carb" or "just keto" or "diet" or "eat healthy".

The difference is that the diet works on some occasions where nothing works, or on some occasions it works very good.

Things like DT2 (virtahealth.com), maybe soon for kidney disease (ex from today Feasibility and impact of ketogenic dietary interventions in polycystic kidney disease: KETO-ADPKD—a randomized controlled trial), many mental disorders (metabolicmind.org, virtahealth will try for depression too), etc.

> diet works on some occasions where nothing works

Is there documented example of this for lung cancer ?

Specifically:

https://www.fortunejournals.com/articles/significance-of-cal...

> Conclusions: This study demonstrated the significant beneficial effect of a calorie-restricted ketogenic diet for two types of aggressive cancers with metastases. Even a brief KD intervention has a profound effect, implicating the significant therapeutic potential for the ketogenic diet as adjuvant therapy for cancer treatment.

Obviously small sample size etc etc

More generally:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6375425/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10221628/

https://www.sciencedirect.com/science/article/pii/S221287781...

https://www.frontiersin.org/articles/10.3389/fnut.2021.59440...

It’s primarily as supporting therapy and quality of life, and is tumor specific, and at this time basically “more research is needed” effectively.

I would love to hear from those more qualified.

I don't know. You can search & ask in /r/ketoscience
I also have a chronic condition and am experienced with what you're talking about. Personally I favor the approved treatment option, while also maintaining a healthy diet and exercise. I know what you mean though, there is a group of people that will reach for the low probability "cure." I think it's a personality trait of people who think they're in on a secret that no one else knows. Some combination of ignorance and arrogance.

Keto operates in both worlds. There are real world, approved applications. Even with multiple sclerosis keto has been shown to help with fatigue and depression, but it's not yet an approved treatment. It probably will never be. On the other hand some people with MS tout keto as a cure, for which there is scant evidence.

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Please tell me what "mildly unconfortable" solution is there for stage 4 cancer that *metastases* into brain? I only know of chemotherapy!

People try diets (I prefer extended water fasting), because it affects everything! If cancer had spread into entire body, it is the only option, where you may keep your hair, and some sort of normal life!!

It is also for free and does not bancrupt your family!

Edit: I read the extract from study, keto was used AFTER chemotherapy to speedup recovery. Still, post chemo is nothing "mildly unconfortable".

> Three months after the cessation of chemotherapy and radiotherapy, a ketogenic diet (KD) was initiated. This approach was an attempt to stabilize the disease progression after chemotherapy and radiotherapy.

> People try diets (I prefer extended water fasting)

One of the ideas of the epilepsy-keto-diet is to mimic fasting (children would stop seizures when fasting).

You get the same benefits from water fasting, but without kidney stones. And you give a chance to your gut to heal.

There is a clinic True North, they do medically supervised fasting, and have a bunch of studies.

People have chronic conditions, you can't water fast for 10 years. And you can't afford for your condition to re-activate every time you break the fast to eat.
Full body radiation I think?
Yeah, don't just read the headline and think that keto is going to be enough to cure or even prevent cancer. This study is a single patient that went on a ketogenic diet AFTER chemo/radiation therapy and saw a .1 CM reduction. Nothing happened even after they stopped the keto diet.

Always take extraordinary claims about cancer treatments with an asteroid sized grain of salt.

The problem is this study is probably already being shared around social media by very questionable people who's interest is selling their diet book.

People quite rightly talk about "big pharma" but ignore that diet fads and dodgy supplements are also a billion dollar industry that is far less regulated than the former.

I watched a video yesterday where a doctor pointed that drugs to treat high blood cholesterol were more effective AND cheaper than Berberine.

Still most of the comments where just calling him a shill for "big pharma" without even a little curiosity about the industry behind supplement's.

The worst are the comments from people saying natural supplements worked for them... and then you see their account hasn't been active for 5 years :(

No idea if we have the same health condition(s) but I know exactly the phenomenon you're talking about. It's interesting/funny how different communities display this at different levels, though: way too many people in the autoimmune arthritis groups try to brute force their way through with sketchy diets (spoiler alert, they don't prevent permanent skeletal damage the way medications do), but most (not all) people in the inflammatory bowel disease groups are like "for the love of god please give me every drug you've got." Doubly interesting that the conditions themselves are often comorbid and the medications that treat one frequently treat both.

For cancer specifically, I've heard some pretty wild anecdotes about the Steve Jobs-esque diet truthers... and none that ended well.

One guy told me that his dad had cancer, and the "shill doctors" were trying to push chemo, but his dad opted for some pressed juice(?) regimen instead, with apparent success.

So I'm like "that's great, man, glad your dad is doing better" and he told me no, his dad did pass away... from getting chemo. Or so he claims. But it sounds to me like he really did just die of cancer.

It could be that diet left him too weakened to survive chemo. A family member on it had to drink a lot of food replacement drinks to keep their nutrition and weight up during it.
That wouldn't surprise me. Paired with the fact that the juice diet probably didn't eradicate the cancer, so being chemo-weakened and cancer-weakened has to be a one-two punch for someone malnourished.
I used to work in radiation oncology and I was treated with chemotherapy for testicular cancer.

This study specifically states that the diet was used after the patient was treated with radiation and chemo. Anyone who has ever been anywhere near cancer treatment knows that there is a tolerability limit for practically all cancer treatments and that this is one of the most difficult decisions clinicians have to make every day, between a patient in obvious agony and another cycle of treatment increasing the chance of recovery from 20% to 23%. Of course, in the United States of Financiers, the insurer will also have something to say about it.

So having another arrow in the quiver is something everyone can be grateful for.

> do the actual treatment, don't mess around with diet

No, you should do both. Telling people not to improve their diets is just as irresponsible as telling people not to take an effective medication. Especially in cases where there aren't effective treatments available, like some autoimmune and neurodegenerative disorders.

This comes with all the obvious disclaimers like do your own research, make sure there is at least some evidence for the diet's overall healthiness and interactions so that it can't make things worse.

Personally, I effectively cured a 2-year stint with long covid through diet (essentially a low sugar paleo diet). Within a few months I was able to exercise again without a fight or flight reaction after years of no improvement. Doctors (including one who was also battling long covid) told me there was nothing they could do to help, but they hoped that some of the experimental treatments like stellate ganglion block might eventually bear fruit. I could have waited around with a much lower quality of life, but instead I started the very difficult diet, and it paid off. There's plenty of snake oil out there, but don't throw the baby out with the bathwater. The world isn't black and white.

> very effective treatment which is mildly uncomfortable and time-consuming.

I'm not certain, but it seems like you are implying that diet is the easier choice. This is almost never the case, broadly speaking. Perhaps it's different in your specific community. The difficulty of sticking to a diet and knowing what foods should actually be included and excluded from a diet is probably the most significant hurdle to treating conditions that could benefit from diet (especially early onset conditions related to overall health). This is mostly a consequence of what's available and affordable in America, but is nonetheless a significant setback for recommending diets.

But where a good diets truly shine is in prevention. Just due to how unhealthy the modern American diet is, it's pretty easy to find benefit, so that should be a starting point alongside exercise when you don't have a cure-in-a-bottle handy.

The diet combined with the treatment does make things worse in the case of the condition I'm talking about. The world isn't black and white over here either. It's not cancer stakes but there are lots of people making themselves miserable with this "do both" approach.
That's an important distinction that you should put next to your "do not mess with diet" advice (if the diet interacts with the treatment). Most diets I would consider to be healthy and balanced are unlikely to interact with any safe drug.
No, it's not. When diet is the treatment, they call it that. There's only a distinction when some huckster like you comes along.
Now you're just arguing semantics, and resorting to ad hominem. Not a great look, kyleyeats.

Regardless, I think it's best for everyone that you don't give medical advice.

Have you tried the other end for your diet?
The problem with "improve your diet"-type advice is that dietary requirements vary wildly from person to person. What's good for you is often not good for someone else—even among two people with the same conditions!

Like, some basic dietary guidelines (e.g., eat less Burger King) are more or less universally helpful, but the specifics are far from it. I know people with autoimmune conditions who swear by gluten-free diets; I also know that when my Crohn's is mad at me one of the only things I can stomach is Wheat Thins.

I also think casting diets as preventative is only useful in the context of certain conditions. Eating well will shield you against type II diabetes, for example, but not multiple sclerosis. Sometimes you really do just need Actual Fucking Medicine. Luckily there are fewer and fewer conditions that truly lack available treatments.

> Luckily there are fewer and fewer conditions that truly lack available treatments.

A significant proportion of autoimmune and neurodegenerative disorders are still very untreatable. And casting (reasonably balanced) diets as preventative is almost always useful for anything that isn't a genetic certainty.

I strongly disagree with your counterexample. MS, for example, is strongly correlated with environmental exposure [0]. Your diet is a constant and cumulative source of environmental exposure if you're eating normal American food all the time (pesticides, genotoxic compounds in processed foods [1], carcinogenic fats, hormones, and dense refined carb spikes with little fiber). Eating healthy is absolutely useful advice if you have some familial risk of M.S.

Worst case? You get it anyways, but are healthier overall.

[0] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6444694/ [1] https://pubmed.ncbi.nlm.nih.gov/15914214/

Ms as the counter exam0le choice was amusing to me because dr. Terry wahls reversed hers with diet and currently does research on a diet protocol to fix ms: https://terrywahls.com/
First principles thinking says, if you remove the fuel and this stops replication while still allowing a host to live, that sounds like it should win outright.

We only carry 3.3-7grams of glucose in the blood stream at one time. This is cycled quite frequently, but in the limit, that's all it takes to sustain and let cancer thrive.

Jobs unfortunately screwed up the direction and ate plenty of sugars with his only fruit diet. My grandmother made the same mistake with breast cancer. Juices are basically cancer-gatorade.

You can also experience ketosis as part of autophagy during the final throws of stage 4 cancer (i.e., when you can no longer eat and starve), but at that point, the cancer is growing strong rather than shrinking.

Where is the threshold between "ketosis treats cancer" and "ketosis is not having a noticeable effect on late stage cancer"?

Personally I have benefited from ketogenic diet and would recommend others try it, but I also need to caveat that support by underscoring my lack of answers for critical questions like this.

You experience ketosis by lowering carb intake. You may get shot in the mouth, stop eating, and get into ketosis but it doesn't mean ketosis results in gunshots to the mouth.

> Where is the line drawn between "ketosis treats cancer" and "ketosis is not having a noticable effect on late stage cancer"?

Different types of cancers, different stages of the cancer, different types of ketosis, different people.

> The size of the brain and lung lesion remained stable after nine years of KD therapy. However, dyslipidemia developed after this time which led to the discontinuation of the diet.

This is new to me, I didn't know that a keto diet can lead to dyslipidemia? If I search for secondary causes of dyslipidemia (primary cause is genetic), the only lifestyle factor I can find is excessive alcohol use.

I was doing the keto diet several years ago. I went from 240lbs to 175. I had to stop though because my bad cholesterol went through the roof. Came to find that I am APOE4/4, basically I have a genetic mutation that among other things means my body has trouble dealing with saturated fats.

I stopped doing keto and ended up getting back up to 220lbs, but my blood levels went back to normal.

I really want to do keto again because it's the only thing that's ever worked for me and I keep hearing about studies like this, but I also don't want to mess up my levels again.

There's evidence that having super high LDL cholesterol on keto may be fine (do your own research, obviously). Check out https://cholesterolcode.com/ and look up Dave Feldman. Some really interesting research will be coming out soon.
Feldman was on Peter Attia's podcast [0] and I was not impressed. LDL seems causal in the process of ASCVD. [1] I can't think of a stronger statement in science than one invoking causality. (In particular, it seems necessary, but not sufficient. Interestingly, it seems you can't go too low with LDL [2].)

I wonder if OP could continue keto, but go on a statin/pcsk9 inhibitor/bempedoic acid/ezetimibe. Of course, these are prescriptions, so he'll need to find a willing doctor. And have money to shell out. It sucks that he's APOE4/4, since that makes him so much more susceptible to other types of metabolic/cardiovascular disease [3]

0: https://peterattiamd.com/davefeldman/

1: https://pubmed.ncbi.nlm.nih.gov/28444290/

2: https://www.health.harvard.edu/blog/ldl-cholesterol-how-low-...

3: https://peterattiamd.com/johnkastelein/

If your body cannot find blood glucose for metabolism then it will respond by efficiently digesting dietary fats and maintaining high lipid levels in the blood.
Coincidentally my mother has an 80yo neighbor who got diagnosed with brain+lung tumors a few weeks ago. I'd like to recommend this article to her. Though it apparently has the risk of dyslipidemia, "Abnormally elevated cholesterol or fats (lipids) in the blood."

(maybe some exercise too to help mitigate that risk)

This study should not be used to make ANY medical decisions and is only useful in proposing additional studies. I would recommend against sharing it with anyone who is not trained to read and understand these results. Often laypersons will take these studies and make absurd claims based off of them that kill people.

Keep in mind that this is a study of a single person and the tumor reduction was insignificant compared to the 4CM reduction from radio/chemo therapies. There is no way to know if Keto even did anything without a larger cohort. For all we know, it made the cancer worse than it would have been.

You read the abstract wrong. The reduction was significant and more than from radiation and chemo (ed. for one of the tumors).

> Computed tomography following radiation and chemotherapy showed a reduction in the right frontal lobe lesion from 5.5 cm × 6.2 cm to 4 cm × 2.7 cm, while the mass in the upper-right lung lobe reduced from 6.0 cm × 3.0 cm to 2.0 × 1.8 cm. Two years after KD initiation and without any other therapeutic intervention, the right frontal lobe lesion calcified and decreased in size to 1.9 cm × 1.0 cm, while the size of the lung mass further decreased to 1.7 cm × 1.0 cm.

Formatting to make it a little easier to parse. There was only a reduction greater than a CM on the right side which almost seems to be just lagging the left side reduction from the Chemo. However without a larger number of participants there is no way to call any of it significant.

DIM ORG->CHM->KTD

RX: 5.5->4.0->1.9 RY: 6.2->2.7->1.0

LX: 6.0->2.0->1.7 LY: 3.0->1.8->1.0

Edit: Also keep in mind that we are talking about 2 dimensions.

For instance on the right side in cm^2: 34.1 -> 10.8 -> 1.9

And the left: 18-> 3.8 -> 1.7

It does look like it could be a lagging effect for the left side. But still, remission and even slight reduction in tumor size are all good signs. When you want to do every possible thing to reduce chances of it coming back (the second time is brutal for many cancers), I would absolutely recommend people to do this basically harmless diet.

Sure it's just one person but given the mechanics of not feeding sugar to tumors, it's a pretty easy recommendation to make.

You may very well be right, but this is how you kill people. You give medical advice based on single person studies and people run with it. For all we know, certain tumors could be supercharged by elevated ketones and it could keep the immune system from doing it's job. We need to the research to know for a fact.

If you want to risk it, that's fine. But medical misinformation kills people every single day. The fact is that we have no freaking idea if any of this is true without other information.

"For all we know"...sure. We already know most cancers use glucose. The problem is you are severely underestimating how dangerous cancers that come out of remission are and severely overestimating how dangerous this diet can be. Any kind of risk analysis would tell you to do this diet.
I understand that it's much more satisfying to make suppositions based on incomplete data than to say "I don't know." However, the fact of the matter is, we do not know one way or another.
A person is never really going to know anything for sure. It's all risk analysis.
At 80 I would be more worried about the tumors than elevated cholesterol / fats
Kinda too late by then. They've found cardiovascular disease in 20 y/os who die of other causes, e.g. car accidents. It's a lifelong process, so early prevention is key.
That’s my point. Go on the keto diet and fill up on saturated fats, throwing caution to the cardiovascular wind, if that has a chance of reducing the tumour growth or send it into remission.
Ah, I didn't read closely enough x_x
Jesus christ. A sample size of one? What on Earth is this quackery doing on a .gov website?

Unbelievable. This is dangerous toxic bullshit.

Not medical advice, if you have cancer don't listen to me.

The keto diet, or subtypes, absolutely is anti-cancer. Nobel prize in 1931 basically proving the keto diet is anti-cancer. But how much, is it even a good treatment? Anthrax is anti-cancer, but doesn't mean ANYONE will use it as treatment.

https://en.wikipedia.org/wiki/Warburg_effect_(oncology)

The thing is, it has more to do with kind of starving the cancer cells. They don't like using ketones.

This won't work for pancreatic and some edge case types of cancer. Lung cancer is probably one of the best ones to treat this way? Far more effective than any of the 'lets poison them to the edge of death and hope cancer dies first'

In the last 5 years many have studied this and the nobel prize may be wrong. Like we are discovering it works in a different way. So it's not keto that you want to do, it's actually starving yourself. Starving yourself to the edge of death and hoping the cancer dies. Kind of similar but far more effective?

I would make a prediction though, this entire field of research is utterly pointless and if my doctor told me I had cancer I wouldn't concern myself with any of this.

During covid, a particular celebrity revealed the cure to cancer. It has been known since the 1970s. His accident in revealing this created this massive censorship move. I've never seen anything at this scale like this, they really didn't want anyone taking it. The drug does seem to have been mislabeled rather egregiously.

But cancer patients who got covid tried it and oncologists in Mexico and China found, 'wait off label anti-cancer use of a drug' The cat is out of the bag.

Huge consequences though. What happens to population numbers if you eliminate the #2 cause of death and roughly 1 million people per year for just north america alone remain alive? I can see how that's beyond scary for the US government.