Special cancer diets

Nutrition recommendations during cancer treatment are typically designed to help people eat well, despite side effects, such as a sore throat, poor appetite or diarrhea. Registered Dietitian Nutritionists (RDN) help people with cancer maintain their quality of life by preventing the debilitating effects of significant weight loss and malnutrition. While this is the standard of care, there is a growing interest beyond weight maintenance and side effect management. People with cancer and their loved ones want to know if using a special diet will help improve cancer outcomes

Diets and cancer

While undergoing cancer treatment, you may start to look at different diet strategies. There’s lots of useful information that is readily available about cancer and diets, but it can be difficult to work out which sources to trust. One diet you may be aware of is the ketogenic diet.

What is a ketogenic diet?

A ketogenic diet is a high fat, low carbohydrate diet. However, significantly reducing your carbohydrate intake and increasing the amounts of fats you eat puts your body in a metabolic state known as ketosis – this is where your body burns fat for energy. For this reason, a ketogenic diet is commonly used to help lose weight, but now there are studies looking into the significance of a ketogenic diet as a metabolic strategy for cancer patients.

Hesistant to use the words “adequate protein” because protein is still restricted.   [BS1]

A ketogenic diet and cancer

In the lab setting, some cancers, including squamous cell carcinoma of the lung, have been shown to  rely upon glucose (sugar)  to grow and survive.1 Because of this, there is growing interest in looking at how patients could adopt a ketogenic diet – to restrict the amount of glucose available to the cancer – and improve survival. There is also evidence to suggest a possible benefit to using a ketogenic diet for other cancers, including some cancers of the brain, breast and head and neck region.^2,3,4

Some studies have also looked into the effectiveness of a ketogenic diet to complement other cancer treatments. Research from 2014 suggested  that the ketogenic diet could complement standard cancer therapies such as radiation therapy and chemotherapy, by inducing metabolic oxidative stress in cancerous cells but not healthy cells.⁵

Despite the promising outlook of a ketogenic diet in cancer patients, evidence is still rather limited. While there are a small number of published studies, lots of these tend to look at patient safety rather than treatment outcomes. Right now, it’s still too early to tell if a ketogenic diet can improve treatment outcomes. We also don’t know which cancers will and will not benefit from a ketogenic diet, and at what point to start the diet. after receiving a cancer diagnosis.

Although a ketogenic diet is widely used in clinical settings for controlling seizures and in the community setting for rapid weight loss, there are some difficulties you should consider. Following a ketogenic diet requires a significant commitment and doing so during cancer treatment  would be extra hard. On top of this, there are some additional side effects you could experience,  including nausea, vomiting, constipation, headaches and feeling lethargic.

If you are interested in pursuing complementary nutrition therapies, you should receive nutritional guidance from an expert & medical supervision. You should start by consulting your GenesisCare team, who would be happy to answer any questions or concerns. You may be referred to an RDN for additional nutritional guidance. You can also find more information about various low-carbohydrate nutrition therapies from the Charlie Foundation.

Here is the link and citation to a recent journal article from 2020: [BS1]

“Effects of Ketogenic metabolic therapy on patients with breast cancer: A randomized controlled clinical trial”:

https://www.sciencedirect.com/science/article/pii/S0261561420303393.

Reference:  Khodabakhshi, Adeleh, et al. “Effects of Ketogenic Metabolic Therapy on Patients with Breast Cancer: A Randomized Controlled Clinical Trial.” Clinical Nutrition, 2020, doi:10.1016/j.clnu.2020.06.028.

1. Hsieh, M., Choe, J., Gadhvi, J., Kim, Y., Arguez, M., Palmer, M., et al., 2019. p63 and SOX2 Dictate Glucose Reliance and Metabolic Vulnerabilities in Squamous Cell Carcinomas. Cell Reports, 28(7), pp.1860-1878.
2. Seyfried, T., Marsh, J., Shelton, L., Huysentruyt, L. and Mukherjee, P., 2012. Is the restricted ketogenic diet a viable alternative to the standard of care for managing malignant brain cancer? Epilepsy Research, 100(3), pp.310-326.
3. Schwartz, K., Noel, M., Nikolai, M. and Chang, H., 2018. Investigating the Ketogenic Diet As Treatment for Primary Aggressive Brain Cancer: Challenges and Lessons Learned. Frontiers in Nutrition, 5(11).
4. Klement, R., 2014. Restricting carbohydrates to fight head and neck cancer-is this realistic?. Cancer biology & medicine, 11(3), pp.145-161.
5. Allen, B., Bhatia, S., Anderson, C., Eichenberger-Gilmore, J., Sibenaller, Z., Mapuskar, K., et al., 2014. Ketogenic diets as an adjuvant cancer therapy: History and potential mechanism. Redox Biology, 2, pp.963-970.
6. The Charlie Foundation for Ketogenic Therapies: https://charliefoundation.org/keto-for-cancer/