The growth of cells in the body is tightly regulated.
Various transcription factors and molecular mechanisms ensure that cells only grow and divide when appropriate.
But cancer cells are in many ways different than other cells.
Something in the regulatory mechanism breaks and they start growing and dividing rapidly.
The cancer cells start hoarding energy from the blood, then they manipulate their surroundings to support their rapid growth.
One interesting fact about the metabolism of cancer cells, is that most of them rely solely on glucose from the blood as a source of fuel. This is called the Warburg effect.
Cancer Cells Lack Metabolic Flexibility
Normal cells of the body have a certain metabolic flexibility. If insulin is low, they can start using either fatty acids or ketone bodies to provide energy.
Most cancer cells are unable to do this. They need glucose.
This has lead to speculation about whether a carb restricted diet can reduce the available fuel for the cancer cells, partly starving them and perhaps being of use alongside other more conventional therapies like radiation and chemo.
But it’s important to realize that even though dietary intake of glucose is low, the body will still make plenty of glucose via gluconeogenesis and cancer cells are particularly efficient at “stealing” the little glucose available from the blood.
So a carb restricted diet won’t starve the cells in this way.
It might reduce their available fuel slightly, while still providing plenty of energy for the other healthy cells of the body via fatty acids and ketones.
Other Potential Mechanisms
Low-carbohydrate diets also lead to lower levels of circulating hormones Insulin and IGF-1.
This may cause the cancer cells to get less signals to grow and divide.
Additionally, ketone bodies have been shown to inhibit the growth of cancerous cells in culture (1).
It is an interesting concept and ketogenic diets are currently being studied as potential treatments for cancer alongside other conventional treatments.
Current Research on Low-Carb, Ketogenic Diets and Cancer
There was a pilot study in 10 advanced cancer patients published last October. The patients did a very low-carb, ketogenic diet for 28 days.
According to a PET scan, 4 of the patients continued to have progressive disease, while 5 remained stable and 1 had a partial remission.
The patients who had the best metabolic response to the diet (that is, lowest insulin and highest ketone levels) saw the most improvement (2 – .pdf).
A Case Report of Two Girls With Brain Cancer
In 1995, a case report of two girls with brain cancer was published.
After 7 days on a ketogenic diet, blood glucose levels decreased and glucose uptake at tumor site decreased by 21,8%.
One of the girls had significant improvement in symptoms and her disease did not progress for the next 12 months (3).
Quality of Life in Cancer Patients
In a pilot trial of 16 advanced-stage cancer patients, a ketogenic diet did improve quality of life and stopped the progression of cancer for the 5 patients who completed the 12 week study (4).
What About Prevention?
Many types of cancer are associated with other diseases of civilization like obesity and diabetes.
Given that low-carb diets can in many cases drastically improve and even cure some of these diseases, it doesn’t take a big stretch of the imagination to see how this diet may reduce chances of developing cancer later in life.
Elevated blood sugar and insulin levels, high circulating IGF-1, these are all risk factors for cancer and are all improved on a low-carb, ketogenic diet.
This Needs a Lot More Research
Cancer is a nasty bitch. You can cut it away, radiate it and overload it with poison, but somehow it often still manages to survive and spread.
Ketogenic diets may turn out to be a useful weapon in the arsenal against this foul disease, but it is definitely premature to make any recommendations based on current research.
Hi Kris, great article. I’ve been doing a ketogenic diet for a while now. I’ve lost plenty of weight and feel great actually. Had no idea that it could have an effect on cancer, that is a very welcome surprise.
If most cancer cells rely solely on glucose for fuel does that mean they don’t contain mitochondria?
I believe they do contain mitochondria, but in those cases are not using them for some reason.
I don’t really know much about cancer, if you ask this guy here then I’m sure he can give you a more satisfactory answer: http://rdfeinman.wordpress.com/
Cancer cells cannot use ketones for energy, but when they run out of glucose they just switch over to using latic acid in the blood for energy but at a much slower growth rate than with glucose, but the liver will turn protein into sugar for the cancer cells.
Nice huh, but that can be defeated also by sweeping the blood of the vast majority of sugar by the use of diabetic drugs. But there’s one last step in killing the cancer… it’s desperate by now… you have to fool it into accepting a sugar analog (substitute). NOW you’ve killed it.
Read the book, “How to stop cancer” you will be amazed.
You are correct, but they don’t need one, they just switch over to lactic acid for energy UNLESS you alter the pH of your blood and most people don’t.
It can be done with simple bicarbonate of soda… that will neutralize the lactic acid in the blood.
The cure has 5 stages, 1) less than 20 carbs per day, 2) proper amount of protein (a must) and fat, 3) changing the pH of the blood, 4) diabetic drugs to lower insulin to very low levels, and 5) a sugar analog to trick the cancer. Read the book “How to cure cancer.”
Hi Norm:
Can you provide a link to the book “How to cure cancer”?
Also — how do you come by all your knowledge on this subject? Are you a biochem major or MD or such?
Regards,
-SB
Hi Kris.
I have been an avid reader of your wonderfully informative site for a few months now. My question is I want to use a ketogenic diet (I know nothing has yet been proven) as a possible therapy for cancer and wonder how you can do it without losing weight. I have been to Dr Feinman’s site but have found nothing on maintaining weight. Any ideas would be appreciated.
Thank you.
I’m not quite sure it’s possible. In one of the cancer studies they deliberately tried to overfeed the people so they wouldn’t lose weight and it didn’t work.
Perhaps you could do it if you ate a lot of extremely high fat foods and use high-fat dairy products and other oils to add fat to your diet while keeping carbs extremely low and protein moderate. Drinking heavy cream might work to increase total calories.
Won’t work… the liver will start breaking down muscle protein to maintain a balanced blood sugar level. Oh, and the liver can also break down fats to try and maintain blood sugar levels, BUT at a very small rate not worth mentioning.
Hey Kris,
Thanks for posting this article.
This is amazing stuff. Since reading this I’ve been reading non-stop about metabolic therapy.
Yet another reason to go High-fat, low-Carb.
Happy New Years,
-Kelly
Kris,
Please correct what you wrote: “In a pilot trial of 16 advanced-stage cancer patients, a ketogenic diet did improve quality of life for those patients who managed to stick with the diet for 8 weeks.
However, only 5 of 16 managed to stick to it and the diet did not slow the progression of their disease (4).”
The fact is that 5 of the 16 patients had stable disease through the 12 weeks. The results section of the publishing was poorly worded. See table 4 and the paragraph that refers to it. The reality of this study is that basically 5 of the 10 people that followed the diet beyond a few weeks did well (stable disease). This, coupled with the results for the young girl with brain cancer, and the RECHARGE trial with Dr. Eugene Fine, show a lot of promise for the ketogenic diet to help treat cancer. There are several other ketogenic diet for cancer trials ongoing in the U.S. and abroad. Happy New Year!
You are absolutely right. I have made the correction, thanks for pointing it out.
You’re welcome, Kris.
I really hope that they are onto something with this ketogenic diet for cancer patients.
I got an interesting book today. About healing properties of buckwheat. I also learned that it is actually a fruit seed that is related to rhubarb and sorrel making it a suitable substitute for grains for people who are sensitive to wheat or other grains that contain gluten. Which means that it is ok to eat it, as it is not a wheat actually… Why I wanted to mention buckwheat at the first place was the fact that it is been said to fight cancer. There is plenty of information about it, if You find it interesting. I just thought I’d write something here about it.
Kris,
Thank you for this well written, well sourced report that summarizes reporting on the Ketogenic Diet. As resourceful as metastatic cancer cells normally are, I have to wonder if, over time, they wouldn’t time, they wouldn’t find a way around the ketogenic obstacle as well. Do you know of any long-term (several years) studies with metastatic patients… or of any 5-year follow-ups with patients who remained on the diet?
Hello CJ.
Unfortunately, studies on ketogenic diets and cancer are scarce. Just a few small, albeit highly promising, studies.
Hopefully we will see some more studies with a greater number of participants in the next few years.
Hi Kris:
You said this: “Quality of Life in Cancer Patients
In a pilot trial of 16 advanced-stage cancer patients, a ketogenic diet did improve quality of life and stopped the progression of cancer for the 5 patients who completed the 12 week study (4).”
I read the study and I do not see any statement that the ketogenic diet “stopped the progression of cancer for the 5 patients who completed the 12 week study”. How did you come to that conclusion?
I read the full text of the article and Jake’s comment — the report does state those 5 patients “were in stable disease” at completion — so disregard my question :)
This is the only sensible article I’ve found on this subject. The theory that a ketogenic diet “starves cancer cells” is physiologic nonsense. No diet alters blood glucose concentration, which is carefully controlled unless you have diabetes or a pancreatic B-cell tumor. If this diet works it is because ketones are directly toxic to cancer cells, or possibly because insulin production decreases, as this article suggests.
Where can one find the randomized, controlled, blinded trials, or even some reliable clinical data?
Another possibility for effectiveness is that although the blood sugar levels don’t change radically, the amount of insulin production is so reduced that the transport of that blood sugar is greatly impeded, so the flow of sugar into cells is vastly reduced. I don’t know this for a fact, but it is a possible model.
Or perhaps there are other effects that impede tumor cells not well understood at this time.
Again I didn’t read carefully — Ricker mentioned reduced insulin. My apologies.