Disclaimer: This article presents emerging research and is not to be considered medical advice. Please consult with an oncologist about the best treatment plan for you.
Cancer research races on. The focus however, has recently switched from genetics and molecular biology to metabolism and biochemistry.
Let’s go back to the 1920’s, before gene-centered approaches to cancer came into the spotlight. Studies on lab rats indicated that cancer cells were primarily fueled by glucose. Previously, scientists believed that oxygen was the main fuel for cancer cells. Not only were these rat tumors feeding off of massive amounts of glucose, but they were able to do it with or without oxygen. The cancer cells relied primarily on the metabolism of glucose even when oxygen was available. This discovery is now known as the Warburg effect.
It is estimated that 80% of cancer follow this Warburg effect and thrive off of glucose. This is why PET scans (positron emission tomography scans) are used as a diagnosis tool for many cancers. Health care professionals are able to diagnose and even stage cancer based off of PET scans that illuminate areas where the body is consuming excess glucose.
Where are we now?
Genetics and molecular biology were the main focus of cancer research for much of the 20th century. Identifying the genomes for cancer, although informational, doesn’t really provide much in the realm of treatment or curing cancer. Recently, the idea that metabolism and biochemistry of cancer should be the focus of cancer research has resurfaced. In fact certain nutritional practices, or lack thereof, are linked to certain cancers. For example, eating a diet heavy in processed meats and low in fiber is linked to colorectal cancer.
A building body of evidence is indicating that carbohydrate restriction can be a viable treatment for certain cancers. Restricting carbohydrates can slow or stop tumor growth, enhancing the treatment for cancer patients and even extending their survival. Benefits for the treatment of cancer are shown when carbohydrates are restricted to 20% of total calories or less. Most of the research is using the ketogenic diet, which restricts carbohydrates to 10% or less of total calories. More research is needed on if carbohydrate restricted diets with also work for cancer prevention.
So far, the scientific data has not shown any negative effects for a low carbohydrate diet for cancer treatment as long as the individual consumes adequate calories. When an individual has cancer, their metabolism is in overdrive and requires more caloric intake than under normal conditions. With appropriate calorie intake cancer patients can preserve their muscle mass and avoid the common complication of cancer cachexia, which is a wasting syndrome that eats away at lean mass. There is a need for additional research on possible adverse side effects to make more solid conclusions.
The Ketogenic Diet
The ketogenic diet is a low carbohydrate, adequate protein and high fat diet. The extreme carbohydrate restriction, usually less than 50 grams of carbohydrates a day, put the body into ketosis. Ketosis is a metabolic state that results from using fat as a primary fuel source. Ketones are a byproduct of the metabolism of fat. Research indicates that cancerous cells cannot metabolize ketone bodies. In the simplest terms, the theory is that when the ketogenic diet is used as a treatment for certain cancers- including brain, colon, gastric, lung, neuroblastoma, pancreatic and prostate cancers- it inhibits the growth of tumor cells through starving the cancer cells.
Two young girls, ages 3 and 8, with non-resectable brain tumors were being treated at the University Hospitals of Cleveland in 2013. Since the tumors were both inoperable, they decided to pursue nutritional treatment interventions and began the ketogenic diet protocol. Within a week, there was a 22% average decrease in the glucose uptake of the tumors. One of the young patients was even able to learn a new skill which is a huge milestone in combatting a brain tumor at such a young age. This same young girl was able to stop the progression of her brain tumor for 12 months on the ketogenic diet. No follow up has been done since that one year mark. These two case studies are an example of many that demonstrate the possible clinical application of the ketogenic diet for slowing or stopping tumor growth for certain cancers and the value of exploring with further research.
This may sound like a cancer treatment miracle, but there are a few considerations to take into account. A ketogenic diet can be challenging to maintain and sometimes hard for people to tolerate. A low carbohydrate diet approach may be something to consider because it can beneficial without having to severely restrict carbohydrates to maintain ketosis. Another concern about this approach to cancer treatment is that nutrients consumed may be inadequate since fruits, vegetables and legumes will have to be limited to keep carbohydrate consumption down. Supplementation might be necessary to make sure individuals get all the vitamins and minerals they need. Anyone considering adapting this diet for cancer treatment should talk to their oncologist and other members of their health care team first.
Food For Thought
The promising future for cancer prevention and treatment involves nutrition as a powerful tool. The Western lifestyle is typically mostly sedentary with a high carbohydrate diet, of well above 50% carbohydrates. If most Americans aren’t moving, whey do they need high carbohydrate diets?
Carbohydrates are extremely important in the world of sports nutrition for active individuals, and some elite athletes eat very high carbohydrate diets because they need the fuel. But for the average American, we see an emerging trend of an overfed, undernourished diet and inactive lifestyle. This lifestyle profile contributes to chronic diseases, like diabetes and heart disease, and even cancer.
Traditional cancer treatments like chemotherapy and radiation take a serious toll on the body. These new alternative methods are hopeful compared to the effects of traditional cancer treatments. Major pharmaceutical companies are even researching ways for medicine to interfere with cancer metabolism. These medicines could be far less harmful to the body. More research is needed on treating cancer through nutrition and metabolism based therapies. New promising research is underway, and hopefully this biochemistry breakthrough can be the secret to slowing cancerous cell growth, stopping cancerous cell growth and even curing cancer.
Brooke West is the Registered Dietician at SFLTHQ, she is the brains behind our nutrition program, and the yin to our yang. Follow her on IG @brookewestrdn to keep up with her adventures in finding the best performance foods for our athletes.