Over recent years, more published pre-clinical data and academic reviews of the potential of KDT to influence cancer metabolism have emerged, although evidence that an effect on brain tumour growth can be achieved and sustained in patients is still lacking. Over the past few years there have been several companies that have been developing ketone esters and salts to artificially raise ketone levels in the body. The ketogenic diet KD was established in the s and consists of a high fat content while providing a low carbohydrate content [ 2, 10 ]. More studies need to be performed before the KD can be recommended as a sole therapy for GBM, and using the KD as a therapy should occur only with direct medical supervision. Ivor Cummins and Bjarte Bakke went to a number of fast-food restaurants to find out. Using the KD as a therapeutic approach for malignant brain cancer rests on the assumption that brain tumors do not have the necessary enzymes to oxidize ketones, and are based on successful rodent studies [ 4 ]. The ketogenic diet: one decade later. In addition, it would be best practice to include a registered dietitian nutritionist with the protocol to improve patient outcomes, educate patients on the KD, monitor patient progress, calculate energy needs and help patients overcome potential barriers while following the KD. Ketogenic diets as an adjuvant cancer therapy: history and potential mechanism. And fortunately for us all, she won. The treatment of brain cancers generally involves a multifactorial approach of surgery followed by chemotherapy with or without radiation therapy.
We report the experiences of twenty-five adult brain tumour patients on KDT for months, with access to the services of a dietetic team specialising in KDT for epilepsy management. A survey was conducted to gather information on reasons for pursuing KDT, the practical issues encountered and perceptions of the impact of KDT on tumour related symptoms, gastrointestinal function, weight management and psychosocial aspects of daily life. In both symptomatic and asymptomatic brain tumour patients, support for their choice to pursue KDT was readily reported to underpin their sense of empowerment and control. However, the patient experience would appear to show that refractory seizures and chronic fatigue may be alleviated by KDT. Furthermore, amongst the group, the survey shows KDT to be sustainable and tolerable. It would appear that KDT is worthy of further clinical exploration for its symptom management benefits alone. Primary tumours of the brain and central nervous system CNS are a group of rare, heterogenous diseases, with widely varying outcomes. However, they are the leading cause of cancer death in the unders, and account for the highest average years of life lost, of any tumour type 1,2. Many patients with brain tumours also have significant symptoms impairing their quality of life, including, physical problems weakness, poor co-ordination, functional problems, seizures, fatigue, depression and cognitive impairment 3. These may be due to the disease, its progression, treatment side effects, or a combination of these. The low carbohydrate, high fat, adequate protein ketogenic diet KD is a dietary approach creating significant interest in the brain tumour community 7,8. Used for almost a century as an effective therapy for medically refractory epilepsy, KDT is known to deliver its effect by triggering a cascade of adaptions in cellular metabolism; restricting glycolysis, increasing fatty acid oxidation, increasing ketone synthesis and leading to enhanced mitochondrial respiration 9.
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