
Fighting cancer by putting tumor cells on a diet - ValentineC
http://www.npr.org/sections/health-shots/2016/03/05/468285545/fighting-cancer-by-putting-tumor-cells-on-a-diet
======
themgt
This is key: _Mayo 's Thompson counters. He points out that data supporting
the ketogenic diet in cancer are limited — and further that rigorous dietary
studies are incredibly hard to pull off. "The drug companies aren't going to
fund these types of trials," he says. "They can't make money marketing a
diet."_

I would highly recommend people do their own research into nutrition and its
relation to health, along with the proven/likely/possible health benefits of
various plants, spices and dietary patterns.

The fact is, our Big Pharma/FDA/IP-driven approach to medicine makes it almost
impossible to test and profit off something like garlic, or a low glycemic
index diet or intermittent fasting or turmeric or fruit and fiber or
astragalus, etc.

The necessary research is just not occurring, because corporate/govt $ are
poured into finding synthetic, patentable compounds to target specific
problems after they occur.

General lifestyle/nutrition advice to prevent/mitigate a huge spectrum of
issues that occur as we age? Ain't no money in that science.

Blatantly obvious how the same thing occurs w/ psychotropic compounds, with
millions being poured into synthetic cannabinoids, opiates, serotonergics,
etc. almost all of which are medically inferior to and more dangerous than the
natural compounds they mimic. The system is not designed around efficacy, but
patentability.

~~~
jszymborski
>The fact is, our Big Pharma/FDA/IP-driven approach to medicine makes it
almost impossible to test and profit off something like garlic, or a low
glycemic index diet or intermittent fasting or turmeric or fruit and fiber or
astragalus, etc.

That's patently false. The vast majority of cancer funding does not come from
industry or private interests, but from government or non-profit sources.

If I can convince my PI that garlic or a low glycemic index diet can improve
survival outcomes in an inducible cancer mouse model, then I'd be grinding
garlic and putting mice on starvation diets for the next 2 years.

~~~
refurb
You're both wrong.

Most drugs comes from private companies, not public institutions. It's about a
2/3 private and 1/3 public split. Note, that's discovery, not development.
Private companies almost exclusively bring discoveries to market.

Second, yes, if garlic cured cancer drug companies could make money off of it.
Isolate the active compounds, optimize it for efficacy and patent it. Kind of
what they've already done for antibiotics, antifungals, anticholesterols and
anticancer drugs. It's nothing new.

~~~
jszymborski
Public institutions wouldn't necessarily find a druggable small molecule, but
every last step up until that point is almost assuredly being funded by the
public. That'd include verifying that diets rich in garlic or what have you
have an affect on overall survival.

My point still stands, private funding is not the bottle-neck. If garlic or
low glycemic index diets actually made a difference in overall survival, it
would mostly likely be discovered in a publicly funded institution. A private
institution would then jump on the opportunity to "discover" and develop a
small molecule that is suitable for drugging and IP'ing based on the findings
of the public lab.

~~~
chii
What if the effects are not based on one active compound, but on a complex mix
which could be rather chaotic, but an experienced practitioner could devise a
treatment, but a drug company can't easily pinpoint a one size fits all
formulae?

~~~
jszymborski
It's inconceivable that an "experience practitioner" can devise a treatment a
drug company can't manufacture, but you are correct that the economics of
personlised medicines aren't financially viable for drug companies.

I don't think there is a simple solution for that, but I can tell you is that
these economics still won't prevent the discovery of such treatments. Some
initial proof of this is the fact that the scientific community has embraced
the concept that cancer is extremely heterogenous and will require a unique
treatment for each individual patient (which has generated the "personalised
medicine" buzzword).

------
tominous
One symptom of cancer, especially late-stage cancer, is cachexia: unintended
weight loss. It is associated with a higher risk of death and lower quality of
life. [1]

In addition, cancer treatments like surgery, chemotherapy and radiation affect
the sense of taste, appetite and metabolism and make it difficult to get
normal nutrition in the first place.

So you can see why clinical oncologists and patients might be wary of
restrictive diets or fasting. In fact many offical guidelines suggest adding
sugar, frying foods, eating more dairy, etc to boost nutritional intake.

Psychologically, even if a patient is overweight they may fear a drop in
weight as a sign that the cancer is progressing. (An ex-colleague was very
obese and lost 60kg before/after being diagnosed with kidney cancer).

A patient may also want to enjoy their remaining time. Food has a huge
intrinsic pleasure and is very important socially.

I'm not saying this is an unworthy line of research but they will need good
evidence or specific, easy interventions to convince people to change their
diet. For example, drugs like metformin or rMETase may be easier than explicit
restrictions.

[1]
[https://en.wikipedia.org/wiki/Cachexia](https://en.wikipedia.org/wiki/Cachexia)

~~~
atomical
SARMS are going through trials for cachexia in cancer patients.

[https://en.wikipedia.org/wiki/Selective_androgen_receptor_mo...](https://en.wikipedia.org/wiki/Selective_androgen_receptor_modulator)

------
kumarski
I think diet experimentation and food avoidance have the capability to be the
next big advanced immunotherapy or combined therapy supplement.

To usher in an age of 10 billion dollar companies we need predictive validity
and models. The ships are fast but the compasses are off.

The gut and controlling it/experimenting with it are the next big leap for
biopharmacetuical development.

The way to get there is to enforce patient adherence to specific ingredient
controlled diets.The only way to do that is control and know the environment
of ingredients.

Check out this company that takes tumor biopsies and uses M3 polypeptide count
to figure out what not to consume.
[http://www.immunodiet.com](http://www.immunodiet.com)

Food avoidance unfortunately isn't something you can commercialize, at least
not easily, specifically for patient treatment. There's also no way to push it
through a clinical trial/ there's no such thing as an FDA approved diet.

Check out this diet: [http://bit.ly/fodmapfree](http://bit.ly/fodmapfree) that
has been shown to reduce the effects of Irritable Bowel Syndrome. Probably
extremely effective but difficult to get FDA approved.

------
sleavey
I'm pretty new to the metabolic theory of cancer, but I summarise below what I
think the main point of the article is:

There is debate between two schools of thought. On one side, Vander Heiden
suggests that tumours must be attacked not only in the mitochondrial level
(where the ketogenic diet has been suggested as part of a metabolic-based
treatment) but also in the cell replication that we traditionally associate
cancer with - where chemotherapy helps. He also blames genetic factors, i.e.
we can still "inherit" a high cancer risk.

On the other side, Thomas Seyfried argues it's all ultimately mitochondrial
and can be controlled via diet. The keto diet, and others, lowers the glucose
intake of the body and helps to shut off the fuel supply for tumours. Since he
argues cancer is ultimately a metabolic problem, shutting off the glucose
supply is a possible cure.

Very interesting stuff.

~~~
danieltillett
In cancer is all theories are sometimes right and always wrong in the general.

~~~
vram22
Borat(ism) is alive and well!

[https://mobile.twitter.com/devops_borat](https://mobile.twitter.com/devops_borat)

~~~
danieltillett
I am tempted to edit my post, but I think the mangled grammar is more amusing.

------
reasonattlm
Contrary to one of the quoted researchers, it is perfectly possible to do
rigorous testing of diet as an adjuvant therapy for cancer patients. One team
is doing this for calorie restriction and fasting, and is putting a defined
fasting / fasting mimicking protocol through the FDA process.

[http://www.eurekalert.org/pub_releases/2014-06/uosc-
fts06021...](http://www.eurekalert.org/pub_releases/2014-06/uosc-
fts060214.php)

[http://michelsonmedical.org/2014/12/26/igf-1-fasting-
discuss...](http://michelsonmedical.org/2014/12/26/igf-1-fasting-discussion-
valter-longo/)

[https://news.usc.edu/82959/diet-that-mimics-fasting-
appears-...](https://news.usc.edu/82959/diet-that-mimics-fasting-appears-to-
slow-aging/)

That said, it is quite true that most of what is said and done in connection
with diet is some variety of nonsense, driven by self-interest on the part of
market participants. Cui bono is the watchword. This just makes it more
important to learn how to tell the difference between good research and junk
science, however.

------
mehrzad
Recently beat cancer and I looked into the research on keto and cancer. A
study I looked at said that the keto diet could actually cause tumor cells to
develop other methods of getting energy, causing the cancer to grow more
rapidly. I was too afraid to try.

~~~
salgernon
Can you share anything? Did you change your diet?

I'm currently sitting in a room at Sloan-Kettering dealing with a post-
surgical infection from getting the left side of my liver lopped off. There've
been no dietary restrictions or recommendations other than eat more protein.
Initially I was told to up my vitamin d:

    
    
      http://meetinglibrary.asco.org/content/139861-158
    

And not worry about weight at all.

Its also been expressed to me that for my specific cancer (stage IV colon
cancer with liver metastasis) surgery is the only curative mechanism.

~~~
mehrzad
I'm sorry to hear that. My nurse said to keep up a high fat and high protein
diet for my leukemia, probably to prevent weight loss when I lost my appetite
later. When my immune system weakened, I stopped eating uncooked plant-based
foods. Certain foods have shown to fight tumor cells in vivo like cruciferous
vegetables but nothing is really as good as actual modern treatment.

------
tosseraccount
~ _apparent_ ~ Link to Baker paper mentioned in the NPR story is here (pubmed
links to actual paper) :
[http://www.ncbi.nlm.nih.gov/pubmed/25528755](http://www.ncbi.nlm.nih.gov/pubmed/25528755)
(Journal of the National Cancer Institute)

From the abstract: _The standard viewpoint that cancer is a genetic disease is
often stated as a fact rather than a theory. By not acknowledging that it is a
theory, namely the Somatic Mutation Theory (SMT), researchers are limiting
their progress. An attractive alternative to SMT is the tissue organization
field theory (TOFT), which is summarized as "development gone awry." ...
Thinking in terms of TOFT can spur new lines of research; examples are given
related to the early detection of cancer._

From the discussion : _The premises of TOFT are that carcinogenesis represents
a problem of tissue organization, comparable to organogenesis, and that
proliferation is the default state of all cells (9,10). Three corollaries of
TOFT are: 1) mutations are not needed for carcinogenesis; 2) cancer can arise
in tissue where carcinogen has not been applied; and 3) genetic instability is
a byproduct of carcinogenesis._

------
plainOldText
Here's an interesting podcast episode interviewing a clinical nuclear medicine
professor about ketosis and water fasts as tools to fight some forms of cancer
for anyone wanting to get more information on these topics:
[https://thequantifiedbody.net/quantifying-cancer-gene-
fine/](https://thequantifiedbody.net/quantifying-cancer-gene-fine/)

------
danieltillett
There is some really interesting work in this area. Many cancers are sensitive
to certain amino acid starvation as well and designing diets that drop out
these amino acids can be very useful. It all depends on the genetic background
of the cancer.

If I got cancer I would definitely have the cancer sequenced and go looking in
the data for defects amenable to dietary intervention.

------
davidjnelson
Always good to be vigilant to notice if this is happening in general: "When
people are locked into an ideology created by a dogma they tend not to focus
on rational alternatives." Interesting area to explore would be techniques to
catch yourself if this has happened. Anyone explored this and have tips?

------
fma
My grandmother was diagnosed with cancer and given several months to live. She
being 90, her doctor, family, and herself decided not to do anything about it
and just live out her life. I came across ketogenic diet...but unfortunately
by that time I found out about it, the writing was on the wall (she passed
away 3 weeks later).

If I was in the same position, given the option of doing no chemo and dying;
doing chemo, suffering, then dying; or doing no chemo, going on a diet, and
maybe somehow it works...I know what I would chose.

------
known
Small companies making a big contribution
[http://gelookahead.economist.com/slideshow/start-ups-
fightin...](http://gelookahead.economist.com/slideshow/start-ups-fighting-
cancer/)

------
shermablanca
So all of those knots in my back and side rib muscle - where oxygen is
constricted - will become cancerous?

------
aviv
Forget diet. Go all the way with a proper water fast. Unfortunately if there
was a way to monetize a person not eating for 30 days we would all be hearing
about it. Big Food & Drug companies can't productize fasting so it remains
fringe as possible cure for many ailments.

~~~
mixedCase
If it has any effect it's because it has the same effect a Keto diet has: It
puts your body in ketosis.

Except in the process you're also putting your body through extremely
unnecessary strain.

