Water-only fasting and an exclusively plant foods diet in the management of stage IIIa, low-grade follicular lymphoma

Goldhamer, Alan; Klaper, Michael; Foorohar, Afsoon; Myers, Toshia R.

doi:10.1136/bcr-2015-211582

Cited by 11 publications

(7 citation statements)

References 32 publications

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“…Moreover, intentional weight loss could be perceived as advantageous in cancer patients given that it indicates maximal metabolic pressure being exerted upon cancer cells. In accordance with this possibility, preliminary reports of fasting and ketogenic diet strategies in patients with advanced tumours, including GBM, have shown that weight loss in the range of 13-28% can be associated with highly positive therapeutic outcomes [31][32][33][34].…”

Section: Discussionmentioning

confidence: 77%

Feasibility and Safety of a Combined Metabolic Strategy in Glioblastoma Multiforme: A Prospective Case Series

Phillips

Leyden

McManus

et al. 2022

Journal of Oncology

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Background. Glioblastoma multiforme (GBM) may be susceptible to metabolic strategies such as fasting and ketogenic diets, which lower blood glucose and elevate ketones. Combining these two strategies may be an ideal approach for sustaining a potentially therapeutic glucose ketone index (GKI). In this prospective case series, we observed whether a combined metabolic strategy was feasible, safe, and capable of sustaining a GKI <6 in patients with GBM. Methods. We provided recommendations and guidelines to 10 GBM patients at various stages of tumour progression and treatment that enabled them to complete a 5–7-day fast every 1–2 months combined with a modified ketogenic diet during the intervening weeks. Patients monitored their blood glucose and ketone levels and body weight. Adverse effects were assessed. Results. Patients completed a mean of 161 ± 74 days of the combined metabolic strategy, with 34 ± 18 (21%) days of prolonged fasting (mean fast duration: 6.0 ± 1.4 days) and 127 ± 59 (79%) days on the ketogenic diet. The mean GKI for all 10 patients was 3.22 (1.28 during the fasts, 5.10 during the ketogenic diet). Body weight decreased by 8.4 ± 6.9 kg (11.2% decrease in baseline weight). The most common adverse effects attributed to the fasts and ketogenic diet were fatigue, irritability, and feeling lightheaded. The metabolic strategy did not interfere with standard oncological treatments. Conclusion. This is the first study to observe the feasibility and safety of repeated, prolonged fasting combined with a modified ketogenic diet in patients with GBM. Using minimal support, patients maintained the combined metabolic strategy for 5–6 months while sustaining a potentially therapeutic mean GKI of 3.22. Weight loss was considerable. Adverse effects attributed to the metabolic strategy were mild, and it did not interfere with standard oncological treatments. Study Registration: This study is registered on the Australia New Zealand Clinical Trials Registry, number ACTRN12620001310954. The study was registered on 4 December 2020.

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Section: Discussionmentioning

confidence: 77%

Feasibility and Safety of a Combined Metabolic Strategy in Glioblastoma Multiforme: A Prospective Case Series

Phillips

Leyden

McManus

et al. 2022

Journal of Oncology

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“…Moreover, when correctly executed, fasting and ketogenic diet protocols can comfortably meet a patient's nutritional needs while exerting a sparing effect on lean mass (38), with some studies indicating that ketogenic diets induce weight gain in cancer patients with cachexia (39). Furthermore, several case reports involving KMT have shown that significant intentional weight loss (up to 28% of initial body weight) can be associated with positive outcomes in patients with GBM and other advanced cancers (31,32,40,41). We cannot draw firm conclusions with respect to the mechanism of KMT in our patient, or its impact on her long-term survival.…”

Section: Discussionmentioning

confidence: 99%

Ketogenic metabolic therapy in conjunction with standard treatment for glioblastoma: A case report

Phillips,

Thotathil,

Hari Dass

et al. 2024

Oncol Lett

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Glioblastoma (GBM) is the most common primary malignant brain tumour in adults. The standard of care consists of surgical resection and concurrent chemoradiation, followed by adjuvant temozolomide chemotherapy. This protocol is associated with a median survival of 12-15 months, and <5% of patients survive >3 years. Ketogenic metabolic therapy (KMT) targets cancer cell metabolism by restricting glucose availability and evoking differential stress resistance and sensitization, which may augment the standard treatments and lead to therapeutic benefit. The present study reports the case of a 64-year-old woman with isocitrate dehydrogenase (IDH)-wildtype GBM who pursued the standard treatment protocol in conjunction with an intensive, multimodal KMT program for 3 years. The KMT program consisted of a series of prolonged (7-day, fluid-only) fasts, which were specifically timed to maximize the tolerability and efficacy of the standard treatments, combined with a time-restricted ketogenic diet on all other days. During the first and second treatment years the patient sustained a glucose ketone index (GKI) of 1.65 and 2.02, respectively, which coincided with complete clinical improvement, a healthy body-mass index and a high quality of life, with no visible progressive tumour detected on imaging at the end of the second year. In the setting of the death of an immediate family member leading to increased life stress, slightly relaxed KMT adherence, and a higher GKI of 3.20, slow cancer progression occurred during the third year. The adverse effects attributed to KMT were mild. Despite the limitations of this case report, it highlights the feasibility of implementing the standard treatment protocol for GBM in conjunction with an intensive, long-term, multimodal and specifically timed KMT program, the potential therapeutic efficacy of which may depend upon achieving as low a GKI as possible.

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“…Notably, although most of these studies involved prolonged fasts, the fasts were still relatively short (the study with the longest fasts averaged roughly 90 hours per fast) [ 110 ]. Longer fasts in cancer patients are rare, although there have been two case reports of patients with advanced cancer undergoing fasts of 7-21 days in duration, both of whom showed long-term (and ongoing) tumour regression and survival in the absence of any standard cancer treatments [ 112 , 113 ].…”

Section: Metabolic Strategies: Restoring Mitochondria Functionmentioning

confidence: 99%

Metabolic Strategies in Healthcare: A New Era

Phillips

2022

Aging Dis

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Modern healthcare systems are founded on a disease-centric paradigm, which has conferred many notable successes against infectious disorders in the past. However, today’s leading causes of death are dominated by non-infectious “lifestyle” disorders, broadly represented by the metabolic syndrome, atherosclerosis, cancer, and neurodegeneration. Our disease-centric paradigm regards these disorders as distinct disease processes, caused and driven by disease targets that must be suppressed or eliminated to clear the disease. By contrast, a health-centric paradigm recognizes the lifestyle disorders as a series of hormonal and metabolic responses to a singular, lifestyle-induced disease of mitochondria dysfunction, a disease target that must be restored to improve health, which may be defined as optimized mitochondria function. Seen from a health-centric perspective, most drugs target a response rather than the disease, whereas metabolic strategies, such as fasting and carbohydrate-restricted diets, aim to restore mitochondria function, mitigating the impetus that underlies and drives the lifestyle disorders. Substantial human evidence indicates either strategy can effectively mitigate the metabolic syndrome. Preliminary evidence also indicates potential benefits in atherosclerosis, cancer, and neurodegeneration. Given the existing evidence, integrating metabolic strategies into modern healthcare systems should be identified as a global health priority.

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Water-only fasting and an exclusively plant foods diet in the management of stage IIIa, low-grade follicular lymphoma

Cited by 11 publications

References 32 publications

Feasibility and Safety of a Combined Metabolic Strategy in Glioblastoma Multiforme: A Prospective Case Series

Feasibility and Safety of a Combined Metabolic Strategy in Glioblastoma Multiforme: A Prospective Case Series

Ketogenic metabolic therapy in conjunction with standard treatment for glioblastoma: A case report

Metabolic Strategies in Healthcare: A New Era

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