ketogenic Diet and Glioblastoma

31 May 2020 0 By Roberto Pugliese

I asked myself many times if the diet that followed Emanuele was of any help or not for his specific case. In fact he gave up many things he liked in the hope that this helped to heal. This doubt remains and I decided to go deeper into the topic now that my emotional situation allows.

Of course it seems reasonable to try to leave the tumor free of substances that help its grow, but the human body is so complex that what seems reasonable may actually not work. I remember talking to different doctors with very different opinions on the subject.

I started research on the subject and found this article published in 2018 in the journal Frontiers of Nutrition very interesting. The article describes the case of a 38-year-old man who has chronic headache, nausea and vomiting accompanied by motor seizures on the left side of the body and weakness of the upper left arm. MRI of the brain revealed a solid lesion in the right partial space suggesting a possible glioblastoma. Serological tests revealed a deficiency of vitamin D and elevated insulin and triglyceride levels. Before subtotal tumor resection and standard of care treatment protocol, the patient underwent a 72-hour water only diet. Afterwards the patient started a ketogenic diet enriched with vitamins and minerals for 21 days with a 900 kcal / day regimen. In addition to radiotherapy, chemotherapy with temozolomide and the ketogenic diet a regimen of 1,500 kcal / day from day 22, the patient received metformin (1,000 mg / day), methylfolate (1,000 mg / day), chloroquine phosphate (150 mg / day), epigallocatechin gallate (400 mg / day) and hyperbaric oxygen therapy (60 min / session, 5 sessions / week at 2.5 ATA). The patient also took levetiracetam (1,500 mg / day) for epileptic seizures. However, the patient did not take any steroid drugs. Post-surgical histology confirmed the diagnosis of glioblastoma. Reduced invasion of tumor cells and thick-walled hyalinized blood vessels were also seen suggesting a therapeutic benefit of pre-surgical metabolic therapy. After 9 months of standard treatment and complementary ketogenic metabolic therapy, the patient’s body weight was reduced by approximately 19%. Seizures and weakness in the left area have resolved. The biomarkers showed a decrease in blood sugar and high levels of urinary ketones with evidence of reduced metabolic activity (choline / N-acetylaspartate ratio) and normalized levels of insulin, triglycerides and vitamin D.

Rapid regression of a glioblastoma is rare after subtotal resection and standard treatment, so, it is possible that the response observed in this case resulted in part from the modifications or better of the treatments that have been added to the standard treatment.

Further studies are certainly needed to validate the effectiveness of the ketogenic diet administered together with the other drugs that selectively increase oxidative stress in cancer cells by limiting their access to glucose and glutamine.

The patient treated today remains in excellent health (Karnofsky score, 100%) with continuous evidence of significant tumor regression.

So what about … in this case it seems that the ketogenic diet combined with the standard treatment and with the addition of other drugs that increase the stress of cancer cells has had a positive effect. It probably also depends on the specific case, but by now we have understood that glioblastoma should be treated in all possible ways and even the diet could have its part.