Keto diet may enhance chemotherapy for prostate cancer

Building on the growing body of evidence showing how fasting diets can enhance cancer treatment, a new study has demonstrated ketogenic dieting can significantly improve the effectiveness of chemotherapy for pancreatic cancer. Using mouse models the research found adding a ketogenic diet to chemotherapy tripled median survival time compared to chemotherapy alone.

The new research focused specifically on the effect of a ketogenic diet as an adjunct to current chemotherapy treatment for pancreatic cancer. Joshua Rabinowitz, lead researcher on the project, says pancreatic cancer has a poor long-term survival rate, so discovering any way to even slightly enhance current treatments could be beneficial.

“There’s been real progress against pancreatic cancer over the past two decades,” explained Rabinowitz. “The problem is that, while a number of patients now see their tumors stabilize or shrink, the benefits of chemotherapy are very short-lived. It often extends patients’ lives six months to a year, but way too rarely do we see the three-plus years of extension in survival that people would, at a minimum, hope for.”

A compelling 2018 study found an experimental cancer treatment that was initially ineffective in treating prostate cancer in human trials, unexpectedly became effective when paired with a ketogenic diet. The study was only in mouse models but it promisingly conducted pointed to novel ways a ketogenic diet could influence the efficacy of drug treatments.

“We know that glucose is a major cancer fuel, and insulin is a cancer-promoting hormone, and that the ketogenic diet in one stroke decreases both,” said Rabinowitz. “We found in this study that the diet decreases levels of glucose more profoundly in the tumor than in healthy tissues and that it suppresses levels of insulin.”

Alongside decreasing levels of glucose and insulin, the new study found the ketogenic diet increased the body’s reliance on 3-hydroxybutyrate as an energy source. Rabinowitz says increasing levels of 3-hydroxybutyrate seems to amplify the cancer-killing effect of chemotherapy.

“One thing we noticed is that 3-hydroxybutyrate acts like a supercharged fuel that dumps electrons into cells, and tumor cells are wired for other reasons to be extra-good at taking up this fuel,” he added. “Fortuitously, too much of this super-charged fuel may be toxic to cancer.”

It is important to note the study found the ketogenic diet alone had no effect on the tumor cells. So the diet in and of itself cannot beat cancer. Only when paired with chemotherapy did the researchers see amplified treatment effects.

At this stage the benefits of pairing a keto diet with chemotherapy have only been demonstrated in animal models. However, Rabinowitz says it is exciting to consider the prospect of a simple dietary intervention enhancing the effects of current cancer treatments. A clinical trial testing the addition of keto to prostate cancer chemotherapy is already underway.

“I think that the most exciting thing here is that we can take chemotherapy regimens that we know to be active, that offer patients the best chance in the clinic right now and, at least in mice, make them work substantially better by pairing them with a ketogenic diet,” said Rabinowitz. “We hope that we’ll see the same types of benefits in patients.”

The new study was published in the journal Med.

Source: Princeton University

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