Treatment of Rectal Cancer with the Paleolithic Ketogenic Diet: A 24-months Follow-up

Csaba Tóth¹ and Zsófia Clemens^1,

¹Paleomedicina Hungary Ltd, Evolutionary Medicine Working Group, Budapest, Budapest, Hungary

Cite this paper:
Csaba Tóth and Zsófia Clemens. Treatment of Rectal Cancer with the Paleolithic Ketogenic Diet: A 24-months Follow-up. American Journal of Medical Case Reports. 2017; 5(8):205-216. doi: 10.12691/ajmcr-5-8-3

Abstract

Background: Ketogenic diets have repeatedly been suggested for the treatment of cancer. Yet, only a few case studies have been published that reported long term benefits associated with such diets. Case report: Here we present a case where rectal cancer was treated with an animal fat-meat based diet, which we refer to as the paleolithic ketogenic diet. Upon diet initiation, the patient discontinued three medicines he had been taking because of hypertension and hyperuricemia. The patient initially received 6 weeks of radiation therapy. Thereafter the patient used the diet as a stand-alone therapy for 22.5 months. The patient was not taking any medicines or dietary supplements while on the diet. During the first five month of the diet therapy the patient exhibited excellent adherence which was paralleled by improving laboratory parameters including decreasing tumor marker levels and decreasing tumor size. The patient was in a constant ketosis during the entire follow-up. From the seventh month on, however, his adherence level was fluctuating with periods of worse adherence paralleled with negative changes in laboratory parameters. Although MRI imaging showed that there was no increase in the size of the tumor, 22 months after diagnosis onset the patient reported an alteration in bowel habits and that the bloody stool had returned. Because of the emergence of these symptoms, 24 months after diagnosis onset, rectal surgery was performed. Conclusion: With using the paleolithic ketogenic diet the patient was able to postpone surgery for two years. During the first five months, when the patient was strictly adhering to the diet, the tumor regressed. Thereafter, with incomplete dietary adherence, disease seemed to be stable but symptoms suggested progression for the last few months of the follow-up. Deviations from diet rules, even those not affecting ketosis, resulted in the progression of the disease.

Keywords:
rectal tumor colorectal cancer paleolithic diet ketogenic diet paleolithic ketogenic diet metabolic therapy

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References:

[1]	Westman EC, Feinman RD, Mavropoulos JC et al. Low-carbohydrate nutrition and metabolism. Am J Clin Nutr, 2007; 86: 276-84.
[2]	Pérez-Guisado J. Arguments In Favor Of Ketogenic Diets. The Internet Journal of Nutrition and Wellness, 2007; 4: 2.
[3]	Kossoff EH. More fat and fewer seizures: dietary therapies for epilepsy. Lancet Neurol, 2004; 3: 415-20.
[4]	Ely JTA. Glycemic modulation of tumor tolerance. J Orthomolecular Med, 1996; 11: 23-34.
[5]	Klement RJ, Kämmerer U. Is there a role for carbohydrate restriction in the treatment and prevention of cancer? Nutr Metab (Lond), 2011; 8: 75.
[6]	Seyfried TN. Cancer as a Metabolic Disease: On the Origin, Management, and Prevention of Cancer. Hoboken, New Jersey, Wiley 2012.
[7]	Nebeling LC, Miraldi F, Shurin SB et al. Effects of a ketogenic diet on tumor metabolism and nutritional status in pediatric oncology patients: two case reports. J Am Coll Nutr, 1995; 14: 202-8.
[8]	Zuccoli G, Marcello N, Pisanello A et al. Metabolic management of glioblastoma multiforme using standard therapy together with a restricted ketogenic diet: Case Report. Nutr Metab (Lond), 2010; 22, 7: 33.
[9]	Schmidt M, Pfetzer N, Schwab M et al. Effects of a ketogenic diet on the quality of life in 16 patients with advanced cancer: A pilot trial. Nutr Metab (Lond), 2011; 8: 54.
[10]	Fine EJ, Segal-Isaacson CJ, Feinman RD et al. Targeting insulin inhibition as a metabolic therapy in advanced cancer: a pilot safety and feasibility dietary trial in 10 patients. Nutrition, 2010; 28: 1028-35.
[11]	Klement RJ, Sweeney RA. Impact of a ketogenic diet intervention during radiotherapy on body composition: I. Initial clinical experience with six prospectively studied patients. BMC Res Notes, 2016; 9: 143.
[12]	Rieger J, Bähr O, Maurer GD et al. ERGO: a pilot study of ketogenic diet in recurrent glioblastoma. Int J Oncol, 2014; 44: 1843-52.
[13]	Champ CE, Palmer JD, Volek JS et al. Targeting metabolism with a ketogenic diet during the treatment of glioblastoma multiforme. J Neurooncol, 2014; 117: 125-31.
[14]	Fine EJ, Segal-Isaacson CJ, Feinman RD et al. Carbohydrate restriction in patients with advanced cancer: a protocol to assess safety and feasibility with an accompanying hypothesis. Community Oncology January 2008.
[15]	Manheimer EW, van Zuuren EJ, Fedorowicz Z, Pijl H. Paleolithic nutrition for metabolic syndrome: systematic review and meta-analysis. Am J Clin Nutr, 2015; 102: 922-32.
[16]	Voegtlin WL. The stone age diet: based on in-depth studies of human ecology and the diet of man. New York: Vantage Press; 1975.
[17]	Cordain L. The paleo diet: lose weight and get healthy by eating the food you were designed to eat. New York: Wiley; 2002.
[18]	Tóth C, Clemens Z. Type 1 diabetes mellitus successfully managed with the paleolithic ketogenic diet. Int J Case Rep Images, 2014; 5: 699-703.
[19]	Tóth C, Clemens Z. A child with type 1 diabetes mellitus (T1DM) successfully treated with the Paleolithic ketogenic diet: A 19-month insulin freedom. Int J Case Rep Images, 2015; 6: 752-757.
[20]	Tóth C, Clemens Z. Successful treatment of a patient with obesity, type 2 diabetes and hypertension with the paleolithic ketogenic diet. Int J Case Rep Images, 2015; 6: 161-167.
[21]	Clemens Z, Kelemen A, Fogarasi A. et al. Childhood absence epilepsy successfully treated with the paleolithic ketogenic diet. Neurol Ther, 2013; 2: 71-6.
[22]	Clemens, Z, Kelemen, A, Tóth, C. NREM-sleep Associated Epileptiform Discharges Disappeared Following a Shift toward the Paleolithic Ketogenic Diet in a Child with Extensive Cortical Malformation. Am J Med Case Rep, 2015; 3: 212-215.
[23]	Tóth C, Clemens Z. Gilbert’s syndrome successfully treated with the paleolithic ketogenic diet. Am J Med Case Rep, 2015; 3: 117-120.
[24]	Tóth C, Dabóczi A, Howard M et al. Crohn’s disease successfully treated with the paleolithic ketogenic diet. Int J Case Rep Images, 2016; 7: 570-578.
[25]	Tóth C, Clemens Z. Halted progression of soft palate cancer in a patient treated with the paleolithic ketogenic diet alone: A 20-months Follow-up. Am J Med Case Rep, 2016; 4: 288-292.
[26]	Chadwick VS, Phillips SF, Hofmann AF. Measurements of intestinal permeability using low molecular weight polyethylene glycols (PEG 400). I. Chemical analysis and biological properties of PEG 400. Gastroenterology, 1977; 73: 241-6.
[27]	Glimelius B. Neo-adjuvant radiotherapy in rectal cancer. World J Gastroenterol, 2013; 19: 8489-8501.
[28]	Marijnen CA, Nagtegaal ID, Kapiteijn E et al. Cooperative investigators of the Dutch Colerectal Cancer Group. Radiotherapy does not compensate for positive resection margins in rectal cancer patients: report of a multicenter randomized trial. Int J Radiat Oncol Biol Phys, 2003; 55: 1311-20.
[29]	Kossoff EH. International consensus statement on clinical implementation of the ketogenic diet: agreement, flexibility, and controversy. Epilepsia, 2008; 49 Suppl 8: 11-3.
[30]	Seyfried TN. Case Studies and Personal Experiences in Using the Ketogenic Diet for Cancer Management, in Cancer as a Metabolic Disease: On the Origin, Management and Prevention of Cancer, John Wiley & Sons, Inc., Hoboken, NJ, USA. 2012.
[31]	Wessling-Resnick M. Iron Homeostasis and the Inflammatory Response. Annual review of nutrition. 2010; 30: 105-122.
[32]	Toiyama Y, Inoue Y, Saigusa S, Kawamura M, Kawamoto A, Okugawa Y, Hiro J, Tanaka K, Mohri Y, Kusunoki M. C-reactive protein as predictor of recurrence in patients with rectal cancer undergoing chemoradiotherapy followed by surgery. Anticancer Res. 2013; Nov; 33(11): 5065-74.
[33]	Hamilton W, Lancashire R, Sharp D, Peters TJ, Cheng KK, Marshall T. The importance of anaemia in diagnosing colorectal cancer: a case–control study using electronic primary care records. British Journal of Cancer. 2008; 98(2): 323-327.
[34]	Warburg O. “On the Origin of Cancer Cells”. Science, 1956; 123: 309-14.
[35]	Soler AP, Miller RD, Laughlin KV et al. Increased tight junctional permeability is associated with the development of colon cancer. Carcinogenesis, 1999; 20: 1425-31.
[36]	Lin JE, Snook AE, Li P et al. GUCY2C Opposes Systemic Genotoxic Tumorigenesis by Regulating AKT-Dependent Intestinal Barrier Integrity. PLoS ONE, 2012; 7: 2, e31686.
[37]	SEER Stat Fact Sheets: Colon and Rectum Cancer. http://seer.cancer.gov/statfacts/html/colorect.html (Retrieved 13 June 2016).