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[[File:CancerAwareness.jpg|right|thumb|500px|Cancer is a leading cause of death in the western world, accounting for 1,600 deaths per day in the US alone.]]The [[Ketogenic Diet]] may help with the treatment of cancer, including brain tumors<ref name="Seyfried-2011"/><ref name="Seyfried-2009"/><ref name="Seyfried-2005"/>. Most of the available information comes from animal experiments, backed up with a few human case studies, but things look promising and [http://www.cancer.gov/clinicaltrials/search/view?cdrid=742309&version=HealthProfessional human trials are occurring]. There are even researchers who believe that the origin of cancer lies with metabolic abnormalities that lead to genetic problems rather than the genetic problems being the root cause<ref name="SeyfriedFlores2013"/>. Note that while the [[Ketogenic Diet as a Treatment| Ketogenic Diet may help with a number of diseases]], the [[Health Risks of the Ketogenic Diet| Ketogenic Diet also has some health risks]]. There are no indications that the Ketogenic Diet is a viable alternative to existing, traditional treatments, but it may become an important way of improving the success of the current approaches.
=How the Ketogenic Diet may help=
There may be several mechanisms behind the effect of the ketogenic diet on cancer. Some may also apply to a lesser extent to other [[Low Carbohydrate Diets]], but some require Ketones. It seems reasonable that the benefits of the ketogenic diet for cancer patients rely on multiple underlying mechanisms.* The ketogenic diet typically reduces blood glucose levels, and high blood glucose is associated with tumor growth and reduced survival rates in cancer patients<ref name="Chaichana-2010"/><ref name="Derr-2009"/><ref name="McGirt-2008"/> and animal models<ref name="Venkateswaran-2007"/>.* Carbohydrate restriction lowers insulin and insulin-like growth factor (IGF) which directly stimulate tumor cell proliferation<ref name="Klement-2011"/>.
* Tumor cells are unable to metabolize ketones<ref name="Maurer-2011"/>.
* Cancers promote the growth of new blood vessels, something the ketogenic diet inhibits, as Ketones are [http://en.wikipedia.org/wiki/Angiogenesis_inhibitor anti-angiogenic]<ref name="Zhou-2007"/>. This is also seen with calorie restriction, which reduces vascularity and increased apoptosis in mouse and human brain tumors<ref name="Mukherjee-2004"/>.
* Cancer cells often don't undergo natural cell death, something the ketogenic diet enhances<ref name="Skinner-2009"/>.
* Ketones may directly reduce the viability of cancer cells<ref name="Skinner-2009"/>.
=Animal Studies=
There are a number of animal studies that have looked at the ketogenic diet and cancer.* A study Some of [http://en.wikipedia.org/wiki/Glioma Glioma] tumor cells showed that an unrestricted these studies combine the ketogenic diet in mice that raised ketone levels without lowering glucose levels did not change survival rates<ref name="Maurer-2011"/>.* The with calorie restriction, while others provide an unrestricted diet combined with [[Omega 3]] access to food, and [[MCT]] delayed some are simply based around complete fasting. Obviously animal studies do not necessarily apply well to humans, but the growth of implanted gastric cancer cells in mice<ref name="Otto-2008"/>evidence is encouraging.
* The ketogenic diet may need to be combined with calorie restriction to ensure lowered glucose levels for the treatment of brain tumors<ref name="Seyfried-2008"/>. A study that compared an unrestricted standard diet, an unrestricted ketogenic diet and a restricted ketogenic diet in mice with implanted brain tumors, only the restricted ketogenic diet improved survival rates<ref name="Zhou-2007"/>.
* The unrestricted ketogenic diet combined with [[Omega 3]] and [[MCT]] delayed the growth of implanted gastric cancer cells in mice<ref name="Otto-2008"/>.
* Short term fasting can improve the survival rates for mice with implanted brain tumors, and this benefit can enhance both chemotherapy and radiation treatment<ref name="Safdie-2012"/>.
* Drugs are being developed for cancer treatment that target metabolic pathways<ref name="Tennant-2010"/>.
* Giving a no-carbohydrate ketogenic diet to rats with grafted prostate cancer tumors resulted in a 33% smaller tumor size than controls fed a western diet<ref name="Freedland-2008"/>. In another study, rats with grafted prostate cancer tumors given 0%, 10% or 20% carbohydrate had similar survival rates<ref name="Masko-2010"/>.
* Rats with grafted prostate cancer tumors given a no-carbohydrate ketogenic diet (83% fat, 0% carbohydrate, 17% protein) had a better survival rate than those given a medium carbohydrate diet (40% fat, 43% carbohydrate, 17% protein), but their survival was similar to those given a low fat diet (12% fat, 71% carbohydrate, 17% protein)<ref name="Mavropoulos-2009"/>.
* Rats with grafted lung cancer tumors showed that a ketogenic diet improved the effectiveness of radiation and chemotherapy<ref name="AllenBhatia2013"/>.
* A study of [http://en.wikipedia.org/wiki/Glioma Glioma] tumor cells showed that an unrestricted ketogenic diet in mice that raised ketone levels without lowering glucose levels did not change survival rates<ref name="Maurer-2011"/>.
* Rats with metastatic cancer had a 57% longer average survival time on the ketogenic diet than controls, and 78% longer when the ketogenic diet was combined with a hyperbaric oxygen therapy<ref name="TangPoff2013"/>.
=Human Case Studies=
[[File:KetogenicCancerTimeline.jpg|none|thumb|500px|Timeline of the treatment of a 65 year old woman with Glioblastoma multiforme ..]]
=Non-Ketogenic Fat Intake and Cancer=
There are a number of studies that have looked at the general relationship between fat intake and cancer. [[Omega 3]] may help inhibit cancer, while Omega 6, and to a lesser extent saturated fats, may exacerbate cancer.
* Fat intake in a non-ketogenic diet impacts tumor growth<ref name="Welsch-1992"/>.
* [[Omega 3]] supplementation may improve the effectiveness of conventional chemotherapy and radiation therapy treatments of cancer<ref name="Hardman-2004"/><ref name="Hardman-2002"/><ref name="Xue-2009"/><ref name="Dupertuis-2007"/>, as well as directly impacting the tumor<ref name="Gutt-2007"/><ref name="Hardman-2007"/><ref name="Kato-2002"/><ref name="Rose-1995"/><ref name="Rose-1996"/> and metastasis<ref name="Rose-1995"/><ref name="Rose-1996"/>.
* Restricting calories intake also impacts tumor growth, with 12% restriction reducing tumor growth in rodents<ref name="Welsch-1992"/>.
* Even modest amounts of Omega-6 or saturated fat may negate the benefit of Omega-3<ref name="Welsch-1992"/>.
=Further Reading=In addition to the scientific papers referenced in this article, there are some books that may be useful. ==Ketogenic Diets: Treatments for Epilepsy and Other Disorders==[http://www.amazon.com/Ketogenic-Diets-Eric-H-Kossoff/dp/1936303108 Ketogenic Diets: Treatments for Epilepsy and Other Disorders, by Eric H. Kossoff] is the best all-around book I've come across on the ketogenic diet, and while it focuses heavily on epilepsy, it does touch on other conditions. If you are considering the Ketogenic Diet, I would consider this as essential reading. It has a positive view of the ketogenic diet, but balances this with the caution that comes with being a medical practitioner that has used the diet for many years.==Anticancer==Anticancer is a [http://www.amazon.com/Anticancer-New-Life-David-Servan-Schreiber/dp/0670020346 book by David Servan-Schreiber]. In the book, David describes his personal battle with brain cancer, and the research he did to understand why we get cancer. The book presents a grim warning of the cancer epidemic that is occurring in the western world, with age-adjusted cancer rates steadily rising since the 1940s. However, the book also offers hope, as there are useful that may help fight cancer. Anticancer is an approach that may reduce our risk of getting cancer, and for those with the disease, it might supplement surgery, chemotherapy and radiation as treatments. The book claims that genes only comprise 15% of the risk for cancer, with smoking and diet contributing 30% each. There are several parts to the anticancer approach:* The book suggests that the immune system forms a defense against cancer. If our immune system is compromised, then cancer can grow. * Avoid high [[Glycemic Index]] foods. Having continuously elevated blood sugar and insulin levels causes chronic inflammation that compromises the immune system and provides growth hormones the fuel cancerous growth. High Glycemic Index foods are also linked to obesity, diabetes, and heart disease.* Eat foods with anticancer properties, such as curry, green tea, soy, garlic. The book contains a longer list, and there is another book [http://www.amazon.com/Foods-Fight-Cancer-Essential-prevent/dp/0756628679/ref=pd_sim_b_1 Foods to Fight Cancer] with more information. I have not looked at the research that supports these foods. * Boost [[Omega 3]] intake and reduce Omega 6 intake, aiming for a 1:1 ratio of Omega-3 to Omega-6. This ratio is found in grass fed animal products, or it can be achieved through foods rich in Omega-3 such as fatty fish or Flax. All Trans Fats should be avoided (look for "partially hydrogenated" in the ingredients to identify trans fats).* Detoxify by not consuming poisons. This primarily means eating more organic food, especially animal products such as meat or dairy. For non-animal products, some are worth getting organic, whereas others pose a more limited risk. There is a list of the 12 least contaminated and 12 most contaminated foods at [http://www.organic.org/articles/showarticle/article-214 The Dirty Dozen].* Exercise for at least 20 to 30 minutes per day. The book notes that different types of cancers require different levels of exercise to achieve a comparable effect; for instance, colon cancer requires twice as much as breast cancer.* Feelings of helplessness ([[Internal Control Index| External Locus of Control]]) and past emotional traumas compromise our body's ability to fight cancer. For some, exercise can restore our feeling of control over our lives, but counseling may also be needed.* Meditation, including [[Yoga]], tai chi, etc., helps reduce stress.==Cancer as a Metabolic Disease==This book, "[http://www.amazon.com/Cancer-Metabolic-Disease-Management-Prevention/dp/0470584920 Cancer as a Metabolic Disease: On the Origin, Management, and Prevention of Cancer]" by Dr. Thomas Seyfried, is an expensive, technical book by one of the leading researchers in this field. It's recommended if you want to research more deeply into this topic. There is also a smaller and cheaper eBook called "[http://www.ketogenic-diet-resource.com/cancer-diet.html Fight Cancer with a Ketogenic Diet]" that is based on Seyfried's book.=See Also={{KetoSeeAlsoKetoList}}
=References=
<references>
<ref name="AllenBhatia2013">B. G. Allen, S. K. Bhatia, J. M. Buatti, K. E. Brandt, K. E. Lindholm, A. M. Button, L. I. Szweda, B. J. Smith, D. R. Spitz, M. A. Fath, Ketogenic Diets Enhance Oxidative Stress and Radio-Chemo-Therapy Responses in Lung Cancer Xenografts, Clinical Cancer Research, volume 19, issue 14, 2013, pages 3905–3913, ISSN [http://www.worldcat.org/issn/1078-0432 1078-0432], doi [http://dx.doi.org/10.1158/1078-0432.CCR-12-0287 10.1158/1078-0432.CCR-12-0287]</ref>
<ref name="TangPoff2013">Chih-Hsin Tang, Angela M. Poff, Csilla Ari, Thomas N. Seyfried, Dominic P. D'Agostino, The Ketogenic Diet and Hyperbaric Oxygen Therapy Prolong Survival in Mice with Systemic Metastatic Cancer, PLoS ONE, volume 8, issue 6, 2013, pages e65522, ISSN [http://www.worldcat.org/issn/1932-6203 1932-6203], doi [http://dx.doi.org/10.1371/journal.pone.0065522 10.1371/journal.pone.0065522]</ref>
<ref name="Safdie-2012">F. Safdie, S. Brandhorst, M. Wei, W. Wang, C. Lee, S. Hwang, PS. Conti, TC. Chen, VD. Longo, Fasting enhances the response of glioma to chemo- and radiotherapy., PLoS One, volume 7, issue 9, pages e44603, 2012, doi [http://dx.doi.org/10.1371/journal.pone.0044603 10.1371/journal.pone.0044603], PMID [http://www.ncbi.nlm.nih.gov/pubmed/22984531 22984531]</ref>
</references>
