How do experts use ketogenic diet? - CancerChoices



Ketogenic diets are high in fat, moderate in protein and low in carbohydrates, with weak to preliminary evidence of anticancer effects, relief of side effects, and benefits on your body terrainthe internal conditions of your body, including nutritional status, fitness, blood sugar balance, hormone balance, inflammation and more.

How do experts use a ketogenic diet?

Experts provide very limited recommendations for a ketogenic diet in treating people with cancer. Learn more about the approaches and meanings of recommendations: Integrative Oncology Programs and Expert Guidelines ›

Published protocols, programs, and approaches

Ketogenic diet is used only one protocola package of therapies combining and preferably integrating various therapies and practices into a cohesive design for care from an integrative oncologists, drawing from both scientific research and observations from years or even decades of treating people with cancer.

We do not recommend specific integrative protocols or programs but provide information for you to evaluate with your healthcare team.

Neil McKinney, BSc, ND

McKinney N. Naturopathic Oncology, Fourth Edition. Victoria, BC, Canada: Liaison Press. 2020.

This book includes descriptions and uses of many natural and complementary protocols for cancer in general and for specific cancers. It also includes information on integrative support during conventional cancer treatment.

Dr. McKinney uses ketogenic diet for brain/nerve cancer.

Other expert assessments

Some researchers conclude that insufficient clinical evidence is available to support a recommendation for KD for any single cancer diagnosis or as an adjunct therapy.1Erickson N, Boscheri A, Linke B, Huebner J. Systematic review: isocaloric ketogenic dietary regimes for cancer patients. Medical Oncology. 2017 May;34(5):72. However, others suggest that even with limited human studies, animal studies “show that KD presents a viable option as an adjunct therapy for cancer”2Smyl C. Ketogenic diet and cancer-a perspective. Recent Results in Cancer Research. 2016;207:233-40. and can be a good option to complement other therapies, “depending on the situation and the extent of the disease.”3Branco AF, Ferreira A et al. Ketogenic diets: from cancer to mitochondrial diseases and beyond. European Journal of Clinical Investigation. 2016 Mar;46(3):285-98.

We have not found any credible sources that recommend KD for cancer prevention. Many of the ketogenic diets focus on coconut oil, heavy cream, fatty red meats from conventionally-raised animals—including cured red meats such as bacon and sausage—to achieve high levels of fat. These are not recommended elements of a cancer-protective diet.4Karen Collins, MS, RDN, CDN, FAND, Oncology Dietitian and Nutrition Advisor to the American Institute for Cancer Research. Presentation March 2017: “Culinary Translation in Breast Cancer Care and Survivorship” in Washington, DC.

Moss Reports

Moss Reports ›

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The Moss Reports conclude that a ketogenic diet has anticancer effects.

Commentary

CancerChoices staff, October 1, 2021: CancerChoices advises that those considering a ketogenic diet consult a clinician who has expertise in prescribing and monitoring ketogenic diets specifically for cancer patients. Also work with a dietitian or qualified clinical nutritionist knowledgeable about ketogenic diets for instructions and ongoing support. Look for “KD-savvy” professionals:

  • Consider participating in a clinical trial, favoring those that provide a registered dietitian or qualified clinical nutritionist to provide education, monitoring and ongoing support.
  • If considering trying the KD outside of the research setting,
    • Find a doctor with expertise in ketogenic diets in cancer (such as a naturopathic or other integrative oncologist) to determine if this is an appropriate therapy for you, set the plan and monitor your response. Favor clinicians who include a registered dietitian or qualified clinical nutritionist to counsel you.
    • Work with a registered dietitian or clinical nutritionist experienced in KD counseling for the course of the KD therapy.

Although you can follow a ketogenic diet on your own, the complexity of following the diet and the possibility of side effects make this difficult and potentially dangerous. While web resources and books are available regarding this diet, they are not specifically tailored to people with cancer, nor do they include diet counseling or monitoring.

CancerChoices staff, May 19, 2022: Certain cells in the tumor stroma, along with catabolic cancer cells, release ketones during a process called autophagyconsumption of the body’s own tissue as a metabolic process occurring in fasting, starvation and certain diseases; cellular self-cleansing. These ketones can be taken up by anabolic (proliferative) cancer cells with intact oxidative phosphorylation and utilized to make energy and fuel growth. This raises concern for some clinicians, such as naturopathic oncologist and CancerChoices advisor Lise Alschuler, ND, FABNO. Dr. Alschuler thinks a KD may benefit some cancer patients, but is concerned about using it long-term in someone with active cancer. She thinks there is a role for the KD, but that its usefulness may be limited in duration and may be dependent upon the type and nature of the patient’s tumor. Since not enough research is available yet to determine susceptible cancers, nor to guide dosing and duration of a ketogenic diet, Dr. Alschuler follows tumor markers and imaging to monitor the continued effectiveness of the KD. If tumor growth is detected, she takes the patient off of the KD and transitions them to a different, plant-based diet.5Lise Alschuler, email communications, September 18, 2017, October 24, 25, 26, 2017, and update May 19, 2022.

Keep reading about a ketogenic diet

Authors

Laura Pole, MSN, RN, OCNS

Senior Clinical Consultant
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Laura Pole is senior clinical consultant for CancerChoices. Laura is an oncology clinical nurse specialist who has been providing integrative oncology clinical care, navigation, consultation, and education services for over 40 years. She is the co-creator and co-coordinator of the Integrative Oncology Navigation Training at Smith Center for Healing and the Arts in Washington, DC. Laura also manages the “Media Watch Cancer News That You Can Use” listserv for Smith Center/Commonweal. In her role as a palliative care educator and consultant, Laura has served as statewide Respecting Choices Faculty for the Virginia POST (Physician Orders for Scope of Treatment) Collaborative as well as provided statewide professional education on palliative and end-of-life care for the Virginia Association for Hospices and Palliative Care.

For CancerChoices, Laura curates content and research, networks with clinical and organizational partners, brings awareness and education of integrative oncology at professional and patient conferences and programs, and translates research into information relevant to the patient experience as well as clinical practice.

Laura sees her work with CancerChoices as a perfect alignment of all her passions, knowledge and skills in integrative oncology care. She is honored to serve you.

Laura Pole, MSN, RN, OCNS Senior Clinical Consultant

Nancy Hepp, MS

Lead Researcher
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Ms. Hepp is a researcher and communicator who has been writing and editing educational content on varied health topics for more than 20 years. She serves as lead researcher and writer for CancerChoices and also served as the first program manager. Her graduate work in research and cognitive psychology, her master’s degree in instructional design, and her certificate in web design have all guided her in writing and presenting information for a wide variety of audiences and uses. Nancy’s service as faculty development coordinator in the Department of Family Medicine at Wright State University also provided experience in medical research, plus insights into medical education and medical care from the professional’s perspective.

Nancy Hepp, MS Lead Researcher

Reviewer

Lise Alschuler, ND, FABNO

Naturopathis oncologist and CancerChoices advisor
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Dr. Alschuler, ND, FABNO, is a professor of Clinical Medicine at the University of Arizona where she is the associate director of the Fellowship in Integrative Medicine at the Andrew Weil Center for Integrative Medicine. She received her undergraduate degree from Brown University and completed her naturopathic medical training at Bastyr University where she also completed her residency in general naturopathic medicine. She is board certified in naturopathic oncology and maintains a clinical practice out of Naturopathic Specialists, LLC. Dr. Alschuler co-hosts a podcast, Five To Thrive Live!. She is co-author of Definitive Guide to Cancer, now in its 3rd edition, and Definitive Guide to Thriving After Cancer.

Lise Alschuler, ND, FABNO Naturopathis oncologist and CancerChoices advisor

Last update: December 12, 2023

Last full literature review: September 2021

CancerChoices provides information about integrative in cancer care, a patient-centered approach combining the best of conventional care, self care and evidence-informed complementary care in an integrated plan cancer care. We review complementaryin cancer care, complementary care involves the use of therapies intended to enhance or add to standard conventional treatments; examples include supplements, mind-body approaches such as yoga or psychosocial therapy, and acupuncture therapies and self-care lifestyle actions and behaviors that may impact cancer outcomes; examples include eating health-promoting foods, limiting alcohol, increasing physical activity, and managing stress practices to help patients and professionals explore and integrate the best combination of conventionalthe cancer care offered by conventionally trained physicians and most hospitals; examples are chemotherapy, surgery, and radiotherapy and complementary therapies and practices for each person.

Our staff have no financial conflicts of interest to declare. We receive no funds from any manufacturers or retailers gaining financial profit by promoting or discouraging therapies mentioned on this site.

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