Introduction During the period between and , the annual number of patients afflicted with glioblastoma multiforme GBM, the most aggressive primary brain cancer, in the United States was calculated to be 10,, and the estimated number of new patients for is 12, 1, 2. Lefevre F, Aronson N. Preclinical studies of KD in glioma models indicate that ketosis mediates its impact by reducing glucose and insulin levels, modulating oxidative stress, reducing inflammation, enhancing anti-tumour immunity, altering gene expression and sensitizing tumours to chemo- radiation Our review of the reported cases of glioma patients revealed five patients who responded to treatment with KD Because of the dire prognosis of this diagnosis, patients and their families often looked for all potential alternative treatments that may complicate attempts to investigate the efficacy of the KD as a single variable. Our first two patients were hospitalized while being started on the diet. Contrary to improvements in the quality of life and survival for many cancers, the outcome for those with brain cancer has not improved in decades. Pediatrics 3 — Epilepsia 54 3 —6. Claudia Drake. There could be a theoretical benefit to this type of diet.
Survival of glioblastoma multiforme GBM with the current recommended treatment is poor. Reported median survivals are approximately 8—15 months. Based on recent publications from animal models, combining cancer drugs, radiation, and diet-metabolic treatments may be a new route to better survivals. To investigate this possibility, we have begun a clinical trial that has enrolled 15 subjects using a ketogenic diet KD as an addition to current standard treatments that include surgery, radiation therapy, and chemotherapy. Of the 15 enrolled, 10 completed the protocol. This perspective describes the challenges and lessons learned during this clinical trial and discusses the critical elements that are essential for investigating treatment with a KD. We also reviewed and compared various types of KDs. Compliance with the diet is best in highly motivated patients who have excellent home support from a family member or a friend who can help to overcome administrative, physical, and cognition deficiencies associated with the disease.
We report the experiences of twenty-five adult brain tumour patients on KDT for months, with access to the services of a dietetic team specialising in KDT for epilepsy management. A survey was conducted to gather information on reasons for pursuing KDT, the practical issues encountered and perceptions of the impact of KDT on tumour related symptoms, gastrointestinal function, weight management and psychosocial aspects of daily life. In both symptomatic and asymptomatic brain tumour patients, support for their choice to pursue KDT was readily reported to underpin their sense of empowerment and control. However, the patient experience would appear to show that refractory seizures and chronic fatigue may be alleviated by KDT. Furthermore, amongst the group, the survey shows KDT to be sustainable and tolerable. It would appear that KDT is worthy of further clinical exploration for its symptom management benefits alone. Primary tumours of the brain and central nervous system CNS are a group of rare, heterogenous diseases, with widely varying outcomes. However, they are the leading cause of cancer death in the unders, and account for the highest average years of life lost, of any tumour type 1,2. Many patients with brain tumours also have significant symptoms impairing their quality of life, including, physical problems weakness, poor co-ordination, functional problems, seizures, fatigue, depression and cognitive impairment 3. These may be due to the disease, its progression, treatment side effects, or a combination of these. The low carbohydrate, high fat, adequate protein ketogenic diet KD is a dietary approach creating significant interest in the brain tumour community 7,8.