The Ketogenic Diet as an adjunct therapy in treating Rectal, Breast and Head & Neck Cancer

Keto4Life

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May 24, 2021
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This group of researchers have been examining the effects of the ketogenic diet, as a complementary treatment to the standard of care, on the body composition of cancer patients receiving radiation treatments (curative radiotherapy). This clinical trial (KETOCOMP) was first registered in July of 2015 and is estimated to be complete in October of 2021. However, the final results from two of the three cancer types studied have been published.

Cancer cachexia (or wasting syndrome) is common in cancer patients, especially in advanced cancer with as much as 80% of patients developing the wasting syndrome. Estimates place cancer cachexia as the ultimate cause of death in those suffering from cancer to be anywhere from 20-40%.

This trial consists of rectal, breast and head and neck cancer patients. The primary outcome measures being examined were/are dropout rates (measure of feasibility/tolerability of the complimentary treatment) and body composition of cancer patients undergoing radio(chemo)therapy (RCT). The body composition parameters measured were: total body weight, fat mass, fat free mass, total body water, extracellular body water and intracellular water.

A control group (consuming a standard diet/SD) and two additional treatment groups of patients were established based on differing complimentary ketogenic interventions in conjunction with standard cancer treatments:
  • Group 1: On irradiation days irradiation after overnight fast + ketogenic breakfast consisting of 50-250 ml betaquik® (vitaflo, Bad Homburg, Germany) and 10g MyAmino (dr. reinwald healthcare gmbh + co kg, Altdorf, Germany).
  • Group 2: Complete ketogenic diet plus 10g MyAmino/day
  • Control: No dietary intervention.
The results of the ketogenic diet as a complimentary nutritional treatment with radio(chemo)therapy (standard-of-care) have been very promising revealing positive and significant outcomes in the primary outcome measures of feasibility/tolerability and body composition metrics. The authors conclude that these optimistic findings confirm previous preclinical studies and warrant further clinical study.

Published summary of conclusions from the authors:

Rectal Cancer Conclusions (Final) – published May 2021
In rectal cancer patients undergoing curative radiotherapy, a KD significantly reduced body weight and fat mass while preserving skeletal muscle mass. We could demonstrate a trend for KDs contributing synergistically to pathological tumor response, a finding in line with preclinical data that warrants future confirmation in larger studies.

Brest Cancer Conclusions (Final) – published August 2020
In summary, a KD in a breast cancer population during radiotherapy improved body composition compared to a SD, with reductions in BW that were mostly due to FM loss and a rapid water loss soon after diet onset. The KD also induced some favorable hormonal changes. Importantly, our KD intervention during radiotherapy was well accepted by the women who started it and feasible within our community hospital setting given minimum requirements of a dietician and motivated hospital staff.

Interim Analysis – published March 2019
Results and conclusion: Patients on the KD exhibited nutritional ketosis, defined as serum β-hydroxybutyrate levels ≥0.5 mmol/l, in a median of 69.0% of blood measurements (range 0-100%) performed in our clinic. In rectal and breast cancer patients, KD was significantly associated with a loss of 0.5 and 0.4 kg fat mass per week (p = 0.00089 and 8.49 × 10-5, respectively), with no significant changes in fat free and skeletal muscle mass. In HNC patients, concurrent chemotherapy was the strongest predictor of body weight, fat free and skeletal muscle mass loss during RT, while consuming a KD was significantly associated with a gain in these measures. These preliminary results confirm prior reports indicating that KDs are safe to consume during standard-of-care therapy. They also provide an important first indication that KDs with ample amino acid intake could improve body composition during RT in curative cancer patients.

Impact of a ketogenic diet intervention during radiotherapy on body composition: IV. Final results of the KETOCOMP study for rectal cancer patients
https://www.clinicalnutritionjournal.com/article/S0261-5614(21)00265-X/fulltext

Impact of a ketogenic diet intervention during radiotherapy on body composition: III-final results of the KETOCOMP study for breast cancer patients
https://pubmed.ncbi.nlm.nih.gov/32819413/

A ketogenic diet exerts beneficial effects on body composition of cancer patients during radiotherapy: An interim analysis of the KETOCOMP study
https://pubmed.ncbi.nlm.nih.gov/32670812/