Continue my summary on Dr. Thomas Seyfried's talk - 'Cancer as a Metabolic Disease: Implications for Novel Therapies' .
At the end of Part II, Dr. Seyfried made a new prediction based on the new hypothesis. Recognizing that all cancer cells require glutamine and glucose to obtain energy through fermentation, especially the metastatic cell, reducing levels of fermentable fuels (glucose and glutamine) while elevating levels of non-fermentable fuels (ketone bodies) should work. Because ketone bodies have to be respired in normal mitochondria, if mitochondria are defective, they can not use ketone bodies for energy. Only normal cell with normal mitochondria can use ketone bodies as fuel, while cancel cells with defected mitochondria can not. Ketones are absolutely toxic to cancer cells. (I wish here he could have given some more evidence to support his claim.) Then how to reduce glucose and raise ketones? It can be done through water-only fasting, calorie restriction and/or ketogenic diets.
They developed the glucose ketone index (GKI) as a simple tool to monitor therapeutic efficacy and the metabolic management for brain cancer and all other types of cancer, because all cancer suffer from the similar problem. The GKI is the ratio of glucose level and ketones. And the therapeutic efficacy is considered best when GKI ratios are approaching 1.0 or below. He admitted it could be challenging to get to these ratios.
They further adopt this GKI into a global cancer management method, which is called the press-pulse therapy. This therapy uses two different strategies: a chronic press that puts stress on the cancer cell metabolism, and acute pulses, specifically drugs and procedures, that will interact synergistically with press therapies. The goal is to gradually move the patient from a state of disease to a state of health by strategically targeting tumor cells while enhancing the health and vitality of normal cells. This is very different with the strategy that is currently done.
Certain press therapies include ketogenic metabolic therapy using restricted ketogenic diets and ketone supplements and stress management. Emotional stress and anxiety contribute to elevated blood sugar through corticosteroid elevation, so stress management is to reduce corticosteroid elevation so as to reduce blood sugar level. Then in pulse therapy, some certain drugs and procedures are used to target availability of glucose and glutamine, i.e. glucose inhibitor and glutamine inhibitor. Gradually, the cancer is degraded slowly, and the patient will emerge from the treatment healthier than when they started. The key difference between the press-pulse therapy and the chemo/radiation therapy in standard of care (SOC) is that the former damages only the cancer cells while the latter damages both the cancer and the normal cells.
He then showed several cases that used press-pulse therapy to manage gliblastoma (GBM), a brain cancer, and breast cancer. In one of the GBM cases they have done, the patient was doing really well for 24 months, but because they had to use it together with SOC which involved radiation and chemo therapy, the patient died at 30 month. The autopsy showed that the patient was died not from the tumor, but from radiation necrosis. They published a paper suggesting that since the current use of radiation and chemo therapies is largely responsible for facilitating the recurrence, growth and demise of the majority of brain cancer patients, replacing SOC with ketogenic metabolic therapy (KMT) will improve progression free survival and overal survival for most GBM patients.
In another paper published in 2020 by a group of researchers in New Zealand, the press-pulse metabolic therapy was used to manage a highly metastatic thioma in a woman. No radiation, no chemo, no SOC, but only metabolic therapy. It presents the rationale of why the approach of metabolic therapy should be considered for the management of cancer. Another paper published in 2020 from his own group talks about why we should consider using ketogenic metabolic therapy as a complementary or alternative approach for managing breast cancer. They think majority of breast cancer patients, no matter whether they are triple negative, or what class they are, because all cancers suffer from the same metabolic malady, they would respond remarkably to ketogenic metabolic therapy as an alternative or complementary approach to SOC. It also showed that taking biopsy tissue from the breast can put the patient at risk of spreading the cancer. Since the genes are largely irrelevant to the disease, it does not make too much sense to take the biopsy to figure out what mutations they have.
In conclusion, cancer is not a genetic disease, but rather a metabolic disease. Non-toxic, cost-effective metabolic therapy can be used to manage most of the cancers.
Although his work is very impressive and convincing, there are still a lot confronting voices out there. In the future, we will look at the challenges from other people in the medical field and what he rebuttals are. This is how science should work. We find problems of the existing systems, propose new solutions, test the new solutions out, find new problems, and then keep improving from there. Both rights and wrongs are good for the future success.