The Ketogenic diet and cancer – part 1 of 8

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Cancer Diet News(NaturalHealth365) In recent months, many people – patients, friends, colleagues, strangers – have contacted my office, wondering what I think about the “ketogenic diet” for cancer as proposed by Dr. Thomas Seyfried, that seems all the rage in both the alternative and conventional medical worlds. Many have asked for a comprehensive response, because Dr. Seyfried’s thesis totally contradicts our approach to treating patients – over the past 26 years.

Having studied the issue at some length, I have decided to provide a detailed review that will be published as a series of articles exclusively for NaturalHealth365.com

Editor’s Note: Dr. Gonzalez wrote “The Ketogenic Diet and Cancer” as an 8-part series of articles, in response to the recent popularity of the ketogenic diet as a potential therapy for cancer patients. To gain access (and re-read) any of these articles – simply visit the Ketogenic Diet and Cancer section of our website, NaturalHealth365.com

In this initial article, I’d like to begin by making the point that the world of cancer research and cancer medicine is littered with the discarded theories and rejected therapies thought at one time to be the next promising miracle, the final answer to this perplexing and deadly disease. In my own professional lifetime, I have witnessed a number of cancer miracles come and go, sometimes in quite dizzying succession and at times with extraordinarily dazzling media hysteria.

I remember one of the first, from 1980 when I was a first year medical student at Cornell; in this case, it was, according to the press and the journals, the magic of interferon, an immune stimulant destined to bring cancer to its knees. Not too long afterward, interferon would turn out to be a bust, with its promise and fame rising and falling in roller coaster-like style.

I lived through a far more extraordinary situation just five years later. I had graduated medical school by that point and was living in Florida, finishing my immunology fellowship under Robert A. Good, MD, PhD, the famed “father of modern immunology” as he had been called.

It was late 1985 when the media broke the story about the next cancer miracle. I was sitting in my apartment overlooking beautiful Tampa Bay, when I read the initial front-page newspaper reports. Dr. Steven Rosenberg, already well-known as Ronald Reagan’s surgeon (the President had a malignant polyp), and a highly regarded basic science researcher running a section at the National Cancer Institute in Bethesda, Maryland, had just revealed to the world – at a press conference, as I remember – his preliminary pilot study results with a new immune modulator, interleukin-2, that would provoke an extraordinary media frenzy.

The initial pronouncements, released with such glowing enthusiasm, indicated that finally, yes finally, after so many disappointments we might actually be looking at a real, universal cancer cure. In both laboratory and preliminary human trials, interleukin-2 – like interferon before it, a natural product secreted by lymphocytes that stimulates other cancer-fighting immune cells into action – had performed almost magically against even the most aggressive of cancers, such as metastatic melanoma and metastatic kidney cancer.

News of Dr. Rosenberg’s “miracle” was everywhere, in the print media, on the local and national news, and in an extended Newsweek story appearing December 16, 1985, with white-coated Dr. Rosenberg on the cover peering intently at the world. The article, titled “Search for A Cure” in large bold print went on for six pages, accompanied by photos of Dr. Rosenberg, one with a patient, another as the serious scientist in the lab. Elaborate, colorful artwork illustrated the narrative, showing the intricate mechanisms of the immune system, and pinpointing interleukin-2’s ability, under the guiding hand of Dr. Rosenberg, to fight malignant disease.

A separate subsection headlined “The Rise of a Superstar, From Reagan’s surgery to the frontiers of research” chronicled the compelling life story of Dr. Rosenberg. You couldn’t buy better publicity than this.

At the end of this piece, the writers did include a brief section titled “Interferon: A Cautionary Tale,“ reminding readers of the hoopla five years earlier over that other immune modulator, which too had been all the rage in the cancer research world. The essay, following the main laudatory articles, began:

To some ears, last week’s exultation over interleukin-2 has a familiar but discordant ring. Something similar happened about five years ago with a substance called interferon, the “magic bullet” of cancer research, featured on magazine covers and in articles with titles like “To Save Her Life – And Yours.” … But by 1984 the magic bullet had misfired; now the articles were called “The Myth of Interferon.”

Over the years, I had become particularly familiar with the interferon story since my boss, Dr. Good, had done much of the original research linking it to a possible anti-cancer effect.

By that point, I knew Dr. Good quite well: during my second year of medical school, Dr. Good, at the time a professor at Cornell and Director of the Sloan-Kettering Institute, had begun guiding my fledgling research career. In 1982, during my third year of medical school, to my dismay the powers that be at Sloan pushed him out rather unceremoniously.

Subsequently, he spent some time at the University of Oklahoma, where he was hired to set up a cancer research division, before moving to All Children’s Hospital in St. Petersburg, where again he established a cancer research-bone marrow transplant unit.

When the news of interleukin-2 first hit the press, I discussed this new “miracle” with Dr. Good, who had grown quite cautious after years of experience and having witnessed many similar announcements followed by the inevitable letdown in the research community.

“Look at the data, always look at the data,” he said, “not the media reports.” I followed his advice, tracked down and studied the actual clinical data, which I found surprisingly unimpressive. As I recall, in the first uncontrolled trial, of more than 100 patients entered only three seemed to have experienced any significant or lasting response.

In subsequent months, reports of enormous toxicity, even patient deaths began to filter through the research community, serving to temper the initial hysteria. And it wasn’t cheap, as miracles go – the very toxic drug was so potentially dangerous it had to be administered in a hospital setting under very close supervision, with costs running in excess of $100,000 for a several-week course of treatment.

Despite the initial warning signs, the media continued its relentless promotion of interleukin-2 for a number of years. In 1992, perhaps due to political pressure more than scientific evidence, the FDA approved the drug for use against cancer, despite the lack of comprehensive controlled trials. Then in the late 1998 a clinical study – completed some 13 years after the initial reporting – showed that interleukin-2, at least with advanced kidney cancer, worked no better than placebo.

It’s still being used, though increasingly rarely, and no one I know talks about it with much enthusiasm.

By the 1990s, just as practicing oncologist were giving up on interleukin-2, bone marrow transplant (BMT) as a solution to poor prognosis or metastatic breast cancer started grabbing the headlines, touted as a cure for this most invidious of diseases striking so many women in the prime of life. Despite the lack of any compelling evidence it worked for this indication, bone marrow transplant was being pushed as a solution to deadly forms of breast malignancy. However, initially insurance companies refused to pay for this unproven and very expensive treatment, which could cost in those days up to $500,000 or more.

Nonetheless, enthusiastic oncologists joined with the media, portraying insurance companies as heartless, greedy bullies depriving women with breast cancer of a curative treatment. Not too long after, the trial lawyers got involved, orchestrating a series of lawsuits against various insurance companies on behalf of women wanting a BMT. In a particularly notable and telling case, Fox vs. HealthNet, the jury awarded the plaintiff, a woman diagnosed with breast cancer whose insurance carrier refused to cover the procedure, $89 million, including $77 million in punitive damages.

Under such threat, the insurance industry relented, finding it cheaper to pay the $100,000 or $200,000 or $500,000 per procedure then risk such catastrophic financial harm.

After some 40,000 women underwent the procedure – at a time when 10-30% of patients died from the treatment itself – it was eventually proven to be worthless. The one glowing positive study from 1995, the infamous South African study of Dr. Bezwoda, turned out on closer examination to be a complete fraud, with the creative researcher simply making up the data. The wonderful and frightening book False Hope describes the bone marrow transplant-breast cancer fiasco in great detail, for those with an interest.

As these battles waged in the early 1990s, I had long left Dr. Good’s group, having returned to New York and private practice. Nonetheless, this story had a personal ring to it, as had the interferon story, since Dr. Good had completed the first bone marrow transplant in history, in 1969, and long hoped this technology would be, yes, an answer to cancer.

Under his direction, during my fellowship years I learned how to do this very tricky and often deadly procedure.

But no fear, there’s always a new miracle around the corner, and in 1998 the newspaper reporters and TV newscasters, having effortlessly drifted away from interferon and interleukin-2 and the bone marrow transplant craze, were all in a tizzy over the newest “final” solution to cancer, anti-angiogenesis, based on the pioneering work of the late Dr. Judah Folkman of Harvard. Dr. Folkman had spent decades studying the process of angiogenesis in cancer tissues, the formation of new blood vessels that allow tumors to grow quickly and invade through normal tissues and organs with deadly effect.

Without a rich blood supply, cancerous tumors cannot grow beyond a cubic centimeter.

Dr. Folkman had developed two drugs, angiostatin and endostatin, that in animal experiments reversed tumor growth by blocking new blood vessel formation, essentially starving out the cancer cells. In a November 1998, presentation of his work at the National Institutes of Health in Bethesda, Maryland, Dr. Folkman announced to the world that at least in mice, “we have not seen a tumor we cannot regress.”

Though Dr. Folkman’s research was all based on laboratory experiments and animal studies, the powerful NCI publicity machine took up the cause, with the smell of “miracle” again in the air, despite the lack of any evidence that Folkman’s anti-angiogenesis drugs worked against human cancer. Nonetheless, with the NCI and NIH on board, the media, large and small, local and national, seemed transported into a state of frenzy.

I recall so well, this time sitting in my mid-Manhattan office, reading that famous May 3, 1998 front page lead New York Times article (in the upper left of the page reserved for wars, revolutions, and, yes, miracles) by reporter Gina Kolata, announcing Folkman’s preliminary findings to the world, extolling anti-angiogenesis in a tone that one more skeptical writer, Jack Breibart, described as “breathless.”

Kolata quoted no less an authority than Dr. James Watson, the Nobel Laureate in 1962 for his discovery, with his colleague Frances Crick, of the structure of DNA, the basic genetic material. “Judah is going to cure cancer in two years,” Watson told Kolata. You couldn’t ask for a better source, making a more definitive claim.

Kolata’s unrestrained reporting continued: “Dr. Watson said Dr. Folkman would be remembered along with scientists like Charles Darwin as someone who permanently altered civilization.”

The writer also quoted an enthusiastic Richard Klausner, MD, at the time Director of the National Cancer Institute, who assured the world, “I am putting nothing on higher priority that getting this into clinical trials.”

The glowing TV stories followed, including a memorable prime time, one-hour special about the subject on ABC hosted by the late Peter Jennings. The other networks, in quick succession, picked up the cause. However, not too long after, word broke that Times’ reporter Kolata had been, through her agent, hawking to publishers an idea for a book about anti-angiogenesis and cancer.

Her agent, according to reports at the time, began circulating a book proposal the day after the Times story ran, asking for a $2 million dollar advance! The whole episode raised some eyebrows over a reporter seeking to benefit personally from a subject she was promoting in the news section of the Times. After a fair amount of criticism, Kolata withdrew her book proposal.

As Dr. Klausner promised, the National Cancer Institute, probably swept up in the national and international explosion of hope and enthusiasm, “fast tracked” a preliminary study of endostatin in human patients, intending to enroll, as I recall, 70 subjects very quickly.

But what surprised me – and what began to concern others I knew in the medical community – was some time later the deafening silence about the trial’s outcome, and what seemed to be a blackout about the actual data. Eventually, the study results were published indicating that 42 subjects had been ultimately recruited for the trial, not the planned 70, and not a single one of these had responded to the drug .

Ironically Jennings himself, who had promoted the therapy with unabashed enthusiasm, would die of lung cancer, only months after his diagnosis in 2005. Folkman too, has passed on, never to realize his hope of an anti-angiogenesis, cancer-free world.

Nevertheless, anti-angiogenesis as the answer to cancer remains a big driving force in “biotech” companies, who have developed a whole slew of angiostatin and endostatin offspring, including the drug Avastin, costing up to $10,000 a month, though it doesn’t work particularly well. The clinical studies aren’t impressive, usually reporting several months of improved survival in patients diagnosed with a variety of advanced cancers.

In a further ironic turn, in December 2010, after approving the drug for treatment of women diagnosed with breast cancer, the FDA rescinded its blessing of Avastin for this indication when clinical trials failed to show any significant benefit.

The anti-angiogenesis love affair not only affected conventional researchers and oncologists, but infiltrated deeply into the “alternative” cancer world. During the late 1990s, I read numerous articles lauding the anti-angiogenic effect of various herbs. Some ten years ago or more, a number of alternative physicians began promoting artemesinin, an herb from Africa long used as a treatment for malaria, as a “natural” anti-angiogenesis supplement.

But ten years after the initial burst of enthusiasm, few of my colleagues even mention it.

And so it goes. We as a culture, as a nation, as a world, are forever looking for miracles from our scientific and medical gurus, miracles that might finally bring cancer to its knees. And there will forever be miracles ripe for the picking. In the next article, I will discuss the “Ketogenic Craze.”

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About the author: Dr. Nicholas Gonzalez graduated from Brown University (Phi Beta Kappa, magna cum laude), and worked as a journalist before receiving his medical degree from Cornell University Medical College. During a fellowship under Dr. Robert Good, former President of Sloan-Kettering, Dr. Gonzalez evaluated an enzyme-based nutritional therapy for use against advanced cancer, as documented in his book One Man Alone. Since 1987, Dr. Gonzalez has been in practice in New York. His other books include, “The Trophoblast and the Origins of Cancer”, and “What Went Wrong” – which portrays Dr. Gonzalez’s battle to have his therapy tested in an NCI clinical study. For more information about Dr. Gonzalez – visit: Dr-Gonzalez.com

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  • I clicked on parasympathetic dominance and got a lengthy unrealted article. After an internet search, this is the definition I got:

    A genetically distinct type of person based on an eclectic and scientifically naïve classification of humans, proposed by Nicholas J Gonzalez, MD. According to Gonzalez, the ancestors of parasympathetic dominants inhabited the cooler parts of America and Asia, and were primarily meat eaters; these individuals allegedly have an efficient parasympathetic nervous system, and should consume primarily fatty meats and dairy products (50% of total diet).

    As a vegan parent of two scholar athletes, I find your article to be thoughtful and interesting, but overtly bias and manipulative, with just one anecdotal example of a vegan parent in a negative light. There are countless examples of healthy thriving vegan kids (and meat-eating kids), but far far more instances of children on the Standard American Diet who are very sick with obesity and diabetes 2.

    I hope your next article on this subject is TRULY objective.

    • Krofter

      I couldn’t help noticing how you worded your comment – you said you were vegan but you did not say your kids were vegan. Not very objective.

      I alternated between being a vegan and a vegetarian for 11 years and became quite sick. It wasn’t until I put meat back in my diet that I began to recover from some of the many health issue that had developed during those years.
      Being that we are all different, my feeling is that if you do well as a vegan, power to you. But if your struggeling as a vegan you should return to the traditional omnivore diet.

    • Krofter

      By the way, you have to click on the “ketogenic diet and cancer” link to get to the rest of the articles.