angry-doctor

The only thing more self righteous than the Archbishop of Seville during the Spanish Inquisition is the modern day oncologist when confronted with a curious patient who might have a suggestion or two in the management of their cancer.  Any physician who has had experience with managing the cancer patient — especially childhood cancer where “treats” are used as a reward for the administration of chemotherapy and many of the other treatments used in modern day oncology — diet is usually casually dismissed with a “eat whatever you want comment” by the oncologist.  This has been the case for years and unfortunately continues despite a growing body of evidence that diet indeed does matter…

Several oncologists with whom I cross-pollinate in the management of cancer have exhibited this sentiment even within the past 6 months.  The alternative medicine movement 20 years ago did include the position that not only did diet matter, but that applied rigorously, it could change outcomes in major ways.  The Gerson therapy program was one of the first to claim that nutrition does indeed matter, but this and other programs have never been studied in rigorous enough ways to warrant publication in the scientific literature.  In fact mainstream oncology considers these approaches as predatory on vulnerable patients seeking any ray of hope for otherwise morbid conditions.  One wonders, of course, why we continue to offer treatments that that cost tens of thousands of dollars per dose to patients who — at the most — might buy another few months of life. These questions are finally being scrutinized, and the answers are not too popular amongst the cancer centers as they commit “pharmaceuticalization”:

This evidence demonstrates that although an increasing number of patients with advanced disease receive drug treatment, this treatment may not match their subjective expectations or informed preferences and that, irrespective of patient preferences, aggressive chemotherapeutic treatment towards the end-of-life is associated with poorer quality of life and death, shorter survival, regret, and in some cases severe financial hardship.

Talk about vending false hope.  But I digress.  In this context one would think that the simple instruction to avoid sugar — and most dietary practices that promote elevated levels of it in our system — might gain some traction in the management of the cancer patient.  This is simply not happening.  The “ketogenic” diet involves the avoidance of foods that raise glucose levels that then favor the growth of cancer cells.  This principle is gaining more and more traction,  yet it is still almost never suggested.  And when it is suggested by a patient to their oncologist, it is almost never encouraged.  One oncologist I know recently treated it with ridicule.  The evidence demonstrates that this may be one of the more important tools in the cancer fight, especially when there is still reasonable hope of long term survival.  In fact this was proposed by no less than a Nobel Laureate back in 1956!  Otto Warburg suggested that cancer cells survive by fermenting sugar rather than the usual and normal cellular process of respiration utilizing oxygen.  Now there is robust literature suggesting that exercise (oxygen!) reduces cancer risks and too much sitting (low oxygen, insulin resistance and sugar!) encourages it.  Duh.

The simple truth is that oxygen and low sugar states discourage cancer growth.  Yet these two essential principles continue to be ignored in favor of the next cycle of chemo and radiation.  It would be obtuse to say that chemotherapy and radiation are not incredibly valuable tools in the management of cancer in most all stages beyond the earliest detectable one (though the definition of “early” is being redefined as we speak).  But it is quite likely that a ketogenic diet (similar to the old Atkins diet with a few modifications) might result in outcomes far superior to those resulting from the “eat anything you want” suggestions usually heard from the oncologist.

 

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