Ketogenic diet in oncology: Series of 2 cases in pancreas and melanoma, with different results

Abstract

Ketogenic diets (KD) are diets high in fat, moderate in protein and low in carbohydrates. They have been used clinically for more than 80 years in childhood refractory epilepsy. In recent years, interest in  KD has increased as a coadjuvant of oncological treatment due to the promising results in preclinical  studies. The objective of this study is to analyze the possible benefits and problems that may arise  when applying a ketogenic diet in oncologic patients, and to know in which cases it can be applied and  in which cases it is not. Case series study of two oncological patients receiving a ketogenic diet, one  with monthly follow-up and one without follow-up. A 48-year-old male diagnosed with pancreatic head  adenocarcinoma who underwent neo-adjuvant treatment with QT / RT along with a modified ketogenic  diet and dose-specific physical exercise. The second patient, an 82-year-old woman diagnosed with an  ankle melanoma with a mutation of the Braf v600 gene, comes to the nutritionist after months of  performing an unsupervised ketogenic diet, presenting symptoms of mild-moderate malnutrition,  involuntary weight loss and symptoms. of diarrhoea and mucositis derived from immunotherapy  treatment. The results of the first patient are positive, observing after monthly follow-up an  improvement at the muscular level, fatigue and complete response to oncological treatment. The result  of the second patient shows that a poorly controlled restrictive carbohydrate diet can increase  the risk of malnutrition. The final conclusions are that the aforementioned nutritional treatment  decision is complicated due to the lack of existing intervention studies, which is not suitable for all patients and that can be a safe and viable treatment,  provided that a continuous and low control is carried out and with the supervision of a qualified health  professional.