Raadpleeg ook literatuurlijst niet-toxische stoffen en behandelingen bij specifiek hersentumoren en uitzaaiingen in de hersenen van arts-bioloog drs. Engelbert Valstar. 

Lees ook andere ervaringsverhalen in gerelateerde artikelen.

Ook uit deze studie blijkt dat een kytogeen dieet bij met name hersentumoren goede resultaten kan geven: Investigating the Ketogenic Diet As Treatment for Primary Aggressive Brain Cancer: Challenges and Lessons Learned : 

19 november 2018: Bron: . 2018; 5: 20. Published online 2018 Mar 29.

Hier een tot in detail beschreven case studie van een 38-jarige man die in februari 2016 werd geconfronteerd met een niet volledige operabele hersentumor van het type Glioblastoma multiforme. Naast een wakkere operatie waar zoveel mogelijk tumorweefsel werd weggehaald, maar niet alles, is de man ook bestraald en heeft hij chemo (temozolomide - temodal) gekregen als standaard behandeling voor deze vorm en stadium van een glioblastoma.

Wat het echter bijzonder maakt is dat de man vooraf aan de operatie (hij werd pas 43 dagen later geopereerd) en ook daarna onder professionele begeleiding is begonnen met een op zijn persoonlijke situatie aangepast kytogeen dieet met daarbij ook aanvullende vitamines en mineralen waar nodig. Zo gebruikte de man ook een tijdje metformin en vitamine D bv. De man werd heel intensief begeleid en zijn bloedwaarden bv. werden heel regelmatig gemeten en mocht het nodig zijn werd zijn dieet en vitamines aangepast.

En met groot succes want op moment van publicatie van de case studie (maart 2018, dus ruim 2 jaar al) was de man nog steeds kankervrij, waren er geen tekenen van een recidief en was de man zijn lichamelijke conditie op de schaal van Karnofsky 100%. Wat duidt op een uitstekende conditie.

Bedenk  daarbij dat de mediane overall overleving van patiënten met een hersentumor van het type glioblastoma met standaard behandelingen ligt tussen de 12 en 14 maanden. Zelfs na een volledige operatie overleven mensen zelden 3 jaar. 

Hier een schema dat de man aanhield de eerste 9 maanden.

An external file that holds a picture, illustration, etc. Object name is fnut-05-00020-g001.jpg

Figure 1

(A) Timeline of clinical course with dates of dietary treatments, magnetic resonance imaging (MRI), magnetic resonance spectroscopy (MRS), and hyperbaric oxygen therapy (HBOT). (B) Glucose/ketone index indicates the ratio of circulating glucose to urinary ketones at all eight clinical assessments during the 15 months period from February 2016 to April 2017.

Onderstaande grafiek laat zien wat de effecten waren op bepaalde waarden in zijn bloed:

Table 1

Influence of ketogenic metabolic therapy (KMT) on the patient’s biomarkers.

Before KMT/first presentationAfter KMT/before surgeryKMT continued/after surgery (months)
Biomarkers 3 9 15 20
Hb (g/dL) 11.0 12.5 13.0 12.9 13.1 16.1
WBC/μL blood 5,000 4,200 3,200 4,500 5,500 4,200
Platelets/μL blood 162,000 171,000 220,000 280,000 310,000 186,000
Cholesterol (mg/dL) 115 – – 168 170 225
LDL (mg/dL) 50 – – 103 106 159
HDL (mg/dL) 34 – – 48 51 62
TG (mg/dL) 155 – – 83 81 101
25(OH)D3 (ng/dL) 3.1 18.0 32.0 48.0 55.0 42.0
Homocysteine (μM) 19.2 16.0 14.9 12.0 9.4 11.9
Fasting glucose (mg/dL) 89 72 64 75 71 65
Fasting insulin (μIU/mL) 13.10 6.50 5.00 4.10 3.80 2.11
Urine ketones UD +++ +++ ++ + ++
Weight (kg) 71.1 – 67.7 56.9 66.2 61.8
BMI (kg/m2) 25.10 – 23.70 19.90 23.17 21.60

UD, undetectable.

De man zijn lichamelijke conditie ging sterk vooruit en bleef uitstekend.

In de conclusie van de studie schrijven de onderzoekers o.a. dit: 

Glioblastoma multiforme blijft een van de meest agressieve en moeilijkst te behandelen primaire tumoren van het centrale zenuwstelsel. Opkomend bewijs geeft aan dat kanker in de eerste plaats een mitochondriale metabolische ziekte is waarbij tumorcellen afhankelijk worden van fermentatie voor groei. Glucose en glutamine zijn de belangrijkste fermenteerbare brandstoffen die de groei en uitzaaiingen van GBM-cellen stimuleren. Er werd een press-puls therapeutische strategie geïmplementeerd om de beschikbaarheid van glucose en glutamine bij een 38-jarige GBM-patiënt te targeten met behulp van een gemodificeerde standaard behandeling (SOC) en een aangepast Kytogeen dieet (KMT). Aangezien minder dan 20% van de jongere volwassenen in het algemeen langer dan 24 maanden met GBM overleven, is het mogelijk dat de reactie die in dit geval werd waargenomen resulteerde in een deel van KMT en de gemodificeerde SOC. De patiënt is nu 40 jaar oud en blijft in excellente gezondheid zonder merkbare neurologische problemen (Karnofsky Score, 100%) na 24 maanden behandeling.

In het studierapport : 

Management of Glioblastoma Multiforme in a Patient Treated With Ketogenic Metabolic Therapy and Modified Standard of Care: A 24-Month Follow-Up staat nog heel veel meer en wordt tot in detail beschreven hoe de man is behandeld en wat de gevolgen daarvan waren. M.i. echt de moeite waard te lezen. 

Hier het abstract van de studie plus referentielijst.

This is the first report of confirmed GBM treated with a modified SOC together with KMT and HBOT, and other targeted metabolic therapies.

. 2018; 5: 20.
Published online 2018 Mar 29. doi:  [10.3389/fnut.2018.00020]
PMCID: PMC5884883
PMID: 29651419

Management of Glioblastoma Multiforme in a Patient Treated With Ketogenic Metabolic Therapy and Modified Standard of Care: A 24-Month Follow-Up

Ahmed M. A. Elsakka,1 Mohamed Abdel Bary,2 Eman Abdelzaher,3 Mostafa Elnaggar,4 Miriam Kalamian,5 Purna Mukherjee,6 and Thomas N. Seyfried6,*
Author information Article notes Copyright and License information Disclaimer

Abstract

Few advances have been made in overall survival for glioblastoma multiforme (GBM) in more than 40 years. Here, we report the case of a 38-year-old man who presented with chronic headache, nausea, and vomiting accompanied by left partial motor seizures and upper left limb weakness. Enhanced brain magnetic resonance imaging revealed a solid cystic lesion in the right partial space suggesting GBM. Serum testing revealed vitamin D deficiency and elevated levels of insulin and triglycerides. Prior to subtotal tumor resection and standard of care (SOC), the patient conducted a 72-h water-only fast. Following the fast, the patient initiated a vitamin/mineral-supplemented ketogenic diet (KD) for 21 days that delivered 900 kcal/day. In addition to radiotherapy, temozolomide chemotherapy, and the KD (increased to 1,500 kcal/day at day 22), the patient received metformin (1,000 mg/day), methylfolate (1,000 mg/day), chloroquine phosphate (150 mg/day), epigallocatechin gallate (400 mg/day), and hyperbaric oxygen therapy (HBOT) (60 min/session, 5 sessions/week at 2.5 ATA). The patient also received levetiracetam (1,500 mg/day). No steroid medication was given at any time. Post-surgical histology confirmed the diagnosis of GBM. Reduced invasion of tumor cells and thick-walled hyalinized blood vessels were also seen suggesting a therapeutic benefit of pre-surgical metabolic therapy. After 9 months treatment with the modified SOC and complimentary ketogenic metabolic therapy (KMT), the patient’s body weight was reduced by about 19%. Seizures and left limb weakness resolved. Biomarkers showed reduced blood glucose and elevated levels of urinary ketones with evidence of reduced metabolic activity (choline/N-acetylaspartate ratio) and normalized levels of insulin, triglycerides, and vitamin D. This is the first report of confirmed GBM treated with a modified SOC together with KMT and HBOT, and other targeted metabolic therapies. As rapid regression of GBM is rare following subtotal resection and SOC alone, it is possible that the response observed in this case resulted in part from the modified SOC and other novel treatments. Additional studies are needed to validate the efficacy of KMT administered with alternative approaches that selectively increase oxidative stress in tumor cells while restricting their access to glucose and glutamine. The patient remains in excellent health (Karnofsky Score, 100%) with continued evidence of significant tumor regression.

Ethics Statement

This study has been reviewed and approved by the Chair of the faculty of Medicine Alexandria University Medical Research Review Board (metabolic management of GBM patients along with the standard of care therapy, protocol number 69/2016). Following IRB-approved directions for this study, a written informed consent was obtained from the participant for the publication of this case report.

Author Contributions

AE: conceived the study, collected the data, and wrote the paper. MB: conducted surgical procedures related to standard of care. EA: conducted the pathological report. ME: assisted in data collection. MK: provided information on nutritional status and helped write the paper. PM: evaluated data and assisted in manuscript preparation. TS: helped write the manuscript and assisted in data presentation and analysis.

Conflict of Interest Statement

MK was employed by Dietary Therapies LLC. All other authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Acknowledgments

We thank the Foundation for Metabolic Cancer Therapies (Single Cause, Single Cure), CrossFit Inc., the Nelson and Claudia Peltz Foundation, Joseph C. Maroon, the George Yu Foundation, Ellen Davis, Lewis Topper, and the Boston College Research Expense Fund for their support.

Abbreviations

KD-R, calorie restricted ketogenic diet; GFAP, glial fibrillary acidic protein; KMT, ketogenic metabolic therapy; EMA, epithelial membrane antigen; CK, cytokeratin; CD31, cluster of differentiation 31; Ki67, antigen KI-67 also known as Ki-67 or MKI67 is a protein that in humans is encoded by the MKI67 gene; HBOT, hyperbaric oxygen therapy; MRI, magnetic resonance imaging; MRS, magnetic resonance spectroscopy; EGCG, epigallocatechin gallate; NAA, N-acetylaspartate; L/P, lactate/pyruvate ratio; IQR, interquartile range; dkl, decaliter; EMK, electronic ketogenic manager; GKI, glucose-ketone index; H&E, haematoxylin and eosin.

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Articles from Frontiers in Nutrition are provided here courtesy of Frontiers Media SA

kytogeen dieet, vitamines, vitamine D., hersentumoren, glioblastoom multiforme, overall overleving, recidief, genezen


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