This is key: Mayo's Thompson counters. He points out that data supporting the ketogenic diet in cancer are limited — and further that rigorous dietary studies are incredibly hard to pull off. "The drug companies aren't going to fund these types of trials," he says. "They can't make money marketing a diet."
I would highly recommend people do their own research into nutrition and its relation to health, along with the proven/likely/possible health benefits of various plants, spices and dietary patterns.
The fact is, our Big Pharma/FDA/IP-driven approach to medicine makes it almost impossible to test and profit off something like garlic, or a low glycemic index diet or intermittent fasting or turmeric or fruit and fiber or astragalus, etc.
The necessary research is just not occurring, because corporate/govt $ are poured into finding synthetic, patentable compounds to target specific problems after they occur.
General lifestyle/nutrition advice to prevent/mitigate a huge spectrum of issues that occur as we age? Ain't no money in that science.
Blatantly obvious how the same thing occurs w/ psychotropic compounds, with millions being poured into synthetic cannabinoids, opiates, serotonergics, etc. almost all of which are medically inferior to and more dangerous than the natural compounds they mimic. The system is not designed around efficacy, but patentability.
>The fact is, our Big Pharma/FDA/IP-driven approach to medicine makes it almost impossible to test and profit off something like garlic, or a low glycemic index diet or intermittent fasting or turmeric or fruit and fiber or astragalus, etc.
That's patently false. The vast majority of cancer funding does not come from industry or private interests, but from government or non-profit sources.
If I can convince my PI that garlic or a low glycemic index diet can improve survival outcomes in an inducible cancer mouse model, then I'd be grinding garlic and putting mice on starvation diets for the next 2 years.
Most drugs comes from private companies, not public institutions. It's about a 2/3 private and 1/3 public split. Note, that's discovery, not development. Private companies almost exclusively bring discoveries to market.
Second, yes, if garlic cured cancer drug companies could make money off of it. Isolate the active compounds, optimize it for efficacy and patent it. Kind of what they've already done for antibiotics, antifungals, anticholesterols and anticancer drugs. It's nothing new.
Public institutions wouldn't necessarily find a druggable small molecule, but every last step up until that point is almost assuredly being funded by the public. That'd include verifying that diets rich in garlic or what have you have an affect on overall survival.
My point still stands, private funding is not the bottle-neck. If garlic or low glycemic index diets actually made a difference in overall survival, it would mostly likely be discovered in a publicly funded institution. A private institution would then jump on the opportunity to "discover" and develop a small molecule that is suitable for drugging and IP'ing based on the findings of the public lab.
What if the effects are not based on one active compound, but on a complex mix which could be rather chaotic, but an experienced practitioner could devise a treatment, but a drug company can't easily pinpoint a one size fits all formulae?
It's inconceivable that an "experience practitioner" can devise a treatment a drug company can't manufacture, but you are correct that the economics of personlised medicines aren't financially viable for drug companies.
I don't think there is a simple solution for that, but I can tell you is that these economics still won't prevent the discovery of such treatments. Some initial proof of this is the fact that the scientific community has embraced the concept that cancer is extremely heterogenous and will require a unique treatment for each individual patient (which has generated the "personalised medicine" buzzword).
It is not as clear sometimes. Private companies provide grants to professors and departments in public colleges for research related to their drugs. Is that included in "private" or "public" in the 2/3-1/3 split? Because depending on which side you'd argue on, you can make it flip flop.
"Well it is public because these are employees of public institutions and their time and effort is spent researching drugs for private pharma companies, instead of say teaching or doing other research". Or one can say "It is private, because the pharma companies pay for it". Now I don't know which is more likely but just thought, that would be an interesting point to look at.
The data i saw (i'll see if i can find a link), just looked at whether or not a public institution's name was on the patent. Not a perfect way to do it, but probably one of the easier ways.
Big Pharma provides major campaign contributions Congress [1]. Would not be surprised if most of the funding from government is to support the OP's idea.
While there are many problems with how research is funded, the NIH and NSF grants awarded to University's and their professors are not biased toward business friendly solutions to diseases, at least as far as I could see during my years in an academic setting.
There has been plenty of research on how dieting increases longevity, and reduces the propensity to catch various diseases such as cancer.
That's a pretty cool visualization! I only wish you could search or highlight a single compound to see how effective it is against a range of symptoms.
big pharma will do what their management and owners force them to do. surprisingly, unlike all other companies in this world, they want to make money and somehow they are in everybody's health business...
as for good advices - i don't think anybody literate in this world doesn't know that being active and doing sports is a massive net benefit to individual. same goes for generally healthy diet - vegetables, fruit, not eating too much, limit sweet stuff and so on.
yet when I look around, I see people trying to blame others, blame evil corps, doing a lot of similar mental work except the very thing that everybody knows is healthy - or why isn't everybody who is able regularly exercising? if I give up on my body, mkay that's called freedom, but damn I won't go around and try to blame corn industry of some crazy conspiracy (even if there would be one). I am the one shopping for food, and healthy in supermarkets ain't so expensive. In fact, many times it's dirt cheap.
until somebody forces my hand to pay for the food i don't want to eat and forces it down my throat, we are free in our choices, and it's only our responsibility to make them as good as possible.
I notice you didn't include anti-oxidants in your list of things it is impossible to test, because of the mounting evidence that they A) do nothing and B) have a plausible mechanism to be harmful.
It's not Pharma or the FDA. Why would a company selling garlic extract want to run a trial to prove that their one product doesn't work? The number of people using it would probably barely increase if the result is positive, and if the result is negative they will go out of business.
> General lifestyle/nutrition advice to prevent/mitigate a huge spectrum of issues that occur as we age? Ain't no money in that science.
If the US had single-payer healthcare, the focus likely would be much more on prevention, because that would mean the government would get to directly save more money on healthcare. It would also encourage the government to put more money into research that the private pharma companies aren't doing, like you said.
> I highly recommend people do their own research into nutrition
Where do I get the massive amounts of money I would need to run a valid nutrition study?
Or do you mean reading papers? How do I, without the time to get a degree, sort through all of the literature of a field where it seems even experts cannot agree?
One symptom of cancer, especially late-stage cancer, is cachexia: unintended weight loss. It is associated with a higher risk of death and lower quality of life. [1]
In addition, cancer treatments like surgery, chemotherapy and radiation affect the sense of taste, appetite and metabolism and make it difficult to get normal nutrition in the first place.
So you can see why clinical oncologists and patients might be wary of restrictive diets or fasting. In fact many offical guidelines suggest adding sugar, frying foods, eating more dairy, etc to boost nutritional intake.
Psychologically, even if a patient is overweight they may fear a drop in weight as a sign that the cancer is progressing. (An ex-colleague was very obese and lost 60kg before/after being diagnosed with kidney cancer).
A patient may also want to enjoy their remaining time. Food has a huge intrinsic pleasure and is very important socially.
I'm not saying this is an unworthy line of research but they will need good evidence or specific, easy interventions to convince people to change their diet. For example, drugs like metformin or rMETase may be easier than explicit restrictions.
I think diet experimentation and food avoidance have the capability to be the next big advanced immunotherapy or combined therapy supplement.
To usher in an age of 10 billion dollar companies we need predictive validity and models. The ships are fast but the compasses are off.
The gut and controlling it/experimenting with it are the next big leap for biopharmacetuical development.
The way to get there is to enforce patient adherence to specific ingredient controlled diets.The only way to do that is control and know the environment of ingredients.
Check out this company that takes tumor biopsies and uses M3 polypeptide count to figure out what not to consume. http://www.immunodiet.com
Food avoidance unfortunately isn't something you can commercialize, at least not easily, specifically for patient treatment. There's also no way to push it through a clinical trial/ there's no such thing as an FDA approved diet.
Check out this diet: http://bit.ly/fodmapfree that has been shown to reduce the effects of Irritable Bowel Syndrome. Probably extremely effective but difficult to get FDA approved.
I'm pretty new to the metabolic theory of cancer, but I summarise below what I think the main point of the article is:
There is debate between two schools of thought. On one side, Vander Heiden suggests that tumours must be attacked not only in the mitochondrial level (where the ketogenic diet has been suggested as part of a metabolic-based treatment) but also in the cell replication that we traditionally associate cancer with - where chemotherapy helps. He also blames genetic factors, i.e. we can still "inherit" a high cancer risk.
On the other side, Thomas Seyfried argues it's all ultimately mitochondrial and can be controlled via diet. The keto diet, and others, lowers the glucose intake of the body and helps to shut off the fuel supply for tumours. Since he argues cancer is ultimately a metabolic problem, shutting off the glucose supply is a possible cure.
Contrary to one of the quoted researchers, it is perfectly possible to do rigorous testing of diet as an adjuvant therapy for cancer patients. One team is doing this for calorie restriction and fasting, and is putting a defined fasting / fasting mimicking protocol through the FDA process.
That said, it is quite true that most of what is said and done in connection with diet is some variety of nonsense, driven by self-interest on the part of market participants. Cui bono is the watchword. This just makes it more important to learn how to tell the difference between good research and junk science, however.
Recently beat cancer and I looked into the research on keto and cancer. A study I looked at said that the keto diet could actually cause tumor cells to develop other methods of getting energy, causing the cancer to grow more rapidly. I was too afraid to try.
I'm currently sitting in a room at Sloan-Kettering dealing with a post-surgical infection from getting the left side of my liver lopped off. There've been no dietary restrictions or recommendations other than eat more protein. Initially I was told to up my vitamin d:
http://meetinglibrary.asco.org/content/139861-158
And not worry about weight at all.
Its also been expressed to me that for my specific cancer (stage IV colon cancer with liver metastasis) surgery is the only curative mechanism.
I'm sorry to hear that. My nurse said to keep up a high fat and high protein diet for my leukemia, probably to prevent weight loss when I lost my appetite later. When my immune system weakened, I stopped eating uncooked plant-based foods. Certain foods have shown to fight tumor cells in vivo like cruciferous vegetables but nothing is really as good as actual modern treatment.
This. As there original post says, there isn't enough research on this which is exactly why for now you should follow the advice of your GP / specialists.
Without knowing anything of what you read I would guess this is could be referencing gluconeogenesis which is the result of eating too much protein and not enough fats while in a ketogenic in state. The result is that the body generates glucose from amino acid breakdown.
~apparent~ Link to Baker paper mentioned in the NPR story is here (pubmed links to actual paper) :
http://www.ncbi.nlm.nih.gov/pubmed/25528755 (Journal of the National Cancer Institute)
From the abstract: The standard viewpoint that cancer is a genetic disease is often stated as a fact rather than a theory. By not acknowledging that it is a theory, namely the Somatic Mutation Theory (SMT), researchers are limiting their progress. An attractive alternative to SMT is the tissue organization field theory (TOFT), which is summarized as "development gone awry." ... Thinking in terms of TOFT can spur new lines of research; examples are given related to the early detection of cancer.
From the discussion : The premises of TOFT are that carcinogenesis represents a problem of tissue organization, comparable to organogenesis, and that proliferation is the default state of all cells (9,10). Three corollaries of TOFT are: 1) mutations are not needed for carcinogenesis; 2) cancer can arise in tissue where carcinogen has not been applied; and 3) genetic instability is a byproduct of carcinogenesis.
Here's an interesting podcast episode interviewing a clinical nuclear medicine professor about ketosis and water fasts as tools to fight some forms of cancer for anyone wanting to get more information on these topics: https://thequantifiedbody.net/quantifying-cancer-gene-fine/
There is some really interesting work in this area. Many cancers are sensitive to certain amino acid starvation as well and designing diets that drop out these amino acids can be very useful. It all depends on the genetic background of the cancer.
If I got cancer I would definitely have the cancer sequenced and go looking in the data for defects amenable to dietary intervention.
Always good to be vigilant to notice if this is happening in general: "When people are locked into an ideology created by a dogma they tend not to focus on rational alternatives." Interesting area to explore would be techniques to catch yourself if this has happened. Anyone explored this and have tips?
My grandmother was diagnosed with cancer and given several months to live. She being 90, her doctor, family, and herself decided not to do anything about it and just live out her life. I came across ketogenic diet...but unfortunately by that time I found out about it, the writing was on the wall (she passed away 3 weeks later).
If I was in the same position, given the option of doing no chemo and dying; doing chemo, suffering, then dying; or doing no chemo, going on a diet, and maybe somehow it works...I know what I would chose.
Forget diet. Go all the way with a proper water fast. Unfortunately if there was a way to monetize a person not eating for 30 days we would all be hearing about it. Big Food & Drug companies can't productize fasting so it remains fringe as possible cure for many ailments.
I would highly recommend people do their own research into nutrition and its relation to health, along with the proven/likely/possible health benefits of various plants, spices and dietary patterns.
The fact is, our Big Pharma/FDA/IP-driven approach to medicine makes it almost impossible to test and profit off something like garlic, or a low glycemic index diet or intermittent fasting or turmeric or fruit and fiber or astragalus, etc.
The necessary research is just not occurring, because corporate/govt $ are poured into finding synthetic, patentable compounds to target specific problems after they occur.
General lifestyle/nutrition advice to prevent/mitigate a huge spectrum of issues that occur as we age? Ain't no money in that science.
Blatantly obvious how the same thing occurs w/ psychotropic compounds, with millions being poured into synthetic cannabinoids, opiates, serotonergics, etc. almost all of which are medically inferior to and more dangerous than the natural compounds they mimic. The system is not designed around efficacy, but patentability.