Restricted Ketogenic Diet Therapy for Primary Lung Cancer With Metastasis to the Brain: A Case Report


A high-fat and low-carbohydrate diet was administered as a complementary and alternative therapy to a 54-year-old man suffering from non-small-cell lung cancer (NSCLC) with brain metastasis. Three months after the cessation of chemotherapy and radiotherapy, a ketogenic diet (KD) was initiated. This approach was an attempt to stabilize the disease progression after chemotherapy and radiotherapy. Computed tomography following radiation and chemotherapy showed a reduction in the right frontal lobe lesion from 5.5 cm × 6.2 cm to 4 cm × 2.7 cm, while the mass in the upper-right lung lobe reduced from 6.0 cm × 3.0 cm to 2.0 × 1.8 cm. Two years after KD initiation and without any other therapeutic intervention, the right frontal lobe lesion calcified and decreased in size to 1.9 cm × 1.0 cm, while the size of the lung mass further decreased to 1.7 cm × 1.0 cm. The size of the brain and lung lesion remained stable after nine years of KD therapy. However, dyslipidemia developed after this time which led to the discontinuation of the diet. No tumor relapse or health issues occurred for two years after the discontinuation of the diet. This case report indicates that the inclusion of ketogenic metabolic therapy following radiation and chemotherapy is associated with better clinical and survival outcomes for our patient with metastatic NSCLC.

Introduction

Despite progress in chemotherapy, radiation, and surgical procedures, malignant cancer continues to be a leading cause of death globally. Therefore, there is a need to develop new therapeutic procedures that are more effective than current approaches. Some factors in the pathophysiology of the malignant cells can possibly suggest improved therapeutic options.

Malignant cancer cells express particular metabolic characteristics that distinguish them from healthy cells. Specifically, most cancer cells lack metabolic versatility due to mitochondrial abnormalities and are largely dependent on glucose for energy according to the Warburg theory of cancer [1,2]. This common phenotype of tumor cells contrasts with that of normal brain cells, which derive energy from ketone bodies when glucose becomes limited [1]….



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