Why Fasting And The Ketogenic Diet Can Help With Cancer Treatment and Prevention

Coming up on this episode of the Doctor's Pharmacy.

We have a couple of studies on fasting and chemotherapy where what you do is you fast sort of just before and during and just after your chemotherapy. And what they've noticed is that those people tend to get a lot less side effects from the treatment.

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Episode of the Doctor's Pharmacy. Hi, I'm Kasia Perowiet, one of the producers of the Doctor's Pharmacy. Fasting, intermittent fasting, and ketogenic diets have all gained a lot of attention in recent years and for good reason. They have been shown to be beneficial in areas ranging from weight loss to chronic disease prevention and treatment, as well as overall longevity. Dr. Hyman recently spoke to physician, author, and researcher Dr. Jason Fung about another benefit of fasting and keto, cancer treatment and prevention. They dive into how this works and what recent research is teaching us about it.

You've written a lot about fasting and the effects of either time-restricted eating, which is 12-14-16 hour fasts every day, or taking a 24, 36 hour fast a week or even longer fast for diabetes. And I'd love you to sort of share why around cancer this is so important. So can you talk about this whole idea of fasting, cancer, ketogenic diets, why it's so important and how it connects to this whole idea of insulin resistance and insulin high insulin levels?

Yeah, that's a great question. And so I talk about in the book about, like what is it that makes cells grow. And what's really important is sort of growth factors. Our body contains natural growth factors that increase the rate of growth. And one of the big things of the last sort of 15-20 years has been the realization that our body contains nutrient sensors, which are hormones that go up when you eat, but they also are precisely the same hormones that our body uses as growth factors. So the most important one is insulin. So insulin insulin, of course, is a well-known metabolic hormone. So you eat and insulin goes up. Assuming you're eating carbohydrates and protein, sort of a mixed meal, you eat, insulin goes up. But more importantly, what it is, is a nutrient sensor. It tells your body that food is available. And the reason that's important is because your body only wants to grow when nutrients are available, right? So you don't want more cells to continue to grow if there's no food available. That's not a good survival strategy. So the body links them. In fact, if you look back in evolutionary times, insulin was not a metabolic hormone. It was actually a growth factor. So, when as we evolved, we actually used the same molecule that we use as a growth factor for nutrient signaling as well. So, we know that insulin is a very potent growth factor. There's this thing called insulin-like growth factor or IGF-1.

And.

Valter Longo actually described this group of Ecuadorian dwarves, the Laron dwarves, who actually have almost no IGF-1, so they're very short. Turns out they're also immune to cancer because if you don't have that growth signaling, then the cells can't grow and the cells that are going to be the most affected are those cancer cells. What you have to do, of course, is say that, okay, if we have too much insulin, then that's going to be a signal to our body that we need to grow. So what can you do to sort of reduce that insulin signaling in the body by reducing nutrient availability, which is two things. One is getting rid of the hyper processed foods, which tends to really amplify the insulin response. So sugar, for example, is especially bad because it causes all this insulin resistance, which causes hyperinsulinemia. A lot of the refined foods are very bad because they sort of take away all the other natural components and you're left with this big spike of insulin. Like if you eat cookies, for example, well, you know, it's just gonna, your insulin is just gonna spike up. And the other thing, of course, if you eat very, very frequently, you're going to keep insulin high all the time. So intermittent fasting is another strategy that you could use to reduce insulin.

You're talking about what is the problem, which is the incredibly high amount of starch and sugar we consume. And you've talked about this in the diabetes code, the obesity code. This is a central driver of almost all chronic Western diseases, heart disease, cancer, diabetes, Alzheimer's, high blood pressure are caused by this phenomena of insulin resistance or too much insulin, which is driven from our diet, basically a highly refined processed carbohydrate diet, and also this constant eating pattern, this thing called snacking, which I think is a modern invention. We have a snack food industry, but I mean, I don't snack. If you eat properly, you're never hungry. I mean, if you don't have these spikes and insulin going up makes you hungry. But what's fascinating is that what you're saying is that insulin actually fuels the.

Cancer growth and sugar fuels the cancer growth.

Yeah.

So both fasting and ketogenic diets have the same sort of goal at the end, which is trying to lower insulin, because the difference between a ketogenic diet, say, and a low carb diet is that, you know, you're sort of low carb, ultra low carb for the keto, but sort of moderate protein because protein can also stimulate insulin. whereas some of the older low carb diets were like very high in protein. You take protein shakes or whatever it is. And that's generally not. Yeah, like Atkins. And so high protein is not always the best idea because you can get high insulin, but you also get this high mTOR, which is sometimes not so good for cancer as well. But the idea is to really drop your insulin levels. And if these are diseases of too much insulin, then that's going to be a very useful adjunctive treatment. So fasting is It's actually fascinating because there's all these different things we're discovering. So one of the things is sort of autophagy. So as you fast, of course, your nutrient sensors go down. So mTOR insulin go down, and then you activate this process called autophagy, where you actually start to break down some of your subcellular organelles and stuff. So basically, your body's just trying to clean house. The idea is that people think that this sort of breakdown process is really bad for you, but it's actually really good for you. And in fact, that's sort of one of the keys to rejuvenating the body. That is, you want to break down all your old stuff and then sort of rebuild the stuff that you need. So the whole idea of fasting is you're trying to put the body into this sort of regenerative maintenance mode, especially for a disease such as cancer, which is a disease where cells are growing too much. You're basically feeding into that growth, and that's going to be very, very bad for you. So what you do instead is you do the fasting and you put yourselves into this sort of maintenance repair mode, and it actually allows allows you to undergo both the chemotherapy and probably the radiation therapy better because chemotherapy, we have a couple of studies on fasting and chemotherapy where what you do is you fast just before and during and just after your chemotherapy. And what they've noticed is that those people tend to get a lot less side effects from their treatment because what you've done of course is taken the cells of your normal body and you've put them into a more quiescent state. They're not trying to grow, they're actually trying to slow down. And chemotherapy, the general way it works is it kills the fastest growing cells, which are usually the cancer cells, but it also kills like the hair follicles because they're fast growing cells. It kills the lining of the GI tract, so you get nausea and your hair falls out. So if you can put those cells into sort of a quiescent sort of repair mode, it's not going to sustain as much damage from the chemotherapy. And instead, the cancer cells, which can't stop their growth, they're always trying to grow. they can't do that. So therefore, they're going to sustain full damage from the chemotherapy while your body is relatively protected. And that's one of the things that might be very interesting to use as an adjunct to sort of standard treatment. I would never advise not to take the standard treatment because of course we spend. You know, there's a lot of interesting.

Work by Dr. Mukherjee, Siddhartha Mukherjee and others looking at ketogenic diets and cancer. And I've heard him present on this. It's just fascinating. He wrote the Emperor of All Maladies. It's about cancer. I'm sure you've read that. And he said to me, he said, Mark, we figured out the solution to cancer. I'm like, what is it? It's this big discovery. He's like, and the cause, and I'm.

Like, what is it?

He's like, it's sugar. I'm like, yeah, I guess that's not really news, but maybe it's good you know that now. And then he said, we've been studying ketogenic diets and seeing incredible results with pancreatic cancer, melanoma, stage four cancers that weren't responding to anything else. They're in animal models. They literally were curing cancers with ketogenic diets. and now they're doing human trials. Can you talk a little bit about some of that research and how it might be applied to people who are struggling with cancer?

Yeah, so this was the sort of big discovery of Dr. Lou Cantley who's discovered sort of this whole pathway, the PI3K pathway that links sort of insulin and growth and cancer. So the important thing is that insulin acts as that growth factor and therefore acts as a sort of pro-growth and therefore a sort of pro-cancer agent. Sugar, of course, plays a big role in the hyperinsulinemia. And it's interesting because Dr. Luke Cantley in several of his, you know, articles or whatever, he goes, Sugar scares me, right? Here's this guy who studies cancer for a living and he's like, yeah, sugar just scares me. And that's the same sort of thing that Siddhartha Mukherjee is talking about too, right? And that's the whole point is that with ketogenic diets, with fasting, and of course, fasting, you have to because you can't obviously fast. You can't fast forever, right? As opposed to ketogenic diet, which is sort of very low carbohydrate, you could sustain that for years and years. You can't fast forever. You need some food at some point. But the idea is the same. What you're trying to do is really reduce those insulin levels.

Dr. Hyman also recently spoke with his friend and colleague, Dr. Patrick Hanaway, who shared his personal experience using the ketogenic diet and fasting as part of his own cancer treatment.

A couple of years ago, you were diagnosed with stage four laryngeal cancer, which is a big deal.

Two years ago tomorrow, I had the biopsy. Two years ago Friday, I had the results. They give you that. I think if they had said I had stage three, I would have said, I can deal with this. I can. I got this, you know, and, and, like, stage four, you start looking at it, and, you know, it's like it didn't have the risk factors, you know, I kind of fit outside the box. So while head and neck cancers, you know, are not, are not prominent, you know, of the kind that I had with no risk factors, it's like, oh, you're in, like, two percent. That's the highest risk of this. And, you know, I'm, what does stage four mean? So what that means is, you know, well, there's a tumor and then there's spread. And generally when there's spread beyond the original tumor, that's, you know, kind of in a generalized term, that's going to be a stage four cancer. So dealing with that degree of uncertainty, you know, and so I did my thing, you know, I talked to doctors at, you know, Stanford and MD Anderson and Cleveland Clinic and Mount Sinai and Hopkins and in Israel and Mayo and one other, I can't remember UCLA, you know, and they're all saying the same thing. And so I got to, okay, I need to actually do chemotherapy and radiation therapy. That's going to be important, you know, but what are other things that I can do? And I began to, you know, take my knowledge of nutrition and talk to the top people. Now, I would say that, that the people I talked to said, oh, you know, ketogenic diet, this is what you need to do. And this is a great thing. and I've already prescribed that for patients, had done it myself, felt comfortable with it. Well, doing that while getting tube feeds because I may not be able to swallow because of the radiation therapy. That's a different thing of trying to get a high fat diet in through a tube, in through a feeding tube. And so we, we, I say we because my wife Lisa was right there beside me, like, how do we figure this out? Now it turns out that, you know, a ketogenic diet is not the answer for every kind of cancer, but it's really good for Cancers where you're doing radiation therapy because it makes the Cancers much more radio sensitive because you're pulling all of the sugar out. And, and so you have this differential stress response. And so I'm like, well, that makes perfect sense. And so we did that. I did that with with them and vigor. And as it turned out, I only lost like three pounds, you know, through the whole thing and. And didn't have to use the feeding tube very much at all. I used it because you just can't taste any food when you're getting radiation and. And food just. There's no taste. So you're just, like, taking food to. To. To get the nutrients. But I did that. But I also did another thing, which was. working with fasting before chemo and the work of Dr. Walter Longo. And so we see all of the fasting mimicking diet stuff that's coming out now, but that's actually all derived from their original work in the early 2000s up to 2009 of working with cancer patients and saying, if we stop giving food before chemotherapy and the chemotherapy, then that's going to slow down the metabolism of the normal cells, but the cancer cells aren't going to be able to slow down their metabolism. And so the cancer will be more sensitive and the normal tissue will be less sensitive. And so we get better tumorogenic effects or tumor lysis effects and we have decreased side effects from it. And so I went through that. And people are saying, really? You're getting chemo every week and you have a feeding tube and you're eating keto and you're not eating any food for two of those seven days. and you think that's going to be okay? Like, I don't know, but I'm gonna try it.

And turns out it's very okay.

Well, as it. And as it went through the whole thing, through the radiation therapy, people were like, you're Irish. You, like, should be having major Burns from the radiation. Why is that not happening? Why are you still eating? Why are you not. Why are you not losing weight? You know, and they look at me and I share with them, and. And they'd say, Probably not.

Don't confuse me with the facts. My mind's made up.

Right.

So anyways, the essence of functional medicine is being able to say, let's look at what's going on here. Let's see what the triggers are. Let's see how I can work to modify lifestyle, to slow down, to take time in nature. you know, which has this great effect that also is going to actually be a anti-cancer effect. You know, we can see that the, the, the forest bathing increases the immune system and decreases, you know, the risk of cancer. That's, that's data that's, that's actually published in Japan in, you know, 2009, you know, so, like, that's already known there. So spending time listening working with the lifestyle aspects to be able to do that and working with the nutrition and working with, you know, the medicine that was there, the radiation and chemo. And so bringing all those together and focusing on the person, the mental, emotional and spiritual aspects that are inside the middle of it. Like that's what functional medicine is. You know, I took those nutritional pieces and, you know, I went through, it was seven weeks of radiation every day. and chemotherapy every week. And PET scan was negative at three months and at 12 months. And the next one will be in a couple weeks. But I get scoped every couple months. It was two days ago, they looked down, no lymph nodes, nothing going on, and I feel great.

The school of thought around cancer used to be focused only on the genetic component. But we now know that our environment, the air we breathe, the food we eat, and even our relationships have an enormous impact on our body's ability to prevent and treat cancer. A diet high in sugar and refined carbs lets insulin run wild, which is why dialing in our food choices is so essential in the fight against cancer. If you'd like to learn more about anything you heard today, I encourage you to check out Dr. Hyman's full-length conversations with Dr. Jason Fung and Dr. Patrick away. If you enjoyed this episode, please consider sharing it and leaving us a review below. Thanks for tuning in. Hi everyone. I hope you enjoyed this week's episode. Just a reminder that this podcast is for educational purposes only. This podcast is not a substitute for professional care by a doctor or other qualified medical professional. This podcast is provided on the understanding that it does not constitute medical or other professional advice or services. If you're looking for help in your journey, seek out a qualified medical practitioner. If you're looking for a functional medicine practitioner, you can visit ifm.org and search their find a practitioner database. It's important that you have someone in your corner who's trained, who's a licensed.

Healthcare practitioner, and can help you make changes, especially when it comes to your health. Don't forget, there's a way to listen completely ad free with Hyman plus on Apple podcasts. You can enjoy every episode without any breaks. Just open Apple podcasts and tap try free to start your seven day free trial. I'm going to transcribe the English words that are spoken.