Intranasal perillyl alcohol + low carbohydrate diet

 Adjuvant effect of low-carbohydrate diet on outcomes of patients with recurrent glioblastoma under intranasal perillyl alcohol therapy

"Results:

In the 1-year follow-up, the POH/LCD group showed a 4.4-fold decrease in the proportion of patients who needed treatment with corticosteroids, as well as a reduction in tumor size and peritumoral edema, as compared to the POH group. While 75% of patients undergoing POH treatment experienced seizures, this fraction was reduced to 56% in the POH/LCD group. A 2.07-fold increase in the proportion of patients with stable disease, along with a 2.8-fold decrease in the proportion of patients with TP, was seen in the POH/LCD group."

POH = intranasal perillyl alcohol

LCD = low carbohydrate diet

TP = tumor progression.

View full study here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7710475/

Feasibility of modified Atkins diet during radiation - retrospective study

Feasibility of a modified Atkins diet in glioma patients during radiation and its effect on radiation sensitization.

https://www.ncbi.nlm.nih.gov/pubmed/31548811

A KETOGENIC PILL FOR GLIOBLASTOMA ?

Came across this study and would love to know others' thoughts. I have been following the progress of the ketogenic (almost no carbohydrate) diet for some time and its potential value in glioblastoma and epilepsy. This study seems to show that some of the purported benefits could be achieved through a ketone ester supplement, which serves to provide the brain with its alternative non-glucose fuel source (Ketone bodies)
direct link to abstract: https://academic.oup.com/neuro-oncology/article-abstract/20/suppl_6/vi36/5154383?redirectedFrom=fulltext )

Any thoughts on this, and how it might be translated to human use?

Thanks!

Improvement of the ketogenic diet

In many studies, it has been shown that a ketogenic diet can be a useful supplement in the treatment of glioblastoma. I would like to discuss the improvement of this diet on the basis of recent research.

1. Ketogenic diet + α-lipoic acid and hydroxycitrate
2017 https://www.ncbi.nlm.nih.gov/pubmed/28122260
"To decrease anabolism, glucose uptake should be reduced (ketogenic diet). To increase catabolism, the oxidative phosphorylation should be restored. Treatment with a combination of α-lipoic acid and hydroxycitrate has been shown to be effective in multiple animal models."

2016 http://crescopublications.org/pdf/CROOA/CROOA-2-019.pdf
"Combination of Metabolic Treatment of Aggressive Primary Brain Tumour
and Multiple Metastases of the Brain"
"We report the cases of 12 patients with advanced brain tumor. They were all treated with
conventional treatment and a combination of sodium R lipoate (800 mgbid), hydroxycitrate at 500 mg tid and low-dose naltrexone at 5 mg at bedtime. Eight patients had primary brain tumour (n=8 including five glioblastomas) four patients had multiple brain metastases."

2. Ketogenic diet + Fenofibrate ?
2016 https://www.ncbi.nlm.nih.gov/pubmed/26869992
"Our results reveal a new, intriguing aspect of cancer cell biology and highlight the benefits of fenofibrate as a supplement to both canonical and dietary (ketogenic) therapeutic approaches against glioblastoma."
2015 https://www.ncbi.nlm.nih.gov/pubmed/26172294
"Given that fenofibrate is a widely used non-toxic drug, we suggest its use in patients with glioblastoma multiforme (GBM)."
2017 https://www.ncbi.nlm.nih.gov/pubmed/28459367
"...the lipid-lowering agent fenofibrate...have potential to lower synthesis or effects of G(M)-CSF and thus deprive a glioblastoma of some of the growth promoting contributions of bone marrow and G(M)-CSF.
It's strange, but in this blog I did not find any information about Fenofibrate. So is it necessary to add it to the ketogenic diet?

3. Ketogenic diet + Inhibition of glutamine metabolism ?
2017 https://www.ncbi.nlm.nih.gov/pubmed/28720668
"Inhibition of glutamine metabolism slows the in vitro and in vivo growth of GLNHigh GBM cultures despite metabolic adaptation to nutrient availability, in particular by increasing pyruvate shuttling into mitochondria."
"...the pleiotropic metabolic inhibitor EGCG, targeting glutamine metabolism, specifically reduces tumor proliferation, in vitro and in vivo, of mesenchymal GLNHigh cells."
How can the findings of this study be used? Only EGCG can not inhibit glutamine metabolism. Maybe there are more options?

4. Ketogenic diet + Specialized medium-chain triglycerides (MCT) ?
2016 http://clincancerres.aacrjournals.org/content/22/10/2482
"MCTs were specifically chosen based on carbon chain lengths (C8:C10::97%:3%), which allow them to rapidly diffuse from the gastrointestinal tract into the hepatic portal system and travel directly to the liver where they are converted into ketone bodies."

5. What other ideas can you offer to enhance the effect of a ketogenic diet?

My wife has been on a ketogenic diet for some time now and I've been weighing the pros and cons of this.

Came across this excellent video, which is <24 minutes, from the "father" of the ketogenic diet as it relates to GBM. I thought it worthwhile to share:
https://vimeo.com/54866497


This is expanded on greatly via this podcast from his acolyte, Dominic D'agostino:
fourhourworkweek.com/2015/11/03/dominic-dagostino/

Download it here to listen while commuting as it's like three hours. Both are worth the time to listen to, if only for background.

I'd like to hear if you are on a ketogenic diet and if it's helped you at all.

Brain tumour diet

Just wondering what sort of diet is everyone doing? I have my hubby (Alan) on a low carb diet, that includes meat(grass fed) and cheese. I thought that was good then Anna mentioned IGF-1 that is connected to some cancers .  Yikes!!

Updated 10/6/15 Cocktail: 63 y/o male with GBM

All - here is the updated list as of 10/6/15.  I've ordered stronger Reishi mushroom capsules so that will cut our pills down by 5 a day.  We're on day 14 and so far he's doing well.  Blood work showed some elevated liver values but nothing concerning and no need to add the Avastin yet.  His speech has improved and walking is a little better, but he shows signs of 'chemo brain' and issues with short term memory and fatigue.

Drug	Dosage	Qty	When
Pterostilbene	100mg	2 tabs	7:30 AM
Keppra	500mg	1 tab	7:30 AM
Dexamethasone	4mg	2 tabs	7:30 AM
Metformin	500mg	1 tab	7:30 AM
Selenium	200mcg	1 tab	7:30 AM
Verapamil	180mg	1 tab	7:30 AM
Depakote	500mg	1 tab	7:30 AM
Green Tea Extract	500mg	3 tabs	7:30 AM
Ranitidine	150mg	1 tab	7:30 AM
Reishi	500mg	6 tabs	7:30 AM
Quercetin	500mg	3 tabs	7:30 AM
Reservatrol	125mg	1 tab	7:30 AM
Omeprazole	20mg	1 tab	7:30 AM
Disulfiram	250mg	1 tab	NOON
Copper	2mg	3 tabs	NOON
Coriolus Versicolor (PSK)	600mg	2 tabs	NOON
Tumeric (NRF2)	600mg	2 tabs	NOON
Curcumin	750mg	1 tab	NOON
Celebrex	200mg	1 tab	NOON
Chloroquinine (Plaquenil)	200mg	1 tab	NOON
Pterostilbene	100mg	2 tabs	NOON
Pterostilbene	50mg	1 tab	NOON
Multi Vitamin		1 tab	NOON
Sulfamethoxazole		1 tab	M/W/F   NOON
Vitamin D3	5000 IU	1 tab	NOON
Green Tea Extract	500mg	3 tabs	NOON
Lycopene	10mg	1 tab	NOON
Maitake	1000mg	2 tabs	5:00 PM
Reishi	500mg	4 tabs	5:00 PM
Green Tea Extract	500mg	2 tabs	5:00 PM
Coriolus Versicolor (PSK)	600mg	3 tabs	5:00 PM
Keppra	500mg	1 tab	5:00 PM
Dexamethasone	4mg	2 tabs	5:00 PM
Depakote	500mg	1 tab	5:00 PM
Metformin	500mg	1 tab	5:00 PM
Ranitidine	150mg	1 tab	5:00 PM
Fluoxetine	20mg	1 tab	5:00 PM
Stool Softener	100mg	1 tab	5:00 PM
Melatonin	10mg	2 tabs	7:00 PM
Zofran	8mg	1 tab	7:00 PM
Viagra		.25 tab	7:30 PM
Temodar	140mg	1 tab	8:00 PM
Temodar	20mg	1 tab	8:00 PM

Questions:
1.  Verapamil - I asked our primary Dr. for more, and told her that I want a total of 480 or 600mg per day.  She instead upped us from 120mg to an extended release 180mg.  Does anyone know if Rich/Ben took extended release or shorter acting Verapamil?  Does anyone else take the extended release?  

Thanks.

Annie

Update on Minjung's status

Hi everyone,
Hope all of you and your beloved ones are doing well.

Here's an update of my fiance's situation.
Minjung's been very ill for the last few weeks. She had finished radiation about a month ago, but she started to have minor but constant seizures and some problems with body coordination. She's been and still is being treated with steroids but things are just getting worse... and now she is unable to open her eyes (she still can see if we force open her eyelids).
3 days ago, she had another surgery because the doctor thought her shunt wasn't working properly. When she woke up, she could open her eyes and we all thought things were going in the right direction.. until the next day when she went back to how she was before the surgery.
Also, the current anti-seizure med (Keppra) is clearly not working at all.
So we asked the staff to tell the doctor to prescribe valproic acid as her anti-seizure med today. We'll see how the doctor responds to our request...

We want her to start Temodal and cocktail therapy as soon as possible, but every time we bring that up, the doctor keeps saying she's not ready at all for chemotherapy. We're even considering switching to other hospital. My worst fear is that Minjung may not even have a fair chance of battling this disease, which to me was the cocktail approach.



Best,
Hyunsun

Low carb diet

Hubby has been on a low carb diet since dx. We are lucky enough to live near an certified organic, grass fed dairy so have access to raw milk, cream and butter which we have been eating a lot of as grass fed dairy has higher levels of CLA which has anti cancer effects, and they also taste good :)

  http://www.ncbi.nlm.nih.gov/pubmed/25448730

Yesterday I read somewhere(can't find where) that fat especially when consuming saturated fats that it   metabolizes into    glycerol which causes blood spikes and increased levels of sugar in blood for longer periods.....exactly what we are trying to avoid. Isn't the ketogenic diet mostly fat? Can anybody shed any light on this?
So much to think about
Linda

Cocktail Profile for Jeremy (Mikes son)

Here is my sons cocktail.  Chloroquine is being taken one month on, one month off.  Disulfiram is being taken on TMZ days.  EGCG taken only when taking TMZ.  DCA taken continuously.  Artemisinin and its analogs taken on a rotation schedule, but schedule is modified as necessary so they will be taken concurrent with TMZ.

Tumor specifics:  IDH1 mutant.  P53 mutant.

Last MRI was July 26th.  Inoperable brain stem GBM continues to be absent and the resected GBM (100%) in the left hemisphere shows no recurrence.  More diffuse lower grade non enhancing tumor is stable since late last year.  Concurrent use of Optune.

	Morning		Evening
Artemisinin  100 mg  Caps   5 days on 5 off	2
Artesunate 50 mg caps   5 days on 5 off	3
Artemether   40  mg caps  5 days on 5 off			2
Fish oil with High EPA/DHA	2		2
DCA  ~17 mg/kg/day  wt is 82 kg	700 mg		700 mg
Longvida Curcumin	6		6
Lycopene 10 mg	1
Melatonin 20 mg			1
Super Coriolus	3		3
Maitake D Fraction	3		3
Berberine  500 mg / capsule	2		2
Vitamin D 10,000 IU capsules	2
Ultra Soy Extract	1
Selenium  200 mcg	1
Milk Thistle   300 mg/capsule	2		2
Thiamin  250 mg			1
Pterostilbene	3		2
Benfotiamine	1
EGCG    (take on days with temodar)			4
Zinc	50 mg
PRESCRIPTION MEDS
Temodar
Vimpat
Tagamet  (200 mg tablets)	2		2
Metformin  (1000 mg tablets)	1		1
Celebrex      200 mg tablets	2		1
Sertraline (Zoloft)   50 mg	1
Minocycline  (100 mg tablets)	1		1
Chloroquine Phosphate    250 mg tablets)	1
Disurfiram (takes days you are on Temodar)