21 Comments
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Abby Cooper's avatar

Thank you for tackling this topic in a balanced, informative way. I appreciate your perspective, especially because my husband and I have had very mixed reactions from oncologists about metabolic therapies like a keto diet. I truly believe it has been one of the factors for that helped him get to eight years post GBM diagnosis (along with other treatments too, including standard of care), but I guess we will never know for sure! More info is definitely needed in this area and it’s promising to see that it is being studied. Just in the past eight years I feel that there has been so much more data and info on metabolic health and the connection to cancer.

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Daniel Flora, MD, PharmD's avatar

Thanks Abby I’m glad you found it useful. So much to learn. I think we need to open some new avenues of cancer research to explore metabolic approaches.

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Luc's avatar

Good article ! Have read alot about Seyfried. I've read recently about some issues for those over 60 wanting to fast but can't find it at the moment. Any issues with that you've seen/heard?

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Daniel Flora, MD, PharmD's avatar

All I can say is fasting and keto diets are hard. They seem to be harder as we age too. Honestly, in the real world I don’t think it is practical for most cancer patients to maintain in the long term. Perhaps short term may have some benefit, but that’s even less clear.

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Luc's avatar

Might be easier to just get people to stop the sugar, bad carbs, sugar free stuff, injected meats (WalMart) and source local farmers. Get some sun!

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Root Causes | Medical Clinic's avatar

Thank you for bridging clinical experience with patient curiosity—metabolic health deserves a bigger seat at the table.

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Rachel Youngman's avatar

Really helpful information. Great to finally find a sensible approach. I can’t have immunotherapy for melanoma (I got encephalitis after 12 months for breast cancer and it didn’t hope back melanoma) so I’m taking targeted therapy and doing everything I can with diet to get my immune system working well. Your posts really inform!

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Daniel Flora, MD, PharmD's avatar

Cancer is never simple. So many variables and the complications of treatment make it all more challenging. Control the variables we can control (diet, exercise, sleep) and the science will keep advancing.

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Victorious Val's avatar

I’m so glad you hit me up on Substack because I’ve benefited greatly from your knowledge. Thanks for this.

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Daniel Flora, MD, PharmD's avatar

Thank you for supporting!

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Linda Figgins's avatar

Very helpful info

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Michael Richman MD, MMM, FACS's avatar

Great article!

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Daniel Flora, MD, PharmD's avatar

I think it meshes well with your recent article. I think the science is promising and we should move forward with more studies in this space.

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Jenny Peterson's avatar

Another great post, Daniel! An acquaintance of mine, Dr. Katie Deming, believes cancer is a malfunction of the mitochondria. She was a radiation oncologist who left strictly traditional cancer treatment to focus on more integrative treatment. I find this all very fascinating!

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Daniel Flora, MD, PharmD's avatar

It’s certainly part of the story, so much we have yet to uncover.

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Mark Stevenson's avatar

Loving this Daniel!

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Daniel Flora, MD, PharmD's avatar

Thanks Mark! It's an important topic and one I think is challenging to cover. Hopefully, others find it helpful as well.

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Travis Reaves's avatar

I vacillate between adhering to this strictly, and also eating a bag of non-dairy cookies. It’s a murky life, just like the science.

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David Bubnoski's avatar

As someone who has been implementing this nutritional path for about a year in more of a prophylactic manner as active treatment is unnecessary at this point, I agree that sustaining a ketogenic diet and incorporating intermittent and multi-day fasting is challenging. What has been key for me in my path as a first step is gradually identifying and eliminating the sugar in my diet and breaking what is essentially a drug addiction. The drug in this case happens to be sugar or glucose in its broken down form. This drug is just about everywhere in the modern standard diet and the general population is highly unaware of it and its potential to support the genesis and proliferation of many diseases of metabolic dysfunction including cancer.

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Somewhere, Somehow's avatar

It is stunning when I see young people undergoing cancer treatment drinking soda. I think it is child abuse to allow these kids to drink/eat this crap while undergoing treatment.

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Daniel Flora, MD, PharmD's avatar

I agree it’s one of the first things I try to tackle when getting started on a plan. I see patients with a host of metabolic health issues at an early age. This is why we are seeing early onset cancers. Insulin is a growth factor.

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