In early 2012 I discovered the ketogenic diet for cancer.
I’ve understood for many years that different diets work for
different people, and I was intrigued by this as another possible
dietary strategy to heal cancer, so naturally I shared information
about it on this site, thinking it might be a viable option for
some. At that time there were no other sites as large as mine
talking about it.
In 2013, awareness of the keto diet exploded, mostly do to Dr.
Mercola’s articles, interviews and endorsement of it. Since then,
many others have jumped on the bandwagon. And at first glance, there
is some very compelling science that presents the ketogenic diet as
a method to starve cancer cells of their primary fuel, glucose, thus
killing the cancer.
Despite the zealous promoters of it, some of whom I have great
respect for, my opinion of the ketogenic diet for cancer has
It started with several long phone conversations and email exchanges
I had with my friend
Dr. Patrick Vickers of
Northern Baja Gerson Center. He was adamant that the ketogenic diet
did not work in healing cancer long term. This coincided with the
recurrence of cancer in someone I knew that was promoting the
ketogenic diet as effective.
It appeared to have some positive short term results for some people
(shrinking tumors), but I was beginning to have some doubts about it
working long term. This persisted for many months and I could not
shake it. So I finally made the decision to take down my very
popular post and youtube video about it. To date, that is the only
post I’ve ever taken down.
Then came the coup de grace from Dr. Nicholas Gonzalez.
Dr. Gonzalez and his colleague Dr. Linda Isaacs have had remarkable
cancer patients with a non-toxic nutritional protocol that
incorporates Gerson principles
along with the late Dr. William Donald Kelley’s protocol which
includes high doses of pancreatic
individualized diets depending on body type and cancer type. I have
huge respect for them, not because of their theories, because they
are getting results, including reversing “incurable” stage four
Recently Dr. Gonzalez wrote an eight part article series for Natural
Health 365 on
the history and failure of the ketogenic diet for cancer. Dr.
Gonzalez’s nutritional cancer treatment expertise is much deeper
than ANYONE currently promoting the ketogenic diet for cancer,
because unlike anyone else promoting it, he actually treats cancer
patients with nutrition every day. And that sealed the deal for me.
There are thousands of people out there who have healed cancer
naturally. I meet natural survivors constantly and even share
their stories on
this site. Most natural cancer healing protocols involve a radical
change of diet and lifestyle that includes overdosing on nutrition
lots of raw plant food, little to no animal food, supplements,
and herbal cleanses along with detox protocols like the
liver/gallbladder flush, coffee
etc. Those are all time-tested methods validated by a large body of
long term survivors.
I know a lot of long-term natural survivors, but I don’t know any
long-term survivors who have used a ketogenic diet to heal.
Like I said, there’s some really compelling science… but no
And that’s my big hang up.
I don’t care how good the science sounds. Survivors
trump science. And
until I see a substantial list of long term survivors, I have no
choice but to retract my support of the ketogenic diet as a viable
option for healing cancer. I am perfectly ok with being proven
wrong, and if so, I will freely admit it, but it will be at least
5-10 years before that is possible.
Having said all that, if a protocol like the one I described above
did not work, I would certainly be open to try to heal with a
ketogenic diet over chemotherapy. It just wouldn’t be my first
Here is a short video in which Dr. Gonzalez explains why he thinks a
ketogenic diet doesn’t work for cancer. Just to recap, Dr. Gonzalez
uses nutrition to heal cancer, putting his patients on a variety of
diets based on their cancer and other factors. Simply put, if the
ketogenic diet worked, he would be using it.
If you really want to dig in, Dr. Gonzalez masterfully dismantles
the ketogenic diet for cancer in the lengthy article below. This is
not a scientific rebuttal, quibbling ad infinitum over theories
about Warburg, glycosis, cell respiration, and ATP, rather it is a
thoughtful, well-reasoned reflection from a doctor in the trenches
of nutritional cancer treatment for nearly three decades. His real
world experience, historical perspective and common sense put him
head and shoulders above the ivory tower theorizers.
Highly recommended for anyone who has read any pro-keto diet
Enter Dr. Nicholas Gonzalez.
In this initial article, I’d like to begin by making the point that the
world of cancer research and cancer medicine is littered with the
discarded theories and rejected therapiesthought at one
time to be the next promising miracle, the final answer to this
perplexing and deadly disease. In my own professional lifetime, I
have witnessed a number of cancer miracles come and go, sometimes in
quite dizzying succession and at times with extraordinarily dazzling
I remember one of the first, from 1980 when I was a first year
medical student at Cornell; in this case, it was, according to the
press and the journals, the magic of interferon, an immune stimulant
destined to bring cancer to its knees. Not too long afterward,
interferon would turn out to be a bust, with its promise and fame
rising and falling in roller coaster-like style.
I lived through a far more extraordinary situation just five years
I had graduated medical school by that point and was living in
Florida, finishing my immunology fellowship under Robert A. Good,
MD, PhD, the famed “father of modern immunology” as he had been
It was late 1985 when the media broke
the story about the next cancer miracle. I was sitting in my
apartment overlooking beautiful Tampa Bay, when I read the initial
front-page newspaper reports. Dr. Steven Rosenberg, already
well-known as Ronald Reagan’s surgeon (the President had a malignant
polyp), and a highly regarded basic science researcher running a
section at the National Cancer Institute in Bethesda, Maryland, had
just revealed to the world – at a press conference, as I remember –
his preliminary pilot study results with a new immune modulator,
interleukin-2, that would provoke an extraordinary media frenzy.
The initial pronouncements, released with such glowing enthusiasm,
indicated that finally, yes finally, after so many disappointments
we might actually be looking at a real, universal cancer cure. In
both laboratory and preliminary human trials, interleukin-2 – like
interferon before it, a natural product secreted by lymphocytes that
stimulates other cancer-fighting immune cells into action – had
performed almost magically against even the most aggressive of
cancers, such as metastatic melanoma and metastatic kidney cancer.
News of Dr. Rosenberg’s “miracle” was everywhere, in the print
media, on the local and national news, and in an extended Newsweek story
appearing December 16, 1985, with white-coated Dr. Rosenberg on the
cover peering intently at the world. The article, titled “Search for
A Cure” in large bold print went on for six pages, accompanied by
photos of Dr. Rosenberg, one with a patient, another as the serious
scientist in the lab. Elaborate, colorful artwork illustrated the
narrative, showing the intricate mechanisms of the immune system,
and pinpointing interleukin-2’s ability, under the guiding hand of
Dr. Rosenberg, to fight malignant disease.
A separate subsection headlined “The Rise of a Superstar, From
Reagan’s surgery to the frontiers of research” chronicled the
compelling life story of Dr. Rosenberg. You
couldn’t buy better publicity than this.
At the end of this piece, the writers did include a brief section
titled “Interferon: A Cautionary Tale,“ reminding readers of the
hoopla five years earlier over that other immune modulator, which
too had been all the rage in the cancer research world. The essay,
following the main laudatory articles, began:
To some ears, last week’s exultation over interleukin-2 has a
familiar but discordant ring. Something similar happened about five
years ago with a substance called interferon, the “magic bullet” of
cancer research, featured on magazine covers and in articles with
titles like “To Save Her Life – And Yours.” … But by 1984 the magic
bullet had misfired; now the articles were called “The Myth of
Over the years, I had become particularly familiar with the
interferon story since my boss, Dr. Good, had done much of the
original research linking it to a possible anti-cancer effect.
By that point, I knew Dr. Good quite well: during my second year of
medical school, Dr. Good, at the time a professor at Cornell and
Director of the Sloan-Kettering Institute, had begun guiding my
fledgling research career. In 1982, during my third year of medical
school, to my dismay the powers that be at Sloan pushed him out
Subsequently, he spent some time at the University of Oklahoma,
where he was hired to set up a cancer research division, before
moving to All Children’s Hospital in St. Petersburg, where again he
established a cancer research-bone marrow transplant unit.
When the news of interleukin-2 first hit the press, I discussed this
new “miracle” with Dr. Good, who had grown quite cautious after
years of experience and having witnessed many similar announcements
followed by the inevitable letdown in the research community.
“Look at the data, always look at the data,” he
said, “not the media reports.” I followed his advice, tracked down
and studied the actual clinical data, which I found surprisingly
unimpressive. As I recall, in the first uncontrolled trial, of more
than 100 patients entered only three seemed to have experienced any
significant or lasting response.
In subsequent months, reports of enormous toxicity, even patient
deaths began to filter through the research community, serving to
temper the initial hysteria. And it wasn’t cheap, as miracles go –
the very toxic drug was so potentially dangerous it had to be
administered in a hospital setting under very close supervision,
with costs running in excess of $100,000 for a several-week course
Despite the initial warning signs, the media continued its
relentless promotion of interleukin-2 for a number of years. In
1992, perhaps due to political pressure more than scientific
evidence, the FDA approved the drug for use against cancer, despite
the lack of comprehensive controlled trials. Then in the late 1998 a
clinical study – completed some 13 years after the initial reporting
– showed that interleukin-2, at least with advanced kidney cancer,
worked no better than placebo.
It’s still being used, though increasingly rarely, and no one I know
talks about it with much enthusiasm.
By the 1990s, just as practicing oncologist were giving up on
interleukin-2, bone marrow transplant (BMT) as a solution to poor
prognosis or metastatic breast cancer started grabbing the
headlines, touted as a cure for this most invidious of diseases
striking so many women in the prime of life. Despite the lack of any
compelling evidence it worked for this indication, bone marrow
transplant was being pushed as a solution to deadly forms of breast
malignancy. However, initially insurance companies refused to pay
for this unproven and very expensive treatment, which could cost in
those days up to $500,000 or more.
Nonetheless, enthusiastic oncologists joined with the media,
portraying insurance companies as heartless, greedy bullies
depriving women with breast cancer of a curative treatment. Not too
long after, the trial lawyers got involved, orchestrating a series
of lawsuits against various insurance companies on behalf of women
wanting a BMT. In a particularly notable and telling case, Fox vs.
HealthNet, the jury awarded the plaintiff, a woman diagnosed with
breast cancer whose insurance carrier refused to cover the
procedure, $89 million, including $77 million in punitive damages.
Under such threat, the insurance industry relented, finding it
cheaper to pay the $100,000 or $200,000 or $500,000 per procedure
then risk such catastrophic financial harm.
After some 40,000 women underwent the procedure – at a time when
10-30% of patients died from the treatment itself – it was eventually
proven to be worthless. The one glowing positive study
from 1995, the infamous South African study of Dr. Bezwoda, turned
out on closer examination to be a complete fraud, with the creative
researcher simply making up the data. The wonderful and frightening
the bone marrow transplant-breast cancer fiasco in great detail, for
those with an interest.
As these battles waged in the early 1990s, I had long left Dr.
Good’s group, having returned to New York and private practice.
Nonetheless, this story had a personal ring to it, as had the
interferon story, since Dr. Good had completed the first bone marrow
transplant in history, in 1969, and long hoped this technology would
be, yes, an answer to cancer.
Under his direction, during my fellowship years I learned how to do
this very tricky and often deadly procedure.
But no fear, there’s always a new miracle around the corner,
and in 1998 the newspaper reporters and TV newscasters, having
effortlessly drifted away from interferon and interleukin-2 and the
bone marrow transplant craze, were all in a tizzy over the newest
“final” solution to cancer, anti-angiogenesis, based on the
pioneering work of the late Dr. Judah Folkman of Harvard. Dr.
Folkman had spent decades studying the process of angiogenesis in
cancer tissues, the formation of new blood vessels that allow tumors
to grow quickly and invade through normal tissues and organs with
Without a rich blood supply, cancerous tumors cannot grow beyond a
Dr. Folkman had developed two drugs, angiostatin and endostatin,
that in animal experiments reversed tumor growth by blocking new
blood vessel formation, essentially starving out the cancer cells.
In a November 1998, presentation of his work at the National
Institutes of Health in Bethesda, Maryland, Dr. Folkman announced to
the world that at least in mice, “we have not seen a tumor we cannot
Though Dr. Folkman’s research was all based on laboratory
experiments and animal studies, the powerful NCI publicity machine
took up the cause, with the smell of “miracle” again in the air,
despite the lack of any evidence that Folkman’s anti-angiogenesis
drugs worked against human cancer. Nonetheless, with the NCI and NIH
on board, the media, large and small, local and national, seemed
transported into a state of frenzy.
I recall so well, this time sitting in my mid-Manhattan office,
reading that famous May 3, 1998 front page lead New
York Times article (in
the upper left of the page reserved for wars, revolutions, and, yes,
miracles) by reporter Gina Kolata, announcing Folkman’s preliminary
findings to the world, extolling anti-angiogenesis in a tone that
one more skeptical writer, Jack
described as “breathless.”
Kolata quoted no less an authority than Dr. James Watson, the Nobel
Laureate in 1962 for his discovery, with his colleague Frances
Crick, of the structure of DNA, the basic genetic material. “Judah
is going to cure cancer in two years,” Watson told Kolata. You
couldn’t ask for a better source, making a more definitive claim.
Kolata’s unrestrained reporting continued: “Dr. Watson said Dr.
Folkman would be remembered along with scientists like Charles
Darwin as someone who permanently altered civilization.”
The writer also quoted an enthusiastic Richard Klausner, MD, at the
time Director of the National Cancer Institute, who assured the
world, “I am putting nothing on higher priority that getting this
into clinical trials.”
The glowing TV stories followed, including a memorable prime time,
one-hour special about the subject on ABC hosted by the late Peter
Jennings. The other networks, in quick succession, picked up the
cause. However, not too long after, word broke that Times’ reporter
Kolata had been, through her agent, hawking to publishers an idea
for a book about anti-angiogenesis and cancer.
Her agent, according to reports at the time, began circulating a
book proposal the day after the Times story ran, asking for a $2
million dollar advance! The whole episode raised some eyebrows over
a reporter seeking to benefit personally from a subject she was
promoting in the news section of the Times. After a fair amount of
criticism, Kolata withdrew her book proposal.
As Dr. Klausner promised, the National Cancer Institute, probably
swept up in the national and international explosion of hope and
enthusiasm, “fast tracked” a preliminary study of endostatin in
human patients, intending to enroll, as I recall, 70 subjects very
But what surprised me –
and what began to concern others I knew in the medical community –
was some time later the deafening silence about the trial’s outcome,
and what seemed to be a blackout about the actual data. Eventually,
the study results were published indicating that 42 subjects had
been ultimately recruited for the trial, not the planned 70, and not
a single one of these had responded to the drug.
Ironically Jennings himself, who had promoted the therapy with
unabashed enthusiasm, would die of lung cancer, only months after
his diagnosis in 2005. Folkman too, has passed on, never to realize
his hope of an anti-angiogenesis, cancer-free world.
Nevertheless, anti-angiogenesis as the answer to cancer remains a
big driving force in “biotech” companies, who have developed a whole
slew of angiostatin and endostatin offspring, including the drug
Avastin, costing up to $10,000 a month, though it doesn’t work
particularly well. The clinical studies aren’t impressive, usually
reporting several months of improved survival in patients diagnosed
with a variety of advanced cancers.
In a further ironic turn, in December 2010, after approving the drug
for treatment of women diagnosed with breast cancer, the
FDA rescinded its blessing of Avastin for
this indication when clinical trials failed to show any significant
The anti-angiogenesis love affair not only affected conventional
researchers and oncologists, but infiltrated deeply into the
“alternative” cancer world. During the late 1990s, I read numerous
articles lauding the anti-angiogenic effect of various herbs. Some
ten years ago or more, a number of alternative physicians began
promoting artemesinin, an herb from Africa long used as a treatment
for malaria, as a “natural” anti-angiogenesis supplement.
But ten years after the initial burst of enthusiasm, few of my
colleagues even mention it.
And so it goes. We as a culture, as a nation, as a world, are
forever looking for miracles from our scientific and medical gurus,
miracles that might finally bring cancer to its knees. And there
will forever be miracles ripe for the picking. In the next article,
I will discuss the “Ketogenic Craze.”
In 2012, Dr. Thomas Seyfried, a PhD basic science researcher,
published the book, Cancer
as a Metabolic Disease, announcing to the world that a
high-fat, no carbohydrate ketogenic diet represents the solution to
cancer prevention as well as to cancer treatment. His monograph has
been greeted with much acclaim, though not yet at the level reached
at the height of the interleukin-2 hysteria in 1985.
Dr. Seyfried, whom I do not personally know, is hardly an
“alternative” medical scientist, since judging by his credentials
listed on the back cover of the book his pedigree seems
THOMAS N. SEYFRIED, PHD, has taught and conducted research in the
fields of neurogenetics, neurochemistry, and cancer for more than
twenty-five years at Yale University and Boston College. He has
published more than 150 scientific articles and book chapters …
A closer look at Dr. Thomas Seyfried and his work
Certainly Dr. Seyfried has put together a most impressive
achievement, chronicling in great detail his belief that cancer does
not develop from genetic alterations – as is generally believed –
but as a result of changes in fundamental cell physiology,
specifically changes in energy production, that in turn lead to the
cancer phenotype. In essence, the genes remain intact, but
metabolism goes awry.
The book summarizes, then enlarges upon, the concepts of Otto
Warburg, MD, the great German scientist who won the Nobel Prize in
Medicine and Physiology in 1931 for his work on cellular oxidation
and energy production. No scientist has ever been nominated more
frequently for the cherished Prize than Dr. Warburg, but he lost his
chance for a second win, according to some sources, in 1944 after
Hitler ordered that no German scientist could accept the award.
Who is Dr. Otto Warburg?
To sum up decades of Warburg briefly, mammalian cells create and
store usable energy in the form of the adenosine triphosphate (ATP)
molecule. Production of ATP is a complex affair involving three
distinct and sequential series of cellular reactions that begin with
the breakdown of the six-carbon sugar glucose. The first of these
processes, glycolysis, does not require oxygen and occurs in the
cytoplasm; the second, the citric acid cycle, occurs within the
mitochondria, the oval shaped organelles dispersed within the
cytoplasm, and requires oxygen; and the third, and most productive
in terms of ATP generation, electron transport, proceeds in the
membranes of mitochondria and also needs oxygen.
In normal mammalian cells, glycolysis represents the starting point
of energy synthesis. Its end product, pyruvic acid, is in turn
shunted first into the citric acid cycle, then ultimately into the
electron transport chain. Along the way, a complex series of
step-wise reactions releases multiple energy-rich ATP molecules.
Based on his years studying cellular metabolism,
Dr. Warburg proposed that cancer cells, unlike normal cells, rely
exclusively on anaerobic glycolysis for energy. Such cells do fine
in the absence of oxygen, since the metabolic machinery of
glycolysis doesn’t require it.
Warburg claimed that in these abnormal cells glycolysis actually
uncouples from the citric acid cycle and electron transport, leaving
the cells dependent solely on this rather inefficient mechanism for
survival. Bacteria also synthesize their ATP energy exclusively from
glycolysis, in the process we know as fermentation.
This uncoupling of glycolysis from the citric acid cycle and
electron transport, and the supposed fundamental dependency of
cancer cells on anaerobic metabolism, has been studied extensively
since Warburg’s day, with many scientists around the world claiming
to confirm, then adding to, Warburg’s hypothesis. As Dr. Seyfried
correctly points out, in more recent times, cancer researchers have
begun drifting away from the study of disordered cellular
physiology, enamored as they are of genetic abnormality as the
primary and only driving force in cancer formation and growth.
Warburg’s ideas about faulty metabolism seem to have been
the elegance of, and fascination for, the “genetic cause of cancer.”
I agree Dr. Seyfried has done us all a great service by redefining,
re-emphasizing and refining Dr. Warburg’s remarkable research from
80 years ago. He makes the case, using the contemporary basic
science data, to support Warburg’s belief that cancer cells depend
solely on glycolysis for survival, with his claim regarding the
uncoupling of this sugar-fueled, oxygen-independent process from the
citric acid cycle and the electron transport chain. But he goes a
major step further, stating as fact that since cancer cells depend
on anaerobic glucose metabolism for energy, they can be stopped in
their tracks by depriving them of blood glucose.
Our normal healthy cells, be they situated in the brain or the skin
of our feet, do prefer glucose as their primary energy source,
obtained from the sugar circulating in the blood. That “blood sugar”
comes from a variety of sources, including dietary carbohydrates
occurring in fruits, starchy vegetables like potatoes, and grains.
The complex carbohydrates in such foods are broken down into glucose
during the digestive process, catalyzed by a variety of
carb-specific enzymes like amylase.
We also maintain a certain amount of stored sugar as glycogen, found
in the liver and muscle and formed when glucose molecules link up to
one another in complex chains. In times of need and if deprived of
dietary carbohydrates, our liver and muscle cells can break down
glycogen into glucose for release into the bloodstream. Our liver
cells can also, when necessary, convert certain amino acids such as
alanine into glucose.
glycogen supplies in the liver and muscle are quite limited,
providing only an 8-12 hour emergency supply. So during a fast, or
starvation, or on a diet providing no carbohydrates in any form, we
quickly run out of glycogen. In this situation, through a variety of
neural and hormonal signaling, our fat cells, or adipocytes, begin
releasing free fatty acids into the blood stream. These fatty acids
can in turn be used by our cells in the alternate ATP producing
process of beta oxidation.
The end result of this series of reactions, acetyl coenzyme A, can
then be shunted into the citric acid cycle and the electron
transport chain, to produce maximum amounts of energy-rich ATP.
Though most of our cells can utilize fatty acids of all stripes via
beta oxidation to create ATP energy, our
central nervous system is at somewhat of a disadvantage.
In fact, long chain fatty acids with 14 or more carbons, which can
yield the most ATP from beta oxidation, do not cross the blood-brain
barrier. However, in a state of prolonged dietary carbohydrate
depletion, the liver begins converting acetyl coenzyme A into
various ketone bodies, such as acetoacetate and beta hydroxy butyric
acid, which easily penetrate into the brain and which can, like
acetyl coenzyme A, be shunted into the citric acid cycle and then
the electron transport chain, providing the brain with ATP.
On a low carb or no carb diet, our billions of cells in all our
tissues and organs switch their energy mechanics from a process
driven by glucose to one propelled by fatty acids and ketone bodies.
The term “ketosis” simply means the state in which, in the absence
of sufficient glucose, our liver synthesizes ketones from acetyl
on a no carb, all meat, high-fat diet, we will still be consuming
some glucose in
the form of glycogen stored in muscle and organ meats, and our
livers will continue to convert some dietary amino acids into
glucose, so blood sugar levels never hit zero on such a diet. But in
such cases, the amounts produced will be minimal.
Though our normal cells do just fine in the absence of
carbohydrates, cancer cells, Dr. Seyfried claims, do not. These
cells, he says, can never use fatty acids or ketone bodies for any
significant energy production, since the citric acid cycle and
electron transport in them remain basically inactive. So, he
proposes, as the culmination of his exegesis, that on a high fat,
moderate protein, no carb diet, a cancer patient will deprive his or
her deadly abnormal cells of their only useful source of energy,
blood glucose, leading to apoptosis, or cell death.
It’s that simple. No dietary sugar, no cancer.
The science is impressive, the conclusion, to many it seems,
extraordinarily promising. But, is
this ketogenic diet really a “new” idea or
simply an old one, repackaged for the 21st century? And, can history
teach us anything about its efficacy against cancer, or any other
During the first half of the 20th century, physicians and
researchers studying the traditional Eskimo (Inuit) culture were
amazed by the health of these people subsisting on a very peculiar –
at least to the Western academic mind – high fat ketogenic diet. The
famed Arctic explorer Stefansson first documented the traditional
Eskimo diet, which was later studied in some detail in the early
1930s by a research team from McGill University in Montreal.
To the surprise of these investigators – at the time no Western
scientist believed any human could survive on nothing but meat –
this Eskimo diet consisted of virtually 100% animal products, 80% in
the form of fat, with much of it saturated, 20% protein, but
essentially no carbohydrates. From
cradle to grave these traditional Eskimos lived in a state of
In retrospect, it makes sense that in the Arctic the Eskimos, in
order to survive, would have adjusted to their high fat, moderate
protein, no carb diet. With its brief summer and lacking soils
suitable for crops, the region provides insufficient plant foods
suitable for human consumption but does offer an abundance of fatty
animal food both on land and in the sea. If the Eskimos hadn’t
adapted to such food, living as they did in such a difficult,
extreme part of the world, they simply would have died off.
Interestingly, as Stefansson pointed out, the Eskimos he studied and
lived with for ten years knew that their exclusive animal food diet
must be high fat, with moderately low protein. They warned a diet
lacking sufficient fat (or as a corollary in Western scientific
terms, high protein), would lead to sickness and eventually death.
As Stefansson and later scientists learned, the
Eskimos living on their high fat, ketogenic diet seemed free from
the typical degenerative diseases including
cancer and heart disease, already becoming rampant in the Western
world during the early decades of the 20th century. In 1960, the
elderly Stefansson – was quite a celebrity by that time for his
adventures to far away places – wrote a book entitled Cancer:
Disease of Civilization?,
in which he made the case that the typical Eskimo diet offered
complete protection from this frightening malady.
In a number of his best-selling books,
Stefansson argued strongly that we should all be living like
Eskimos, indulging in high fat, moderate protein, no carb diets –
that is, if we wanted superb, enduring good health.
Blake Donaldson, MD, who ran a general practice for decades on Long
Island, New York, began prescribing a ketogenic diet in the 1920s.
Donaldson, who was quite familiar with Stefansson’s reports on the
Eskimo diet, began recommending an all-meat, high-fat regimen for
his patients diagnosed with a variety of complaints such as obesity,
diabetes, and heart disease, though he doesn’t appear to have
treated cancer specifically. In his 1961 book, Strong
Dr. Donaldson summarized his findings and his many years of
experience recommending a high fat diet.
More recently, the
famed New York diet doctor, Robert Atkins, MD, popularized the
ketogenic diet, not for cancer, but as the ultimate
weight loss plan with his books over the decades selling in the tens
of millions of copies. The original version of the Diet Revolution
published in 1972 sold at one point more than 100,000 hard copies a
week, in those days the fastest selling book in the history of
United States publishing.
As the years passed, Dr. Atkins, a cardiologist by training, began
to see in the ketogenic diet the answer to many of the problems of
Western civilization beyond obesity, including heart disease,
diabetes, hypertension – and yes, even cancer.
The traditional Atkins’ Diet was certainly high fat,
in the range of 70% or more, nearly all from animal sources, and
with minimal dietary carbs, less than 10%. Dr. Atkins, famed for his
all-encompassing emphasis on ketosis during his early years as a
diet doctor, insisted his patients routinely check the levels of
ketone bodies in their urine several times a day, using special
In his books and in his office working with his own patients, Dr.
Atkins warned that to reap the benefits of his diet, one must reach
and stay in a state of ketosis, much like the traditional Eskimos.
Even a slight deviation from the diet, some ill-advised cheating
with a cookie or candy, could stop ketosis in its tracks, and with
it, the value of the diet.
I knew Bob quite well,
and considered him a friend. We first met when I interviewed him for
a nutrition story during my journalism days, and later on while I
was a medical student, we kept in close contact.
During my freshman year at Cornell Medical School – from which Bob
had received his own medical degree – I arranged for him to speak as
part of a lecture series I had set up on alternative approaches to
After I finished my conventional immunology training under Dr. Good,
in 1987 Bob graciously offered me a job in his clinic, not to work
with patients seeking dietary or general nutritional advice, but to
help supervise a cancer unit he was then in the process of
establishing. Though I was grateful for the proposal, I turned him
down, determined to set up my own practice.
Bob had achieved great success as a diet doctor,
with an estimated wealth at the time of his death in 2003 in the
range of $350 million. He was also a very driven and very smart
physician, who clearly saw in cancer, and not in obesity, the
ultimate challenge in medicine.
Bob, who knew Stefansson’s work well, told me during more than one
dinner together in the late 1980s that the ketogenic diet might
represent the ultimate solution to cancer. He thought, as Donaldson
and Stefansson had claimed before him, that all humans should be
following a ketogenic diet to achieve ultimate ideal health. But
were they right? Or was there another, perhaps more accurate way, to
look at the human dietary condition?
Nathan Pritikin believed, and fanatically so,
that all humans were genetically and metabolically programmed to
follow a high carb, very low fat, exclusively plant-based diet,
which if applied diligently would protect us from all the major
degenerative disease killers, such as diabetes, heart disease,
hypertension – and perhaps, even cancer.
The traditional Pritikin diet was literally a mirror image of the
Atkins’ Diet, with about 70-75% of all calories derived from
carbohydrates, 15-20% from protein, all from plant sources, and 8%
or less from fat, again all plant-derived.
After Pritikin’s death in 1985,
Dr. Dean Ornish of San Francisco would pick up the Pritikin mantle,
eventually testing a similar diet in patients diagnosed with heart
disease as well as in patients with prostate cancer.
The nutritional world then, as it is today, was surely confusing,
with various scientists, physicians, and lay authors promoting one
diet or another, often – as in the case of Atkins and Pritikin –
offering completely contradictory dietary recommendations.
Fortunately, when in 1987 Dr. Atkins offered me a job, I had already
found what I thought represented a solution to the dilemma of
dueling dietary dogma.
By the time I began medical school in 1979 I had read the
pioneering work of Weston A. Price, DDS, the American
dentist and researcher. Beginning in the late 1920s, Dr. Price,
accompanied by his wife, spent seven years traveling the world
evaluating isolated groups of people living and eating according to
long-standing tradition. Today such a study would be impossible,
since just about everyone everywhere has adopted the “Western” way
of living and eating, down to jeans and junk food.
But in Dr. Price’s day, many groups living in many different
locations still lived according to tradition largely untouched by
modern Western influence. Price’s travels took him from the Eskimos
of the Arctic, to the descendents of the Incas living in the high
Andes, to the Masai on the plains of Kenya, to isolated Swiss
herders in the Alpine mountain valleys, to Polynesians living on
pristine tropical islands.
The variety of diets around the world
Each of these groups Dr. Price studied seemed well adapted to the
available food supply. The Eskimos, as Stefansson earlier had
reported and as Price confirmed, thrived on their high fat, no carb,
animal-based diet. The Inca descendents, on the other hand, had done
quite well consuming grains like quinoa, along with tubers, fruits,
and some animal protein and dairy. The Masai flourished on a rather
extreme diet consisting, for an adult warrior, of a gallon of raw
milk a day with some blood and occasional meat, but no fruits,
vegetables, nuts, seeds, or grains.
The Swiss herders did just fine living on raw pastured cow milk and
cheese accompanied by a nutrient-dense, whole grain bread. The
Polynesian diet centered around coconut in all its incarnations, the
milk, meat, and cream, creatively used in a variety of ways, along
with fish, some wild animal meat, and fruits. These diets could not
be more different; an Eskimo never drank milk or ate a coconut, the
Inca descendents never saw a coconut or whale blubber, a Masai never
ate coconut or grains, the Polynesians never consumed grains, never
drank milk, and never ate cheese.
However different these diets might be, each of these groups, and
the many other traditional peoples Price studied, enjoyed excellent
enduring health, free from the diseases of civilization – cancer,
diabetes, heart disease, and hypertension. In his extraordinary and
very detailed 1945 book
and Physical Degeneration, Dr.
Price documented his thesis that we humans over the millennium
adapted to and thrived on not one, as the experts usually claim, but
a variety of different diets.
There were some commonalities among the diets, of course; all these
traditional people ate some animal products, and all consumed a fair
amount of fat, whether from plant or animal sources. All the food
was, of course, locally grown, locally harvested, or locally hunted,
since these isolated groups lacked access to the industrialized food
of modern “civilization.”
The food had to be local. And all these groups ate some food in its
raw, uncooked form, which they believed possessed special
Having first read Dr. Price’s book during my journalism days, I knew
that according to his exhaustive work, humans were a varied species,
in the past living in and adapting to all ecological niches
excepting the Antarctic, offering a variety of food sources. To
me, his work offered a solution to the conflicting dietary advice even
then being offered to the world. It didn’t make sense as Nathan
Pritikin insisted or as Bob Atkins argued, that all humans should
follow one specific type of diet: It just didn’t seem reasonable, to
me at least.
I would receive further support for my thinking during the summer of
1981, after completing my second year of medical school. That July,
through one of my journalism contacts from my previous life, I had
the opportunity to meet the controversial alternative cancer
practitioner, the dentist Dr. William Donald Kelley. Over a 20 year
period beginning in the early 1960s, Kelley had developed a very
intensive nutritional approach to cancer that came under harsh
public scrutiny and media attention when he agreed to treat Steve
Steve McQueen was diagnosed with advanced mesothelioma,
a particularly deadly form of cancer associated with asbestos
exposure, sought out Kelley after the conventional approaches,
radiation and immunotherapy, failed to halt the progression of his
disease. Though he seemed to rally initially, McQueen, according to
accounts of those involved with his care, was not particularly
compliant, and appeared at the time he first consulted Kelley too
sick for any therapy to work. He would eventually die at a Mexican
clinic under the condemning gaze of the media for his choice of an
My writer friend had been in touch with Dr. Kelley, thinking that
with all the attention around him he might make a good subject for a
successful book. But she wanted me to meet in person with Kelley,
who happened to be in New York to discuss her book project. Frankly,
as she explained to me, she needed my take on the man, whom she
really couldn’t decipher – was he truly onto something useful and
extraordinary with his odd therapy, or was he simply a huckster,
taking advantage of vulnerable cancer patients, as the media had
Though initially reluctant, I agreed to meet with Kelley, who turned
out to be far different from what I expected. I found him to be very
shy, very thoughtful, and clearly very smart. And, I could see that
he was passionately devoted to his nutritional approach to cancer.
During that first meeting, Kelley described in some detail the
tenets of his therapy. In summary, it involved three basic
components: individualized diet, individualized supplement programs
with large doses of pancreatic enzymes Kelley believed had an
anti-cancer effect, and detoxification routines such as the coffee
enemas. He fervently believed that each patient required a protocol
designed for his or her particular metabolic, physiologic, and
biochemical needs, and that one diet would never be suitable for
As I was to learn, the
diets Dr. Kelley prescribed ranged from largely plant-based
high-carb to an Atkins-like diet, with patients
prescribed fatty meat several times daily. In general Kelley
believed patients diagnosed with the typical solid tumors – cancers
of the breast, lung, stomach, pancreas, colon, liver, uterus, ovary,
prostate – did best adhering to a plant-based, high carb type diet,
low in animal protein and animal fat.
Patients diagnosed with the immune based “blood cancers” like
leukemia, lymphoma, and myeloma, as well as the sarcomas, a type of
connective tissue malignancy, required a lower carb, high animal
fat, moderate animal protein diet. Other patients, usually with
problems other than cancer, thrived on a more “balanced” diet,
incorporating a variety of plant and animal foods.
his patients ate some carbs in the form of fruit and carrot juice,
the amounts allowed varying according to the underlying metabolic
makeup. All this resonated with me, having studied the work of
Weston Price so intently.
After my original lengthy conversation with Dr. Kelley, my research
mentor Dr. Good suggested that during my summer break I begin an
informal review of Kelley’s patient charts located in his Dallas
office. From my first day in Dallas, I found among Kelley’s records
patient after patient with appropriately diagnosed poor prognosis or
what would be considered terminal disease such as metastatic
pancreatic and metastatic breast cancer, who had done well under his
care for many years, often with documented regression of his
These preliminary findings spurred Dr. Good to encourage a more
thorough investigation of Kelley’s methods and results. As the
project grew in scope, I continued my “Kelley Study” in my spare
time during the last two years of medical school, and ultimately
brought it to completion while pursuing my immunology fellowship
training under Dr. Good at All Childrens’ Hospital in St.
For the study I
reviewed thousands of Kelley’s charts, interviewed over a thousand
of his patients, and evaluated 455 of them in some
detail. I eventually put my information into monograph form under
Dr. Good’s direction, including 50 lengthy case reports of patients
with 26 different types of appropriately diagnosed, poor-prognosis
cancer who had responded to Kelley’s nutritional regimen.
One of these patients, a woman from Appleton, Wisconsin, had been
diagnosed in the summer of 1982 with stage IV pancreatic
adenocarcinoma, the most aggressive form of this most aggressive
disease. A liver biopsy during exploratory surgery confirmed the
diagnosis of metastatic cancer, which the Mayo Clinic would later
confirm. When the Mayo oncologist on the case said there was nothing
that could be done, the patient being looking into alternative
approaches, learned about Kelley’s work, and began his therapy.
Thirty-one years later, she is alive and well,
having seen her children – and now her grandchildren – graduate
college. To put this case in perspective, I know of no patient in
the history of medicine with stage IV pancreatic cancer and biopsy
proven liver metastases who has lived this long.
Another memorable patient written up for the book had been diagnosed
with what was thought to be localized endometrial cancer in 1969.
After a course of radiation to shrink her large tumor, she underwent
hysterectomy, and was told they “got it all.” Over the next few
years, however, her health began to deteriorate: she experienced
persistent fatigue, malaise, pelvic pain, and weight loss.
Though she returned to her primary care physician repeatedly, he
dismissed her complaints as “nerves,” suggesting only a
tranquilizer. Eventually, in 1975 she developed a palpable mass the
size of a grapefruit in her pelvis, thought by her doctors – finally
taking her seriously – to be an indication of obvious recurrent
disease. A chest x-ray at the time revealed multiple nodules in both
lungs, consistent with widely metastatic cancer.
Though told her
situation was dire and her cancer incurable, she
underwent surgery to remove the large pelvic tumor, to avoid an
impending intestinal obstruction. Shortly afterwards she began a
synthetic progesterone used at the time as a treatment for
metastatic uterine cancer.
Her doctors admitted the drug would not be curative, but hopefully
might extend her life a few months. However, she stopped the
medication after a few weeks because of serious side effects, and
with no other conventional options in sight she began looking into
She learned about Kelley’s work, began the program, regained her
and avoided all conventional doctors for many years. In 1984, nine
years after coming under Kelley’s care, she returned to her primary
care physician who was quite perplexed she was still alive after all
this time. A chest x-ray showed total resolution of her once
widespread lung metastases.
This patient eventually lived until 2009 when she died at age 95,
having survived 34 years from her diagnosis of recurrent metastatic
Although Kelley did prescribe a variety of diets for his cancer
patients, these two exemplary patients followed a plant-based eating
plan, high in carbohydrates with a minimum each day of four glasses
of carrot juice, dense in nutrients but also dense in natural sugar.
Each of these diets allowed considerable fruit and whole grain
products, foods again loaded with carbs. According
to Seyfried’s hypothesis, both should have died quick miserable
At the time I finished my monograph in 1986, I hoped that with its
publication, fair-minded researchers might begin taking Dr. Kelley
and his nutritional therapy seriously. As I was to learn, I
completely and rather naively misjudged the animus of the scientific
community toward unconventional cancer treatment approaches that
didn’t fit the “accepted” model. Even with Dr. Good’s support, after
two years of trying I could not get the book published, either in
its entirety, or in the form of individual case reports appropriate
for the conventional medical journals.
Editors responded with disbelief,
claiming the results couldn’t be real since a non-toxic nutritional
therapy could never be useful against advanced cancer. I found the
logic, “it couldn’t be true because it couldn’t be true” perplexing,
for editors of scientific journals. In any event, the book would
finally be published, in a rewritten and updated form, in 2010.
Discouraged by our failure to get the results of my five-year effort
into the world, in 1987 Kelley closed down his practice and more or
less went off the deep end, disappearing from sight for a number of
years. After we parted in 1987, he and I would never speak again.
In 2005, he would eventually die with his dream of academic
acceptance unrealized. But my
colleague Dr. Linda Isaacs and I have worked diligently over the
past 26 years, keeping the Kelley idea alive, that
different people may require completely different diets. In the next
installment, I will address my own experience treating patients
diagnosed with advanced cancer with a Kelley based approach. Our
therapy involves, oftentimes, diets high in carbohydrates, which
proponents of the ketogenic diet would predict should fuel, not
After Kelly closed down his practice, in late 1987 I returned to New
York and began treating patients with advanced cancer, using a
Kelley-based enzyme approach, with immediate good results. One of
the first patients who consulted me had been diagnosed two years
earlier, after a series of mishaps, with inflammatory breast cancer,
the most aggressive form of the disease.
This patient had a very unfortunate story:
by the time of her original diagnosis in 1985, her breast tumor was
too large to allow for surgery, so her doctors recommended a course
of radiation to the chest, hoping to shrink the tumor and allow for
She proceeded with the planned radiation, but at surgery the tumor
was still quite large at 8 cm, with 18 of 18 lymph nodes involved
Her doctors informed her that her disease would inevitably prove
fatal, but suggested aggressive chemotherapy to hold off the cancer
as long as possible. She again followed her doctor’s advice,
beginning multi-agent chemo.
In the fall of 1987, two years into treatment,
she developed evidence of new metastatic disease in the bone. At
that point, she began looking into alternative approaches, learned
about our work from a social worker she knew, and came under my care
only a couple of months after I had begun in private practice.
To summarize her nearly 26 years of treatment with me, she has been
disease-free for years as per bone scan studies, continues on her
nutritional program, and continues leading a normal, cancer-free
By the standards of conventional oncology, this patient’s complete
regression of metastatic disease and very long-term survival must be
One of my favorite patients,
whom I have discussed at times in my lectures, was diagnosed in
August 1991 with stage IV pancreatic cancer, with multiple
metastases into the liver, into the lung, into both adrenals, and
into the bone. After a lung biopsy confirmed adenocarcinoma, his
doctors discouraged chemotherapy, telling him and his wife
conventional treatments would only ruin his quality of life while
offering no benefit.
He was given, as he would later tell me, two months to live.
The patient’s wife, a former college professor with an interest in
nutritional medicine, learned about our approach from an article she
read in an alternative health journal, and in the fall of 1991 he
began treatment with me. Some
fifteen months later, repeat CT scans showed
stabilization of disease. Since he felt fine at the time, following
his program religiously, he decided against any further conventional
testing until 1998, seven years after he had started with me, when a
series of CT scans confirmed total resolution of his once extensive
This patient would eventually die at age 85 in 2006, 15 years after
his diagnosis, from the residual effects of a serious automobile
To put his case in perspective,
I know of no similar case with documented stage IV pancreatic cancer
that had spread at the time of diagnosis into multiple organs who
survived 15 years after diagnosis with confirmed total resolution of
For both these patients, in the traditions of the Kelley system I
prescribed a plant-based, high carb diet, including
multiple servings of fruit, with its content of natural sugar, along
with four glasses of carrot juice daily. By Seyfried’s hypothesis,
both of these patients should have died quick, miserable deaths
under my care.
Currently, after more than 25 years in practice, I am writing a
two-volume set consisting of detailed case histories of our own
patients, like the two mentioned above, to make the point that the
therapy works in practice. For those diagnosed with poor-prognosis
solid tumors, many now alive in excess of 10 years, I
have prescribed a high carbohydrate diet, in total contradiction to
what Dr. Seyfried proposes as the ideal anti-cancer approach.
Just this week as I write this, one of my newer patients, a
wonderful, creative inventor and computer whiz from the Washington,
DC area, came into my office for his regularly scheduled six month
re-evaluation appointment. When he started with me in January 2010,
three and a half years ago, he had been diagnosed with stage IV
metastatic squamous cell carcinoma of the lung, with multiple tumors
in both lungs and with evidence of metastases in his ribs. His local
doctors in DC had explained he had terminal disease, for which
chemotherapy would be useless.
His rib lesions were causing him so much misery his doctors did
suggest a course of radiation for palliative pain control. However,
he had learned about my work from a mutual friend who recommended he
dispense with all conventional treatments and instead pursue my
He followed her advice, refused radiation, came to see me, and over
the years he has proven to be a very vigilant, determined and
compliant patient. Within
a year on his nutritional program, which includes a high carb diet,
his pain had resolved, his energy, stamina, and
concentration had improved, and scans confirmed total resolution of
all his original extensive disease – in complete contradiction to
what Dr. Seyfried would predict or claim possible.
When I saw the patient in my office during this recent visit, he
remarked that over the preceding months, he had been craving more
carbs than ever before, so in response he had significantly
increased his daily intake of carrot juice, fruits, and starchy
vegetables, foods allowed on his diet with no limitation.
With this increased carb intake, he has actually lost 16 pounds of
excess weight, and his energy is better than it has been in 30
years. And, he remains cancer free. According to Dr. Seyfried, on
this high-carb regimen his cancer, thriving as he claims on sugars,
should long ago have exploded with deadly results.
Despite my experience, is
there any data to support Dr. Seyfried’s concept that
all cancer patients should follow a strict ketogenic diet? In the
next article, I will discuss just this issue, looking first to those
who have prescribed the diet in the past.
Despite Kelley’s and my own positive experience treating cancer
patients with non-ketogenic, often high-carb diets,
can I muster any data, past or present to support what Seyfried
claims? What does past experience and current data show, about the
miracle of the ketogenic diet for cancer?
In my previous articles, I discussed my friend, the late Dr. Robert
Atkins, the famed diet doctor, who long before Dr. Seyfried appeared
on the scene hoped his “ketogenic” diet might be an answer to
cancer. During the late 1980s and right through most of the 1990s,
Dr. Atkins treated hundreds of cancer patients, many, though not
all, with a ketogenic diet, along with a variety of supplements and
intravenous vitamin C.
It was 1992, when his chief IV nurse, who had been with him for
years, called me, wishing to take me to lunch. I knew him through my
friendship with Dr. Atkins, and in fact he had been quietly
referring a number of patients to me from the clinic, patients
who were not responding to the Atkins’ treatment.
We did meet for lunch several days later, and I was surprised that
after some general chatter, he asked me point blank if there was any
chance he could work for me! He seemed quite serious, but I
explained that my colleague Dr. Linda Isaacs and I didn’t use IV
treatments so I would have no use for his particular skills.
Now intrigued, I asked why he would want to change jobs, since our
practice was by design slower paced, whereas Bob ran a very busy
clinic and active IV unit which would seem perfectly suited for this
nurse’s expertise. He then explained, with obvious disappointment,
that none of the hundreds of cancer patients they had treated or had
been treating had responded to any significant degree, with the
exception of those he had referred to me.
The failures had taken an emotional toll on the nurse, who was ready
for a change.
Though I would see Bob occasionally at conferences, I never
mentioned any of this to him. Some years later we met for lunch in
Washington, DC, at a conference where we were both scheduled to
speak. To my astonishment, he told me he was closing down his cancer
unit completely, to concentrate on his traditional area of expertise
– obesity, diabetes, heart disease, hypoglycemia, the metabolic
syndrome – problems for which he knew his nutritional approach with
the ketogenic diet worked quite effectively.
In terms of cancer, after
more than ten years of trying on hundreds of patients, his treatment
had been a disappointment. I certainly appreciated his
honesty, and was gratified when he expressed his admiration for what
he had been hearing about my successes.
I think it was still hard for him to accept that many cancer
patients, and many humans without cancer, did best on a plant-based,
high carb diet, so foreign to his way of thinking. Though he had
heard me expound on the Kelley approach many times over the years,
it was to him implausible that humans as a species had adopted to a
variety of diets, some high fat, some high carb, some more balanced,
and that in medical practice, we as physicians had to be aware that
different patients might require completely different diets for
To his grave, as far as I know, he believed that all humans should
be on a high fat diet with minimal carbs.
In my opinion, Bob Atkins knew more about the theory and practice of
the ketogenic diet,
its benefits and limitations, including as applied to cancer
patients, than anyone in the history of medicine. For him, the
concept was hardly the musings of a PhD laboratory scientist, but
the practical observations of a physician who treated thousands of
patients over decades. And
cancer, the ketogenic diet just did not seem to work.
Bob wasn’t the only physician, his clinic not the only place, where
the ketogenic diet has been applied in modern times. At the Johns
Hopkins Medical Center, for many years a group of researchers and
neurologists have prescribed a very strict ketogenic diet for
children with intractable seizures, that is, seizures unresponsive
to currently available medications. For this particular indication,
in adults as well as children, the diet works quite well.
evidence does Dr. Seyfried himself provide to prove his point that
the best diet for all cancer patients, whatever the type, is the
ketogenic, high fat, no carb diet? Well, very little. Certainly the
400 plus pages of elaborate biochemistry and theory are impressive
and informative. But in terms of practicalities, that is, results
with actual human patients diagnosed with cancer, there is next to
Dr. Seyfried does include a chapter toward the book’s end entitled
“Case Studies and Personal Experiences in using the Ketogenic Diet
for Cancer Management.” Here, Dr. Seyfried provides a description of
a pilot study, written by the investigators themselves, discussing
the use of the ketogenic diet in children with inoperable brain
cancer. However, the authors admit the study was intended only to
evaluate the diet’s tolerability and effect on glucose metabolism as
determined by PET scanning, not treatment benefit or survival.
As the authors write, “the protocol was not designed to reverse
tumor growth or treat specific types of cancer.” The researchers
also acknowledge the patient numbers were too
small to allow for meaningful statistical evaluation,
even for the avowed purposes. Overall, the discussion centers on the
practicalities of implementing the diet and the results of the PET
Interesting information, but hardly useful in terms of treatment
In this same chapter, there are also two
case reports, neither very impressive. The first, written
by the mother, tells the story of a four-year old child diagnosed in
2004 with a low-grade (less aggressive) but quite large and
inoperable brain tumor. The parents, as the mother writes, entrusted
their child into the hands of the experts, who prescribed the usual
“gold standard” treatments, which are not clearly described
initially but presumably mean chemotherapy and perhaps radiation.
In subsequent years, the boy continued on aggressive conventional
therapeutics, when in 2007, the parents learned of the preliminary
research of Dr. Seyfried. While continuing low-dose chemotherapy
combined with the ketogenic diet, the patient experienced a “15%”
reduction in tumor size. The chemo was eventually discontinued while
the parents maintained their son on the ketogenic diet, and the
child, sadly, eventually died.
In my monograph One
I included a case report of a patient treated by Kelley, diagnosed
with an inoperable and very aggressive form of brain cancer that had
spread into the spinal canal. After failing radiation, the patient
began treatment with Dr. Kelley in 1981. At the time, the patient’s
wife actually had to administer the treatment, even the coffee
enemas, since the patient himself was largely incoherent and
As I wrote in my book, “Nevertheless
on the therapy [Kelley’s] he slowly began to improve, to the point
his mental status normalized and over a period of a year, he
progressed from a wheelchair to a walker to a cane.” When
I completed my study in 1987, he
had survived 5 years and was in excellent health, with no
evidence of cancer in his brain or spinal canal.
A second brief report in Seyfried’s “Case Studies” chapter, this
time written by the patient himself, describes a physician who had
been diagnosed in 2009 with multiple myeloma, a cancer affecting the
bone and bone marrow. The diagnosis came about when the physician
fractured his arm while lifting weights.
After scouring the literature, he became quite attracted to the
“good science” behind the ketogenic hypothesis, so under Dr.
Seyfried’s direct supervision, he began the diet. Though the patient
seems quite enthusiastic about his response, he admits in his note
that with the diet there has been “no progression,” presumably in
terms of x-ray studies, and some improvement in the blood studies. He
still considers his disease as “incurable.”
First of all, myeloma patients, even when diagnosed with an
aggressive form, often linger for years before the disease advances.
I would never have included such a two-year survivor in One
or in any other book I have written or plan to write – unless,
possibly, there has been documented significant regression of
disease, not apparent in this case. I do include a case of multiple
myeloma treated by Dr. Kelley in my monograph, a woman diagnosed
with extensive cancer throughout her skeleton with evidence of
When she first consulted with Dr. Kelley in 1977 she was in a near
terminal state after having failed intensive chemotherapy.
Nonetheless, despite her dire situation within a year she had
experienced complete regression of her extensive bony lesions, as
documented by x-ray studies. Though in subsequent years her
compliance with her nutritional regimen would waver and her disease
would in turn recur, invariably when she resumed Kelley’s treatment
the myeloma would go into remission.
At the time I finished the monograph in 1987, she
had survived 11 years. I found this case acceptable for
my Kelley report, but a two-year survivor with no evidence of
disease regression but lots of enthusiasm, I would never had
I might add that for myeloma patients, Dr. Kelley prescribed, and I
prescribe, a high fat diet – but never ketogenic.
wonders, if Dr. Seyfried’s actual data is so thin, have
so many physicians, scientists, and writers jumped on the ketogenic
Let me say out front I
have no problem with scientists who propose a theory, in short
papers or in the case of Dr. Seyfried, in long, detailed books. I do
have a problem when scientists go a step further, insisting in the
absence of any significant human data or even impressive case
histories they have unraveled the mystery of cancer. I am also quite
surprised, in the case of Dr. Seyfried, that both alternative and
conventional practitioners have risen up in a loud chorus of
enthusiasm, as if indeed Dr. Seyfried’s theories are correct, and
that he has solved the cancer riddle.
I found a typical response to Seyfried’s book in a review on Amazon,
written by the esteemed conventional oncologist Dr. Stephen Strum:
I am a board-certified medical oncologist with 30 years experience
in caring for cancer patients and another 20 years of research in
cancer medicine dating back to 1963. Seyfried’s “Cancer as a
Metabolic Disease” is the most significant book I have read in my 50
years in this field. It should be required reading of all cancer
specialists, physicians in general, scientific researchers in the
field of cancer and for medical students. I cannot overstate what a
valuable contribution Thomas Seyfried has made in writing this
From the alternative front, on his website read literally by
Dr. Joseph Mercola has been an enthusiastic supporter of Dr.
Seyfried and his ketogenic thesis. In two lengthy articles Dr.
Mercola proposes that the ketogenic is an answer to cancer.
In the first posting appearing on his site June 16, 2013, based on
an interview with Dr. Seyfried, Dr. Mercola writes in his
Could a ketogenic diet eventually be a “standard of care” drug-free
treatment for cancer? Personally, I believe it’s absolutely crucial,
for whatever type of cancer you’re trying to address, and hopefully
someday it will be adopted as a first line of treatment.
In a second article from June 30, 2013, entitled “The Ketogenic Diet
– An Excellent Approach to Cancer Prevention and Treatment,” Dr.
Mercola discusses the work of Dr. Dominic D’Agostino, PhD, another
basic scientist, this time from Florida, who enthusiastically
reports his animal and laboratory work with the ketogenic diet.
As I ponder this enthusiasm,
I have to think that perhaps I am just a little slower, or more
cautious, than most. The day after I first met Dr. Kelley in New
York in July 1981, I was on a plane to Dallas to begin my review of
Kelley’s charts. As previously discussed, I quickly found among
Kelley’s records case after case of appropriately diagnosed
poor-prognosis and/or terminal cancer, patients alive five, ten,
even 15 years later, with no possible explanation for such survival
other than Kelley’s odd nutritional treatment.
After I returned to New York some three weeks later carrying with me
copies of dozens of patient records, and after reviewing my findings
with Dr. Good, I
knew Kelley was on to something. One thing for sure, at
the time I didn’t, as I easily could have with my journalism
contacts, think about “explosive” news stories, or a book contract.
Quite the contrary, as I discussed in a previous article, I met
Kelley through a journalist friend who thought he might make an
excellent subject for a potboiler, a wealth-generating best seller.
After only a few days in Kelley’s Dallas office, I quickly realized
that he, as odd as he may have seemed to some, as peculiar as his
therapy might be to conventional researchers, had put together a
potentially useful, non-toxic, nutritional cancer treatment.
I also quickly understood that for his approach to gain academic
acceptance, Kelley must back off completely from involvement with
popular controversial books and media hysteria. When I expressed my
opinion about such things to him, he accepted the wisdom of my
position unconditionally. When he then told my writer friend in a
rather difficult phone call that he had no interest in pursuing the
book she had suggested, she was, to say the least, livid with me –
especially since she had brought Kelley and me together in the first
place, seeking my opinion about his authenticity.
Ironically, because I thought him to be possibly legitimate, I had
instructed him to avoid involvement with any popular book including
writer friend would not speak to me for 16 years, until
we met at a conference in New York. We hugged, after all those
years, and made up.
Only after interviewing 1,000 of Dr. Kelley’s patients, and
evaluating 455 of them at length over a five-year period, did I even
begin to think about the book that would be written – not a popular
potboiler, not a tome expounding his elaborate theories, but a
serious academic monograph about our findings. It is just not in my
makeup to put out a book with lovely theory and two case reports,
however inspiring they might be.
I do have a challenge, a
gentlemanly academic challenge of course, to Dr. Seyfried.
In this article, I have presented a number of cases, seven to be
exact, four from Kelley’s files and three from my own practice. The
four Kelley cases include the 31-year survivor of metastatic
pancreatic cancer confirmed at Mayo, the 34-year survivor of stage
IV endometrial cancer, the five-year survivor of aggressive brain
cancer, and the 11-year survivor of advanced, aggressive multiple
The three from my practice include the stage IV 25-year survivor of
metastatic inflammatory breast cancer, my 15 year survivor of stage
IV pancreatic cancer, and my three and a half year survivor of stage
IV lung cancer that has totally regressed on my therapy.
With the exception of the myeloma patient, all the other six
patients, both Kelley’s and mine, followed a high carb, plant-based
diet, replete with frequent servings of fruit and multiple glasses
daily of sugar-rich carrot juice. I
challenge, for the benefit of science, Dr. Seyfried to match these
seven simple straightforward cases. In my experience, no
one else has been able to meet the challenge, so I question whether
Dr. Seyfried can either.
The point I’m trying to make is simple. In science, as in most walks
of life, a little caution certainly goes a long way. In my practice,
I am already receiving letters and faxes and calls from prospective
patients diagnosed with advanced cancer of a variety of types, who
with great enthusiasm jumped on the ketogenic diet bandwagon – with
In my next and final article in this series on the ketogenic diet as
a cancer treatment, I will offer my suggestions as to why
the diet most likely won’t work for most people, based on
past epidemiological research and current biochemical thinking.
First, as Weston Price proved 70 years ago in his exhaustive
epidemiological study, over the millennia different groups of humans
adjusted to different types of diets, depending on the locale in
which they lived and the available food therein, ranging from high
carb to virtual no carb. Though Dr. Price was not evaluating dietary
treatments as such for disease, his point should nonetheless be well
taken – different
humans (for optimal health) need different diets.
In terms of our specific discussion, diet as cancer treatment, Dr.
Kelley demonstrated more recently in his Dallas, Texas, and
Winthrop, Washington offices, no one diet suits all patients
diagnosed with the disease, quite the contrary. Over a 20 year
period working in the trenches treating many thousands of people,
Dr. Kelley came to learn that each patient who walked into his
office required a diet designed specifically for his or her
metabolic needs, and these dietary requirements could vary
enormously from patient to patient.
Unknown to most, even within the alternative world, my friend Bob
Atkins tried the ketogenic diet for some 12 years on many of his
cancer patients, with no significant success as he reported to me.
As a telling point, under the name “Dr. Robert Atkins” on Amazon,
one will find dozens of books he authored including his original
diet book, its many incarnations and editions, along with books on
vitamins, minerals – but glaringly absent, no book on cancer. Yes, the
ketogenic diet has been tried before, with cancer patients, and
I also might offer a thought as to why, from a more esoteric, more
biochemical perspective, for most people diagnosed with cancer the
ketogenic diet might not work. For the past 150 years, researchers
have approached cancer as a disease in which perfectly happy, normal
mature cells sitting in some tissue somewhere suddenly go awry, lose
their normal regulatory restraint, develop a primitive,
undifferentiated appearance or phenotype, begin proliferating
without restraint, begin invading through tissues and organs, begin
migrating, spreading, creating new blood vessels along the way to
feed the rapacious appetite of cancer. But over the past 15 years,
gradually, a new, more productive, and I believe more truthful
hypothesis has emerged, spearheaded particularly by Dr. Max Wicha at
the University of Michigan. Scientists such as Dr. Wicha have
be a little more complicated than
we have thought these long decades.
In recent years stem cells have been a hot topic in the research
world, and a hot topic, for better or worse, in the media. These
headline-grabbing stem cells are primitive undifferentiated cells,
located as nests in every tissue and organ in the body, that serve
as a reserve supply to replace cells in the tissue or organ lost due
to normal turnover (as in the bone marrow or along the intestinal
lining), disease, injury, or cell death.
In this way, stem cells allow complex life to exist and continue,
providing tissue replacements as needed, appropriate for the tissue
in which they live. That is, liver stem cells will create new liver
cells as needed, bone marrow stem cells will create new bone marrow
clones as required, intestinal stem cells will form, as necessary,
intestinal lining cells. In this way, the developmental capacity of
stem cells seems to be governed by the local environment.
After stem cells were discovered in the 1960s, scientists initially
thought that they had a limited repertoire, that is, liver stem
cells can only create more liver cells, but not bone marrow or
intestinal cells, bone marrow stem cells can only create more bone
marrow cells, but not liver cells, and so on. But we now know that
isn’t the case.
Stem cells, wherever they may be found, can adapt quite nicely,
and are far more flexible than originally believed. In laboratory
animals, a liver stem cell placed into the bone marrow starts
creating not liver, but bone marrow cells, a bone marrow stem cell
transplanted into the liver begins to generate not bone marrow, but
liver cells. The environment appears to be the key, ultimately
determining the direction of stem cell development.
In terms of cancer specifically, many scientists believe that the
disease does not develop from normal healthy cells that for some
reason go molecularly berserk, but from stem cells that have lost
their normal regulatory controls, creating in turn the disease we
know as cancer.
Like any normal tissue or organ, in a tumor these cancer stem cells
generate a variety of cell types that can mature to some extent, but
the stem cells remain always primitive, undifferentiated, capable of
replicating endlessly, capable of killing eventually. Most standard
therapies fail, Dr. Wicha and his associates believe, because they
attack the more mature tumor line, not the essential tumor stem
cells, the actual engines of cancer creation.
Dr. Seyfried makes the case that normal stem cells, like cancer
cells, are obligatory glucose consumers, relying solely on anaerobic
glycolysis for the energy needed for survival. I
agree, to a point. But I will also make the case that as
with normal stem cells, cancer stem cells are very flexible, capable
of adjusting to the local environment.
If deprived of oxygen, stem cells happily will turn to glycolysis as
the main source of ATP energy. In an oxygen rich environment, I
believe these stem cells can adapt accordingly, recoupling at least
to some extent glycolysis to the citric acid cycle and electron
transport, with great efficiency, and in terms of cancer, with
Some years ago, a patient of mine, a professor at a well-known
university, became interested in oxygenation therapies for cancer,
used widely in the Mexican Clinics. These “oxygen” treatments were
an offshoot of Dr. Warburg’s work, i.e., that cancer cells as
obligatory anaerobes can synthesize needed energy supplies only via
glycolysis. Therefore, the theory goes, in the presence of oxygen,
particularly ozone, a form of hyped up oxygen, cancers cells, unlike
normal cells, will be poisoned.
My professor patient seemed quite taken by the ozone approach,
which he thought I should start implementing in my practice.
However, I become somewhat doubtful about the theory, and the use of
ozone as a treatment for cancer. At the time I had already taken
care of dozens of patients who prior to consulting with me had been
to the Mexican Clinics to receive ozone along with other treatments.
All seemed to have initial good responses followed by explosive
return of their malignancy. I explained to my professor patient that
I believed cancer stem cells could quickly adapt to oxygen, despite
what the Warburgians might claim.
At about this time, ironically, this professor’s dog developed a
very aggressive sarcoma, for which standard treatments were of no
avail. Enchanted by oxygenation therapies, he actually bought an
ozone generating machine meant for rectal installation, which he
began, against my advice, using on his most patient dog.
After two weeks, the large tumors, quite evident to the naked eye,
regressed substantially, to the professor’s great joy. He called me
with the good news, and in a collegial sense, suggested he might be
teaching me, the cancer expert, something new. I told him to wait
before we came to a conclusion.
Unfortunately, some four weeks later, the professor called me again,
reporting sadly that after the initial miraculous response, the
tumors had recurred with a vengeance, and the dog had
It’s an interesting story but of course just that, a story that I
fully acknowledge proves nothing, though in my mind it does
illustrate how adaptable cancer cells, specifically cancer stem
cells can be. It is a good lesson, for all of us, before we tout the
next great cancer miracle.
-Dr. Nicholas Gonzalez, MD
This article originally appeared on Natural