Keto

PCa is lipid driven so a high fat diet might fuel the cancer in it’s early stages. Advanced PCa is glucose driven so a high carbohydrate diet might fuel the cancer in it’s later stages.

PCa is heterogenous and I speculate that some PCa cells are glucose driven while some are lipid driven. Therefore cycling a high carb diet (I prefer plant-based to maximize fiber and phytonutrients) with a high fat (ketogenic) diet might help deprive the various cells of their preferred fuel sources.

My PCa is not metastatic, however it isn’t in it’s earliest stages.

In general a ketogenic diet is 10-15% protein, 2-5% carbs, with the rest coming from fat.

As an example of my diet on a Keto day:

1. Approximately 4 oz of lemon from a 20% lemon juice/80% green tea mix.
2. 1 oz strawberries
3. One Bolthouse Farms Non-Dairy Keto coffee drink
4. 4 oz Beyond Beef plant based burger substitute
   • 4 oz avocado
   • 1 oz onion
5. 6 oz olives
6. Some more coffee
7. 4 oz nuts (mostly walnuts)
8. 4 oz Orgain Keto Collagen protein

The total calories are 3100, protein 110 g, fat 271 g, net carbs 32 g, fiber 44 g, fruit and veggie servings 8.

I choose organic when possible. My maintenance calories are about 3450 so I lose weight on the Keto. It is mostly fat and water.

I have tried short bursts of Keto 4 times.

1. In 03/2020 my PSA was 0.06. After 2 weeks of Keto my PSA was zero (<0.04).
2. In 06/2020 myPSA was 0.05. After 1 week of Keto my PSA dropped to 0.018 (I used a more sensitive test).
3. In 10/2020 my PSA was 0.06. After 2 weeks of Keto my PSA was zero (<0.01).
4. In 02/2021 my PSA was 0.056. After 3 weeks of Keto my PSA had gone up slightly to 0.059 (with test resolution and normal fluctuations I think this is pretty much unchanged).

I am trying an experiment now to see if a press/pulse type of diet cycling with appropriate supplements and therapies will continue to keep my PSA under control. (https://prostatecancer.health.blog/2021/02/20/boost-kill-diet-drugs-sups/)

I must stress that I had surgery at the Mayo clinic in Scottsdale (RP) in 12/2018. My urologist and my oncologist were both in agreement that there was close to a 100% chance that PCa would return aggressively within 3 months. To date (as I write this it is 03/2021) the PCa has not returned. Other than the initial surgery I have had very few SOC treatments. In the summer and fall of 2019 I did 6 months of estrogen patches to lower my testosterone to zero (https://prostatecancer.health.blog/2019/07/27/adt-androgen-deprivation-therapy/). I view this as a pseudo-SOC treatment. After I concluded that I have been injecting large amounts of testosterone cypionate each week (my total testosterone runs 2100 ng/dl to >3000 ng/dl). (https://prostatecancer.health.blog/2019/09/20/hormonal-manipulation/)

One of my main goals is to keep my PSA and cancer under control. To this end if my PSA rises but only slowly it is aligned with my goals. Scans in 09/2020 showed that I have no cancer activity. My SOC oncologist thinks that I am “doing great” and that I should keep doing what I’m doing “because it is working”.

Unfortunately there aren’t very many human studies on Keto. However, I found this recent one:

Freedland SJ, Allen J, Jarman A, et al. A Randomized Controlled Trial of a 6-Month Low-Carbohydrate Intervention on Disease Progression in Men with Recurrent Prostate Cancer: Carbohydrate and Prostate Study 2 (CAPS2). Clin Cancer Res. 2020;26(12):3035-3043. doi:10.1158/1078-0432.CCR-19-3873

Study conclusion was that Keto was safe and the subjects lost a lot of weight on the diet vs. the control subjects (“normal” diet). The study was terminated because of “futility”. However a post hoc study that accounted for some variables concluded that “PSADT was significantly longer in LCD versus control (28 vs. 13 months, P = 0.021) arms.”

PSADT is PSA doubling time. Very important stat. The longer the better.

Barring new information, if my PSA ever starts going up I won’t hesitate to give Keto a shot again.