Medizinische Universität Graz - Research portal
Selected Publication:
Hantschk, M.
Dietary Interventions to Support Cancer Therapy
Humanmedizin; [ Diplomarbeit ] Medizinische Universität Graz; 2025. pp.
- Authors Med Uni Graz:
- Advisor:
- Prokesch Andreas
- Altmetrics:
- Abstract:
- One of the biggest global health issues is cancer. Therefore, adjuvant approaches that increase the effectiveness or mitigate the side effects of current anticancer treatments are needed. In this thesis, a comprehensive and up-to-date literature overview that evaluates fasting and ketogenic diet (KD) as preventive measures and adjunct to existing cancer therapy will be presented. Fasting deprives the organism of calorically usable nutrients for a specific period and exerts profound metabolic adaptations in the host organism. This adaptive response leads to altered cellular signaling and behavior, that is exploited in cancer treatment and prevention. Similar to fasting, KD aims to lower blood glucose and induce a state of ketosis, which can be maintained for longer periods of time without nutrient deprivation. The rationale to utilize fasting or KD as preventive measures lies in their inherent ability to reduce blood glucose and insulin and induce autophagy, thereby improving insulin sensitivity. Furthermore, they lower inflammation and oxidative stress and may enhance anti-tumor immunity. Low nutrients (such as glucose) and the ketogenic state pose a serious threat to cancer cells, due to their rewired metabolism and ravaging need for nutrients to support rapid growth. Decreasing nutrients might exert an anti-Warburg effect by forcing cancer cells to use oxidative phosphorylation (OXPHOS) as a means to derive energy, which makes them more vulnerable to cancer therapies via increases in oxidative stress, DNA damage, and apoptosis. Fasting might further be able to effectively increase protective qualities in healthy cells (differential stress resistance (DSR)) while sensitizing cancer cells to toxic insults (differential stress sensitization (DSS)), as demonstrated in various preclinical cancer models. This thesis further provides an overview of ongoing clinical trials exemplifying settings that methodically integrate fasting protocols or KD in cancer patients. Overall, the current literature proposes fasting and KD as a safe and feasible option to combine with various existing therapies. Multiple plausible mechanisms are discussed as to how fasting could benefit therapies ranging from surgery, radiotherapy, immunotherapy, and conventional anti-cancer drugs. In many cases, fasting greatly reduces side effects of existing therapy regimens. In addition, dietary restriction (DR) is easy to implement at zero cost and therefore a viable clinical adjunct cancer therapy. Nevertheless, implementing dietary interventions in clinical settings faces multiple challenges, including patient heterogeneity, compliance, potential nutritional deficiencies, long-term sustainability and potential side effects.