Transcript of Episode 155: Supporting the Healing of Brain Tumors
With Dr. Daniel Pompa, Meredith Dykstra, and Dr. Adrienne Scheck
Meredith:
Welcome to Cellular Healing TV. I’m your host, Meredith Dykstra, and this is Episode #155. We have our resident cellular healing specialist, Dr. Dan Pompa, on the line. Today we welcome special guest Dr. Adrienne Scheck. We are really excited to talk to Dr. Scheck today because we have an awesome topic today. She is a research scientist, and we’re going to be delving into more cancer research and some alternative therapies she’s using, one of which is the ketogenic diet. We’re really going to delve into that.
Before we get started, let me tell you a little bit more about Dr. Adrienne. Dr. Adrienne C. Scheck is an associate professor in neuro-oncology research at the Barrow Brain Tumor Research Center at the Barrow Neurological Institute in Phoenix, Arizona. She is also an adjunct professor in the School of Life Sciences at Arizona State University and an associate investigator in the cancer biology program at the Arizona Cancer Center of the University of Arizona.
Dr. Scheck received her undergraduate degree from the University of Rochester and her Ph.D. from Rensselaer—oh, I don’t know if I pronounced that correctly—Polytechnic Institute in Troy, New York. After a post doctoral fellowship in viral oncology at the Pennsylvania State College of Medicine in Hershey, Pennsylvania, she moved to Memorial Sloan Kettering Cancer Center to study AIDS-related dementia. She began her study of brain tumors while at Sloan Kettering and moved to the Barrow Neurological Institute in 1989.
Dr. Scheck is an acknowledged leader in the field of metabolic alteration as an adjunct to the standard of care to improve survival and minimize side effects for patients with malignant brain tumors. To this end, her laboratory has been studying the use of therapeutic ketogenic diet for the treatment of malignant brain tumors. Their work has shown that the ketogenic diet reduces the growth of malignant brain tumors through a wide variety of mechanisms, and it potentiates the effect of radiation and temozolomide chemotherapy. These preclinical studies have led to a clinical trial for patients with glioblastoma multiforme. The second main goal of her research is to identify biomarkers that improve on the current methods of diagnosing and prognosis for this devastating disease.
Dr. Scheck has a strong interest in science education, and her laboratory team includes seven to ten high school students and college undergraduates. She directs the high school component of the scientific enrichment program for students, a program that places high school students in research laboratories around the Phoenix area.
Quite an impressive bio, Dr. Scheck. Welcome to Cellular Healing TV.
Dr. Scheck:
Thank you.
Dr. Pompa:
Yeah, thank you. I almost have the tendency to go right into our Dr. Seyfried interviews where we interviewed Thomas Seyfried who you work closely with, Dominic D’Agostino who you work closely with who spoke at our seminars, all of which has been on the show. We would lose a lot of our viewers and listeners because if they didn’t see that show, they’d be like what are you talking about?
First of all, I want to thank you for your research because, as I read these studies, I see your name on so many things. It’s really exciting that someone with your experience, working at Sloan Kettering and all these amazing places—that we’re getting more people pulling out of the conventional treatment for cancer and looking other places. If you’re losing a war, it makes sense to me that just maybe, just maybe, we’re doing something wrong or we need to do something different. To me, that seems obvious. Your research is showing that. You’re into some really amazing work.
The first question I have is this: how in the world did you come from that world to this? What brought you here?
Dr. Scheck:
When I moved to Barrow Neurological Institute in 1989, I had just started getting into brain tumors. I moved with a colleague of mine who was—she and her husband were starting the brain tumor work here at the BNI. I moved here, and I basically was a microbiologist. I was looking at genes that were involved in therapy resistance, things like that.
Then, maybe five or six years ago, I had a conversation with Dr. Jong Rho. Jong is an international expert in the ketogenic diet for epilepsy. He’s a pediatric epileptologist. He’s also a fantastic researcher, which is an unusual match for somebody to be really good in both arenas, and he is. His lab was on the same floor as mine at the time.
We started chatting after one of his seminars. He said to me hey, do you want to try this ketogenic diet in brain tumors? There’s this guy in Boston that’s doing it. It kind of looks interesting. I have this student who wants to work in my lab for six months, and I have the money to pay her. I’ll give her to you if you want. I’m no dummy. I’m going to take free labor, right? I said sure, but I also said to him the only way I’m willing to look at it is if it is in addition to the standard of care because otherwise it really will not get to most people. His answer to me was something to the effect of you’re the brain tumor person. Do whatever you want.
Essentially, this individual came into the lab for six months, and we started doing some work. We started with cultured cells, just growing cells in a lab from a human tumor. It was a very, very aggressive human brain tumor. We just added beta-hydroxybutyric and acetoacetate, and it inhibited growth. It slowed their growth.
Then I added the chemotherapeutic agent that this patient had had because these were patient-derived cells that had been derived by my colleague back in the 80s or something. This patient had received a particular chemotherapy. We tried that. When that was added in combination with ketones, it basically wiped the tumor out. That was really enough for me to say okay, this is worth pursuing. This is worth doing more on.
At the time, for another project, we were in the process of getting an animal model up and running in the lab. I’m an animal lover, and that’s my last resort not my first resort. We were in the process of doing this for another project, as I said. We tried the ketogenic diet in the animals, and sure enough, it extended survival. When we tried it in combination with radiation, it was amazing.
We actually used KetoCal, which is a human formulation of the ketogenic diet. It’s four to one fats to protein plus carb. In 9 of 11 animals, the tumor disappeared. These tumors were bioluminescent. That means we genetically engineered them to glow like fireflies, so we have an instrument in the basement that can actually see these tumor cells. Live tumor cells can be picked up by this instrument. We know these animals had their tumors, but when we added radiation—because we also have a little animal radiator downstairs. When we added radiation to the ketogenic diet in these two separate experiments, a total of 11 animals, 9 of the tumors completely disappeared.
After about 100 days, we decided well, let’s put these animals back on standard diet. We did that, and the tumors never came back—
Dr. Pompa:
That’s awesome.
Dr. Scheck:
That was really exciting.
Dr. Pompa:
What is it? We know that chemo and radiation can be destructive to not just tumor cells, cancer cells, but all cells, hence the problem, correct? Obviously there’s something about the ketogenic diet that gives the healthy cells some protection. Explain what you found.
Dr. Scheck:
We were basically following the epilepsy literature to a large extent. Even in epilepsy where this has been used for many, many, many years, they really don’t know the full mechanism. One of the things we looked at is reactive oxygen species. We looked at that early on in collaboration with Dr. Rho and his lab. It turns out that the ketogenic diet reduces reactive oxygen species. Now, I think in cartoons, so if somebody says what’s a reactive oxygen species, I tell them to think about a pinball machine. A reactive oxygen molecule is a ball, and it just bounces around. It hits things, and it busts them up.
It reduces reactive oxygen species, and that should be good for normal cells. The confusing thing is that it reduces it in the tumor cells. How does radiation work? It works in part by causing the creation of reactive oxygen species, and that’s in part how it kills cancer cells. We had at the time, and we still have, this conundrum of we’re reducing active oxygen species but it’s make radiation work better.
We haven’t answered that part yet. We do think that there are other things about the radiation in the cancer cells that the ketogenic diet is affecting. I think it’s affecting the repair of damage. If it’s reducing reactive oxygen species in the normal cells, perhaps it’s actually helping to protect the normal cells.
From all the things I’ve heard when I’ve spoken to physicians, or family members, or whatever and all the papers I’ve seen, it does appear like the ketogenic diet, and intermittent fasting, and things like that do help protect normal tissue. What our work showed that I thought was really important is it doesn’t protect the cancer cells because obviously if you protect the cancer cells, it doesn’t matter if you protect normal cells. If you damage normal cells as much as you damage cancer cells, again, it doesn’t matter. You need a differential between damaging normal cells and damaging cancer cells.
Dr. Pompa:
One of the things that I’ve seen clinically, and I know we’ve talked to Seyfried about in some of our past shows, is we can just see that when you put these cells under the stress of being able to only burn fat, for example—when someone goes into ketosis, what they’re cells are burning is a fuel source majority of fat. The bad cells have trouble making some of these transitions or adaptations, if you will. We’ve noticed even just moving people in and out of different diets, this adaptation doesn’t occur in a lot of these damaged or bad cells. What’s your feeling about that? Do you think that’s part of it?
Dr. Scheck:
I think that’s part of it. Again, excuse my cartoon analogy, but when I talk to people about stress—because even at the genetic level when you look at cancer cells, the ones that are really, really, really genetically screwed up are more sensitive to therapy usually. I tell them okay, if you yell at your kid for having a dirty room during summer, he’ll probably just say yeah whatever and clean it. If you yell at them during exam week, they might yell back. If you start from a stressed point of view, you’re less able to take additional stress. I know it’s a very nonscientific, generic comment, but it seems like it works for me when I try to think about these things. It seems like everything I’ve seen in the past that has come out and things that have continued to come out suggest that a stressed cell is usually less likely to be able to handle additional stress, whether that’s metabolic, therapeutic, whatever.
Cancer cells are Darwinism speeded up. They basically can keep shuffling their genes, and some percentage of them will survive whatever stress you give them. Interestingly, like I said, the ones that are at the genetic level more bizarre are often ones that are more sensitive. It’s the ones that are similar to normal cells that are more resistant. That’s something that my colleague, Joan Shapiro, found at a genetic level a long time ago.
That’s my thought process on a lot of that. The other thing, though, that we found that’s—I don’t think it’s confusing, but it’s very interesting. When you talk about the ketogenic diet, or fasting, or any of these things, our original work when we first tried this was with cells grown in the lab in very, very, very rich media. By that I mean they had glucose. They had everything a cell could possibly want. They were in cell heaven, and we still inhibited them by added ketones. We have found that routinely. In all the work we’re doing in cultured cells, we have not dropped the glucose level yet. We will eventually, but for now we’ve just been adding ketones. We’re seeing sensitization to radiation, all kinds of things.
I think the cells—I don’t know if they preferentially use the ketones, especially not if they’re cancer cells. From a molecular point of view, I think there’s probably things that dropping the glucose does that’s good for the person and bad for the tumor. There’s definitely things that raising the ketones do that’s bad for the tumor. If you put the two together, it’s wonderful. That’s the way we’re looking at things.
Dr. Pompa:
We see it clinically. I know some of your work has to do with ketones. I think when Dr. Dominic was at our seminar, he presented a few papers on how it’s affecting the epigenetics, that you’re learning the ketones, even down to the micro RNA—explain that. I don’t want to lose our viewers or listeners, but it’s important work. We know that ketones, which every ancient culture on the planet has gone into ketosis, either the lack of food, the change of food, into ketosis. We know that it has this epigenetic effect, meaning turning off bad genes and turning on good ones. We’re finding that in the lab, right?
Dr. Scheck:
Right, we’re definitely finding that in the lab. Epigenetics means—well, this isn’t the real definition, but it’s the way I think of it. Epi means outside and genetics would be the genes, as in the code of the genes. Our DNA is an alphabet. It’s basically an instruction manual. Instead of having 26 letters in the alphabet, there are 4. When things happen when cells become cancer cells or when you inherit something, usually it is due to a change in a letter in the alphabet.
What epigenetics are is—you don’t have to change the alphabet, but you can still change the gene and whether or not it’s turned on or off. This is changeable, meaning the environment can change this particular on/off switch. In fact, it’s also even inheritable to some extent. They’re finding things from parent to child, that some of the epigenetics are actually inheritable, but they are changeable.
It’s another on/off switch outside of the one that’s hardwired. It’s a software on/off switch not a hardware on/off switch. Micro RNAs are hardwired, in a sense. They are very, very small pieces of a molecule called RNA. What they do is they also are able to turn on and off the expression of genes. When I say on and off, I mean on and off like a light switch. Our cells don’t use every single gene they have. That’s why our skin cells look different than our muscle cells.
The genes that are necessary are turned on and off. Micro RNAs are one of the things that turn those things on and off, but micro RNAs are odd in that one of them can turn on a bunch of genes. You have changes that occur from a cell ingesting ketones that has a whole lot of what we call downstream effects, changing groups of genes and, in fact, entire pathways of genes.
Genes don’t work by themselves. They work by pathway, kind of like a basketball team. You don’t get the basket unless the ball is passed amongst people back and forth a lot. That’s kind of like what our cells are doing, too.
Epigenetics and micro RNAs are ways that those entire pathways can be disrupted. What’s cool about it is the way it’s being disrupted is usually disrupting the aberrant, which is a fancy word for screwed up, the aberrant pathways and making them more like normal pathways. Essentially, they are making the tumor cells in some ways behave a little bit more like normal cells.
Dr. Pompa:
Interesting. Yeah, we’ve seen it clinically. We move people in and out of the ketonic states, ketosis. For our new listeners, this is when we’re getting the cells—your cells can use two things for energy, glucose and fat. We’re getting your cells to be more fat efficient, and then it makes these things called ketones that your brain loves and evidently your cells.
Anyways, we see these ketones are able to turn off some of these expressed gene conditions. Even things -inaudible- turned on for health, thyroid conditions, these things that are expressing in a certain way. It is a magical tool that we don’t understand exactly how it’s working. Until some of your science, we just thought gosh, we don’t know what it’s doing exactly, but it works.
Dr. Scheck:
One of the things we found it does in a brain tumor is it reduces the expression specifically of a gene called COX-2 or cyclooxygenase-2. That is a pro-inflammatory gene. In fact, the over-the-counter medicine -inaudible- Celebrex actually works to try and reduce that, and so does the ketogenic diet
When I first started working with the ketogenic diet, I had trouble believing our own data. Nothing is this good. This is like snake oil. Look at all of these genes that promote the growth of tumors, it dials most of them down. Nothing affects this many things, but it does. That’s what’s incredibly cool about it. It really does.
Dr. Pompa:
It is amazing. Meredith, you might have some questions.
Meredith:
Always. Dr. Adrienne, in your research were you using exogenous ketones, or the ketogenic diet, or both? Can you delve into that a little bit more and maybe what you see in benefits of either or using both synergistically?
Dr. Scheck:
In our mouse brain tumor model, we used the ketogenic diet. At some point, we will probably go towards using exogenous ketones, but for now we’re doing it—basically, we started this before exogenous ketones were really available for people. I’m a basic researcher. My goal is what can I do that is going to get this implication, that’s going to convince a clinician to put this into a patient. The easiest way to start with that was let’s use something that the patients can do, that they can eat, that the epilepsy community has already shown is doable. That’s the only way we’ve done it so far in vivo is what it’s called, in the animal models.
In our cell culture, we simply purchased beta-hydroxybutyrate and acetoacetate. When you say exogenous ketone, yes, those are exogenous ketones, but they were purchased chemical. They’re not something that a person could just go, and weigh out the powder, and eat, at least not to my knowledge. I wouldn’t because they’re not made for humans.
Now there are essentially exogenous ketones, things that Dom D’Agostino has been involved with making. They’re making it more palatable and things like that. They are essentially a source of beta-hydroxybutyrate, as far as I know. We just purchased beta-hydroxybutyrate from a chemical company for our cell culturing.
Dr. Pompa:
Yeah, you’re right. It’s new science. Dominic’s on the cutting edge of that. We’re utilizing some of these exogenous ketones clinically. People always ask me the question. I say it’s too early to tell.
Dr. Scheck:
Yes, exactly. That’s exactly the question that I’ve been getting. I was asked to give a—at the global conference for ketogenic diet therapies which was in Banff last year, the end of last year, last fall, I was assigned to present an update on clinical trials and brain tumors. I say assigned because I would have preferred to talk about my research, as any good scientist would. In preparing for that talk, I actually contacted everybody who had clinical trials going that I was aware of and asked them what was going on and what were they finding. I can summarize that pretty easily.
First of all, in terms of survival, it’s too early. Everybody said the same thing. It’s too early. Second of all, it is not an easy thing to do in terms of staying on it. I think it’s much easier now than it used to be because there’s premade meals and things that can help people. A lot of the brain tumor patients, anyway, and their families had difficulty with it. I think there’s a lot of reasons for that that are not getting fixed in terms of giving out the support these people need, the fact that they already have a devastating disease that is exhausting them. They have to go for therapy every day. All of these things that are involved in life, and then you completely change everything that they’re eating. Stuff becomes difficult.
The other thing that some of the centers were doing is they were going—pre-selecting is the wrong word, but they were actually doing a test upfront to see if they thought the person would be compliant. What they found was only, in general, one in four of the patients or one in five of the patients actually should be enrolled in that clinical trial based on their ability to be compliant.
Dr. Pompa:
Yeah, I believe that.
Dr. Scheck:
There was a lot that went into it. There’s a lot that’s going into it. My personal bias on all this is we’ve been looking at this wrong and this includes me, in trying to get it through the clinical side. Everybody says well, it’s just food. The problem with it’s just food is that people don’t see it as an actual therapy. Then you get things like Aunt Jane said I can eat this and that’s ketogenic. It’s like no, that’s not what your dietician said. Your dietician said to do something else.
The other thing is it doesn’t always work. Sometimes it works. Sometimes it doesn’t no matter how compliant the person is. If you look at brain tumors, they are—and I’m sure other solid cancers are the same. They are something called heterogeneous. What that means is if you look at ten cells in a person’s tumor, you will find ten different genetic makeups. They are not identical. If cells have different genetics, then they have different capabilities.
What I think we need to do, and what is starting to happen with other therapies, is try to find some markers to suggest the patients where this will be the most useful. One of the ways to do that is to do the molecular analyses that they’re using for all the other therapies out there and do the same thing for fasting, for ketogenic diet, for all of those things. Let’s try to find out what traits about a tumor make a particular metabolic therapy work or not work.
Dr. Pompa:
Yeah, even the type of cancer. Thomas Seyfried talked about the metastatics, and they can go after glutamide. They can break a protein down into a fuel. Now all of a sudden oh, we don’t get the same result. What’s your feeling on that, the glutamide thing? Where are we on that with these metastatic types of cancer?
Dr. Scheck:
I haven’t been doing a lot of work in metastatic tumors, so I’m not sure I’m qualified to make extreme comments about that. I don’t think it’s just the metastatic cancers. There was a really, really interesting talk at one of the last meetings in last year nationally—in one model system, taking exactly the same tumor cells and, depending on where they were implanted, their metabolism was different. They were actually using different things for metabolism.
Again, I think it comes down to—in people anyway, I think it comes down to when you find a person where it worked, analyze that tumor and see what’s going on. When you find a person in which it doesn’t work, analyze the tumor. See what goes on. There are therapies that can be added to something like the ketogenic diet, something like exogenous ketones, that might help make it work better.
For example, you’ve got a tumor where you say okay well, most of this tumor receded, and then it grew again. What changed? What’s going on? Oh gee, the cells that survived and were growing again, that was the Darwinian selection for the glutamine-using cells. Let’s inhibit glutamine.
People have not been looking at metabolic therapy in the same way that they’ve been looking at other therapies, meaning, at the molecular level, what makes it work.
Dr. Pompa:
Yeah, I think we run into that with everything because there are some people who respond positive to antioxidants, even Vitamin C, and other cancers do not. It feeds it. It makes it worse. It really backs this topic with almost everything. Why this and not that? Why did this person do well with simple Vitamin C and the other one didn’t?
Dr. Scheck:
The interesting thing about Vitamin C is apparently it mimics glucose. If you do a very high dose, like IV Vitamin C, it mimics glucose. First of all, it completely messes up your glucose readings if you’re using a meter. Also, it makes a difference—how that works with glucose, and I’m paraphrasing a paper that I kind of remember from a little while ago. It makes a big difference whether the person is in ketosis or not in terms of what the high-dose Vitamin C does.
One of the issues with things going to the lay public is how it goes there. Somebody says Vitamin C cured this person of cancer. Vitamin C didn’t cure this person of cancer. They forget to mention all of the other aspects of the science. Was the person in ketosis? What kind of cancer was it, all of these things?
To me, it all comes down to exactly the same thing: people have got to look at these metabolic alterations in exactly the same way as they look at chemotherapy, radiation therapy. Look at the underlying mechanisms of how it works, why it works on some people, meaning, look at the tumors when it works. Look at the tumor when it doesn’t work. Then we can start to use it in a much more intelligent way.
It does seem like something like the ketogenic diet, and when I say the ketogenic diet, I’m kind of—I know it’s not exactly the same, but I’m kind of lumping caloric restriction and fasting together at this point because there hasn’t been enough work to separate out one versus the other.
Dr. Pompa:
One thing we’ve found is the ketogenic diet it seems like in and of itself becomes even more magical when you put it in some restriction like intermittent fasting daily or block fasting. It seems like you get more bang for your buck, if you will. It’s so simple. We’ve found that clinically. Seyfried, I know, in some of his studies finds the same thing.
Dr. Scheck:
I would not even begin to argue that. I think that’s probably true. Again, I think it probably comes down to raising ketones, lowering glucose. Either one alone helps. Both together are the best and however you’ve found to do that. I think there’s other changes that are happening that we don’t even begin to understand.
The issue is getting clinicians to do it. The things I heard back from our clinicians when I first started trying to get them to do something with this was it’s disgusting. It’s awful. You’ll ruin the patient’s quality of life. When we had two patients that chose to do it, which is what convinced our clinicians to actually try this, it turned out it didn’t have to be disgusting and certainly nowadays. Five years ago, we weren’t where we are now, with so many recipes, and premade foods, and so many ways to make it more palatable. It’s not as bad.
In terms of quality of life, for some patients they can’t handle it. For the patients that do stay on it, it doesn’t hurt their quality of life. We’ve gotten some real positive comments about how the person feels. Again, I’ve got more anecdotal evidence. Honestly, a lot of the anecdotal evidence is even better than the clinical evidence in terms of how people have done. That’s not enough to prove it to the clinicians, but it’s enough to at least start. We are doing quality-of-life analyses, and it doesn’t appear to be hurting quality of life.
Dr. Pompa:
Listen, when I go in—I’m in ketosis as of today, back in. I move in and out of the state, Meredith as well. As a matter of fact, no one makes it more palatable than Meredith, I’m telling you. Meredith, is a ketogenic lifestyle hard? Not according to Meredith.
Meredith:
I know! I was going to say that I find it so palatable. For years, I shunned a lot of different meats, and fats, and things like that. Now, I have so much fun with the keto-diet. Of course, I cycle in and out of it. I found that that was best for my hormones to add in carb days, as you suggest with the diet-variation principle, Dr. Pompa.
Oh my gosh, I think the ketogenic diet is delicious. It’s all about approaching it the right way, and being creative with your recipes, and not overdoing the protein. When you incorporate that intermittent fasting, as you said, and the restriction is when you get the most magic and the best results. I’m a big fan, of course, within variation and having that balance, too.
Dr. Scheck:
Here’s the kicker on that. For a person who’s healthy, who enjoys cooking, who has time to cook, who enjoys playing in the kitchen, it can be great. For a cancer patient that’s doing just daily living things, and if it’s a younger cancer patient dealing with their children, dealing with their husband or wife, all of those things—the additional time and the additional effort to do something in a different way than they’ve done it before can be overwhelming.
Dr. Pompa:
Yeah, Dr. Adrienne, you’re right. It’s a game changer.
Meredith:
Great point.
Dr. Scheck:
That’s where I think if we get more clinicians involved, if we get more dieticians involved, and if we get some of these premade foods to be called classified as medical food so they’re not so expensive that the patient can’t afford it, you can take a huge amount of the burden off because now a person can say okay, I can cook ketogenic for a couple days, but the kids have soccer. I can’t do this. I’ve got to feed them. Okay, great. I can go to the fridge and get a TV dinner for myself, and still be ketonic, and still do things within my energy level.
We had one of our patients that started this. It was because their husband was very supportive and into sports nutrition. They had a lot of friends that helped. When I told her that some of these premade meals were coming out, she did and is still doing, I’m thrilled to say, very well. She said oh God, that would have made it so much better, so much easier when I was getting my other treatments and undergoing this. The only way we were able to do it was because of all of the outside help we had. With those, we would have been able to do it even without it.
If you can get those things classified as medical food so they’re cheap enough—because then we can get more data. If we can get more people doing it, we get more data. We can prove it works. We can find out how it works. It’s kind of a big spiral.
Dr. Pompa:
I’ll tell you, intermittent fasting really helps. When you’re only eating one or two meals a day, it’s so much easier to—even when I’m not in ketosis, Dr. Adrienne. In the morning, my ketone numbers would be low, but by the afternoon, I’m .5, .7. I’m high ketones even without trying just because of the fast, right? My point is, even then, I can eat a dinner that would have not appeared necessarily as a ketone dinner, but because it was my only meal, I remain in ketosis. It does make it a little bit easier.
Dr. Scheck:
Absolutely, and you’re keto-adapted. Here’s the other thing that we ran into that I know people are still running into, and that is—it doesn’t happen in brain tumors very much, but in other cancers, there’s something called cachexia, which is muscle wasting. Brain tumor patients don’t tend to have it. Other types of cancers do tend to have it. If you tell an oncologist that their patient has lost a few pounds, they are not happy at all. More than a few pounds they hit the panic button. If you tell an oncologist that you want their patient to fast, some of them will hit the roofs. No way, Jose. Absolutely not! I can’t afford to have them lose weight.
We don’t know the difference between losing the—it’s not that they don’t know the difference. I apologize for that. In their practice, they don’t separate out the cachexic weight loss from another type of weight loss. The tools to look at that are not readily available to them. It’s -inaudible- that the ketogenic diet is probably muscle sparing. It will probably—
Dr. Pompa:
It is. According to studies, it is. By the way, so is intermittent fasting. My son—
Dr. Scheck:
When I said ketogenic diet, I include the intermittent fasting.
Dr. Pompa:
Exactly, both are muscle sparing. I’ve read the studies on ketosis being protein sparing, as well as intermittent fasting, because it’s hormone optimization. We get these people—now body builders are using this as a strategy to keep muscle and become more anabolic, basically. It’s opposite.
Dr. Scheck:
Intermittent fasting just before chemotherapy, there’s papers out there that show that it seems to not only enhance the chemotherapy but also reduce the side effects. There are some papers that are getting out there of people doing this. It terrifies the oncologists because they’re so used to cachexia.
The other thing is then when a person is tired, and I’ve never known a cancer patient to not be—and I’m not a clinician, but from everything I’ve heard, from all my friends, from everything. If you’re getting chemotherapy, and you’re getting radiation, and you’re getting surgery, or you’re getting any one of those, you are going to be tired. Bottom line, you’re going to be tired.
Dr. Pompa:
Here’s the other problem. As you’re going into ketosis, the first week or two is going to make you more tired. It is. Until you keto-adapt, or what we call get fat adapted, there’s a few weeks there that your glucose is lacking, and you don’t have the ability to burn fat yet and make enough ketones yet. In that yet period is when people are going I can’t do this. I’m too weak. I can’t even get out of bed. Some people may not make the transition.
Dr. Scheck:
Right. Again, in a normal person, you’re very tired. A lot of normal people can live with it. Okay, I’m tired. When you add that on top of what is already a virtually devastating, in some cases, level of exhaustion, or coming right out of surgery, all those things—it’s really, really hard to do. If the clinician isn’t 100% on board and isn’t a major cheerleader saying look, I know you’re really tired. I know you think it’s the diet. Let me explain this to you. The diet’s going to help later. Right now, it’s a combination. You’re going to be tired from radiation. You’re going to be tired from this. You’re going to be tired from that. Don’t just blame the diet. Stick with it. Hang in there with me, patient, and we’ll get you through this.
Most clinicians are not for it enough. They haven’t seen the clinical trials to prove it works, so they don’t push it that hard. That’s, I think, really—we need the research. We need the clinical trials. We need the clinical trials to be more successful. To make them more successful involves having clinicians that are more on board. It’s a little bit of a Catch 22.
I think we’re getting there. Slower than I’d like us to but I think we are getting there. There are more and more people that are interested, more and more people doing it. Some of us are trying to collect information from patients that includes information from their clinicians so that it—anecdotal isn’t necessarily bad. It isn’t necessarily wrong. It’s just not controlled.
Dr. Pompa:
I was just going to say one of the things we said before we got on the air, you said look, this work is so important. I was thanking you for the work. You said yeah, it’s just keeping it going. We need grants. We need money. We have a lot of people watching this show I guarantee that have the resources to help. You need to give them a place where they can do that, contact you, because this is important work that needs to get done. It is so important because if this is—there’s an answer here. Like you said, most of these doctors don’t realize what’s going on. They don’t understand what’s happening because it’s about a money shortage. That’s it.
Dr. Scheck:
Yeah, more data is helpful. The more patients that we can put out there in publications, and a number of us are trying to do that, the better. If anybody would like to donate to my lab, I would love it. That would be incredibly helpful. It is totally tax deductible, just like you donate to American Cancer Society or something. If somebody passes away, you can donate to the lab. It’s just as tax deductible. We write a nice letter. I will personally write a thank you letter in addition to whatever our foundation does.
You can either email me, and I don’t know if you provide the email in your information. It’s Adrienne.Scheck@DignityHealth.org. You can go online to the Barrow Neurological Institute. Go to the foundation. You can go to Barrow Neurological Foundation. There’s a donation page. You just have to make absolutely sure that in the comments section you mention the Scheck Laboratory. Then the donation will—
Dr. Pompa:
Repeat your website one more time, your email.
Dr. Scheck:
My email or the website?
Dr. Pompa:
Repeat your email one more time. They would probably rather—I think they’re more apt to give if they can contact you directly.
Dr. Scheck:
That would be fantastic. My email is Adrienne.Scheck, so that’s A-D-R-I-E-N-N-E dot S as in Sam C-H-E-C-K at dignity health, and that’s one word, dot O-R-G.
Dr. Pompa:
Okay, thank you.
Dr. Scheck:
The other thing people should understand about not only donating to my lab but donating to any lab, it’s not just the people that have 100, 1,000, $5,000. $25, $5: it all adds up. We appreciate every penny. We put it to really good use, all of us as scientists.
Dr. Pompa:
This work is so important. Like I said, I know that with more studies, that’s the key. We’re going to get more doctors on board, more oncologists on board. Ultimately, it’s going to save more lives. When I look at the work that you, Dominic, Seyfried are doing, you all are just in a corner somewhere compared to the billions being spent on the genetic research and the billions being spent on all of the more popular, more common therapies. I hope that we see a shift in that, I guess, is my hope.
Dr. Scheck:
Me, too. I’m a little bit different from the way Tom looks at things. We’ve kind of agreed to disagree on this in that I’m not against standard of care. I think the ketogenic diet can enhance the standard of care, or intermittent fasting can enhance the standard of care, caloric restriction can enhance the standard of care, exogenous ketones can enhance the standard of care. If you can use those to enhance the efficacy of the current therapies, maybe you can reduce the doses. It also helps protect the normal cells. Frankly, if you want more clinicians to do it, you can’t take away the standard of care. You have to add to it. Then maybe you can start weaning away from the standard of care if it turns out that that’s okay.
Dr. Pompa:
I think you’re right in that sense because I know this for a fact, that so much of the money from the drug companies, etc.—I don’t know that it will take off without some support there. Believe me, you follow the money trail. If you’re saying okay, we’re going to alongside your treatments, great. If you’re saying oh, we’re against them. Even if you believe it or not, you might cut your own throat. I think Tom sees that and recognizes that. I think there’s a slippery slope.
Dr. Scheck:
It’s been a long road. He and I have had conversations for many years. He’s an amazing guy, totally amazing.
Dr. Pompa:
He really is. His heart is—he is 100% devoted to this, as you are. Look, we are at the top of our hour already. Holy cow, that went fast. Meredith, I’m going to hand it back over to you. Dr. Scheck, I just want to thank you for coming on. We just want to put out the word. We want people to donate. Thank you. I don’t know if you have a book coming out soon, or if you want to announce anything, feel free.
Dr. Scheck:
We just put a chapter in in a book that was edited by Susan Masino. We’re not doing our own book, but I’ve got some chapters and things. People can just go online and look it up. Some of the talks that Dom, and Tom, and I have given are actually online on YouTube. You can just look there and find us.
Thank you so much for the opportunity to speak on your show.
Dr. Pompa:
Thank you. We have hundreds of thousands of people that view this show, so God will stir the heart of the ones that need to do more, that’s for sure.
Dr. Scheck:
Thank you, awesome. That’d be great.
Meredith:
Awesome. Thank you, Dr. Pompa. Thank you so much Dr. Adrienne for sharing your research and all the amazing things that you’re doing on your end. I think it’s a lot of excitement ahead in the industry. It’s so exciting to think about the conventional world coming together with the allopathic world and bringing the best of it all together to transform more lives. I know that’s what we all want.
Dr. Pompa:
Yeah, thank you.
Dr. Scheck:
Thank you.
Meredith:
Thanks everyone. Thanks for tuning in. Have a wonderful weekend, and we’ll catch you next week. Bye-Bye.
