Can Keto Fight Cancer?

Thomas: You look like a healthy guy, right? I don't know.

Brent: I hope. Yeah, I think.

Thomas: Okay. Why don't you go down today to Farber and say, "Can you please give me the treatment that you give your colorectal cancer patients? Give me a dose of radiation and poisonous chemicals." You're not going to look the way you look right now. And yet, when you have cancer, they do that stuff to you. It doesn't make any sense.

Brent: Welcome to Death Clock. I am your host, Brent. Today we speak with Doctor Thomas Seyfried about metabolic health and cancer. Both during the process of treating cancer and in preventing cancer, as well as heart disease and Alzheimer's, metabolic health is so important. Doctor Seyfried is a professor of biology at Boston College and a leading voice in the field of cancer metabolism.

Brent: He's best known for challenging the genetic theory of cancer and proposing instead that cancer is a metabolic disease rooted in mitochondrial dysfunction. He's the author of Cancer as a Metabolic Disease and a pioneer in using dietary interventions like the ketogenic diet as a part of metabolic therapy for cancer and other chronic conditions. We had originally teed up this conversation as a conversation about keto.

Brent: But as you'll see, Doctor Seyfried is really passionate about the importance of metabolic health. So when we think about our biomarkers—this is our blood glucose, our A1C, our C-reactive protein—the importance of metabolic health in preventing cancer, basically all chronic diseases, and in the treatment of cancer, he's a really passionate and well-informed guest, and I just loved the conversation.

Brent: I hope you all enjoy as well.

Brent: Doctor Seyfried, welcome to the show.

Thomas: Oh, thank you very much. It's a pleasure to be here this afternoon.

Brent: Thank you. I think we'll spend the majority of the time talking about keto, but I think we're going to have to start with some of your views that differ from others—maybe they're becoming more mainstream, I think we'll get into that—on the origin of cancer and this question of genetic versus metabolic. But before we do that, can you just give us a sense of your bio and background?

Brent: Yes.

Thomas: Well, thank you. I'm a professor here at Boston College, and I teach general biology to non-majors and cancer metabolism as an advanced seminar class. We have an active research program in energy metabolism and cancer across a broad range of cancers: pancreatic cancer, breast cancer, brain cancer. So we are constantly developing new, non-toxic therapies for managing cancer.

Thomas: We do our preclinical work here, and then I have a large group of MDs that will attempt to apply our discoveries here to folks with cancer in the clinic.

Brent: Core to your work and your belief is that the origins of cancer are more metabolic than genetic, or that metabolic dysfunction plays a greater role than genetics do—or maybe we tend to overweight genetics. Can you explain that view of the world?

Thomas: Yeah. Well, that was first described by Doctor Otto Warburg in the last century. He clearly understood the origin of cancer is related to mitochondrial dysfunction. It's important for people to know that the organelle inside the majority of our cells, the mitochondrion—which is actually kind of a network system that generates energy efficiently—is corrupted in all major cancers, forcing these cells to rely on an ancient way to generate energy, which is fermentation: the type of energy that was used to generate living cells before oxygen came into the atmosphere 2.5 billion years ago.

Thomas: So cancer cells are simply relying on these ancient fermentation pathways, mainly because of chronic disruption of the mitochondria's ability to generate energy efficiently. So cancer is a chronic disease of mitochondrial energy metabolism, making it a metabolic disease. Because of that disruption and mitochondrial dysfunction, reactive oxygen species are produced that cause the mutations in the nucleus, making the mutations that we see in cancer downstream effects of the damage or dysfunction of the mitochondria.

Thomas: That's why cancer is a mitochondrial metabolic disorder. But the field for many decades has been focusing on red herrings and mutations as if they were the cause, when they are really the effects. As a result of that misunderstanding, we have 1,700 people a day dying from cancer in the United States, which is about 70 people per hour.

Thomas: And that will continue uninterrupted until the field begins to realize that cancer is a mitochondrial metabolic disorder that can be both prevented and managed using far more strategic, non-toxic ways.

Brent: How far is the field from accepting this more widely? What percentage of the field accepts this view and is pursuing treatment with this view in mind, and what percentage of the field is still on the wrong path in your estimation?

Thomas: Well, I really can't answer that because I don't know these percentages. When you have dogmatic ideology and confirmation bias, it's extremely difficult to change a paradigm. The cancer industry is a multi-billion dollar industry. Everybody is backslapping, making a lot of money, while 1,700 people a day are dying. Changing the status quo is not easy.

Thomas: Even when you see the data, even when you see the outcome, many physicians would love to be able to do metabolic therapy on their patients, but they're not allowed to do it by the system. The system says cancer is a genetic disease, so you must use radiation, chemo, and surgical mutilation to treat cancer patients.

Thomas: So it takes time. It took 1,800 years before the work of Copernicus could be realized—before people realized that the Sun, and not the Earth, was the center of the solar system. This is a very similar situation. The only difference is we have all these dead people dying every day from the misunderstanding that we have.

Thomas: Whereas if you believe that the Earth was the center, you didn't have 1700 people a day dying from that misunderstanding.

Brent: Okay. So when we think about metabolic distress and metabolic issues, I immediately think of diabetes, specifically type 2 diabetes. I think about the amount of sugar we're consuming and carbs, and what my glucose levels look like and what my A1C looks like. Can you connect the dots for us between your perspective on the origin of cancer as dysfunctional mitochondria and contemporary American diets?

Thomas: Yeah. I think there's a tremendous overlap here. The factors that lead to cancer can also create a whole range of metabolic disorders: diabetes, Alzheimer's disease, hypertension, obesity. All of these are consequences of mitochondrial dysfunction in one way or another. They are all associated with systemic inflammation caused by poor diets and lifestyles.

Thomas: Some people develop cancer, some develop diabetes, some develop hypertension or Alzheimer's disease. All of these chronic diseases, which make up the majority of what plagues our current healthcare systems, are in one way or another linked to mitochondrial dysfunction. With diabetes, you have insulin insensitivity, which also leads to obesity and creates systemic inflammation.

Thomas: Obesity is now in the process of replacing smoking as a major risk factor for cancer. What happens in cancer is some people's cells gradually switch from oxidative phosphorylation to substrate-level phosphorylation, which is fermentation. In other conditions, cells die and don't become cancer cells. But in one way or another, all major chronic diseases link back to the function of our mitochondria, which is the organelle that maintains metabolic homeostasis.

Thomas: Let's put it this way: our Paleolithic ancestors living 500,000 years ago were dying from infections and injuries. They were not dying from diabetes, cancer, and Alzheimer's. How do we know that? Because we have folks on the planet who live according to ancestral ways, primitive tribes, and these chronic diseases are not present in any significant amount in these tribes.

Thomas: So we pretty much know that our ancestors were not dying from chronic diseases. They had a lot of activity. They were largely carnivores or omnivores—they ate anything that walked, crawled, or flew on the planet—and they were very active. We know the same thing for wild animals like wolves.

Thomas: Wolves die from injuries and infections in the wild. Domestic dogs are all derived from the wolf, and they're dying from cancer and chronic diseases just like we are, because they eat the same processed food and have the same lifestyle that we have. When you understand evolutionary biology, you can put all the parts of the puzzle together and explain what's going on.

Thomas: When you look at it like that, yes, we can link all major chronic diseases, including cancer, back to various types of mitochondrial dysfunction, putting us at risk for chronic diseases and disturbing internal metabolic homeostasis.

Brent: Just to be clear, you mentioned at the top that your group recommends non-invasive treatments for people who have existing cancer, but I assume this is preventative as well. So what we're going to talk about can be used for the treatment of cancer, but you would also recommend it for preventing cancer in the first place?

Thomas: Yeah, absolutely. Why did our Paleolithic ancestors not get cancer? Albert Schweitzer, the great humanitarian physician, looked for cancer in primitive tribes and didn't find it after examining roughly 10,000 people. Why? Because it's hard to get cancer if you keep your mitochondria healthy.

Thomas: We have to really abuse our bodies to get cancer. People might say, "I took good care of myself and still got cancer." Well, we have microplastics and forever chemicals, and we're not exercising as much as we used to. We're living a diet and lifestyle that is strikingly different from the one in which we evolved.

Thomas: Biologically, we are still Paleolithic humans living in a modern society. Our food science and technology have evolved far faster than our biology. Eating too many highly processed carbs, lack of exercise, emotional stress, and poor sleep all put you at risk for cancer and other chronic diseases.

Brent: Can we be more specific about what you recommend in terms of prevention, outside of general advice like getting 7 to 9 hours of sleep, eating mostly whole foods, and exercising an hour a day? Is it that simple, or how would you be more specific?

Brent: How would you be more specific outside of that?

Thomas: That's exactly right, but the problem is: how do you know this is helping you? How can you be certain? That's why we developed the Glucose Ketone Index (GKI). The GKI is a biomarker tool that tells you your level of metabolic homeostasis.

Thomas: We published these papers for cancer, but it's not out for the general population yet, and we're working on that as we speak. Everyone will eventually be able to measure their Glucose Ketone Index with meters—whether continuous glucose-ketone monitors or finger-prick monitors. We can then know our GKI, which tells you what level of metabolic homeostasis you are in.

Thomas: If you're in metabolic homeostasis, it becomes very difficult to get cancer or chronic disease.

Brent: How is that different from standard biomarkers? The ones that come to mind for me are blood glucose for short-term levels, hemoglobin A1C for a three-month view, and high-sensitivity C-reactive protein to measure inflammation. Are those markers no good, or is there just a better way to measure it?

Brent: And then I don't know like something like high sensitivity C-reactive protein to understand inflammation. Are you saying that those, those markers are no good or there's just a better way to measure it?

Thomas: Those are excellent markers. The problem is they're not readily measurable every day by an individual. You're not going to measure A1C or C-reactive protein on a daily basis; you need a clinical chemistry lab for that. When you go to the doctor and look at blood work, lipid profiles, and micronutrients, you're getting a quantitative assessment that isn't available at home day-to-day.

Thomas: The Glucose Ketone Index is directly correlated with those other markers. When you maintain a low GKI, C-reactive protein and hemoglobin A1C go down. All the different biomarkers enter the range of metabolic homeostasis. We now have a tool that allows everyone to know where they stand at any given moment of the day.

Thomas: We published the paper on GKI for cancer patients, and many are using it to manage cancer. When you lower blood sugar—the prime fuel for cancer—and raise circulating ketone bodies, the ketone bodies and fatty acids replace glucose.

Thomas: Tumors cannot use fatty acids and ketone bodies as fuel, but normal cells in our brain, muscles, and heart can switch from glucose to ketone bodies. As glucose goes down, ketones go up, metabolically marginalizing tumor cells that have a rapacious need for glucose.

Thomas: Tumors can't burn ketones or fatty acids. Lowering glucose also lowers hemoglobin A1C, C-reactive protein, and significantly reduces triglycerides, which are key markers for cardiovascular disease. In effect, you have clinical chemistry in the palm of your hand.

Thomas: Our Paleolithic ancestors were almost always in a state of nutritional ketosis simply because they didn't have donut shops on every corner. It wasn't a choice; their environment prevented them from overeating carbs.

Thomas: Today we are in a very different state. When you measure your GKI and see it at 50 or above, you know you're not in ketosis. Some diabetic patients have a GKI of 1,000, whereas it should be around 1 to 5.

Thomas: If you reduce carbohydrate intake and exercise more, you can watch that number drop and bring your body into a new metabolic state. We're working on making this tool readily available and understandable for the general public.

Brent: Okay. To clarify: our cells require energy, which can come from glucose or fat. Cancer cells feast on sugar and cannot feast on fat. In ketosis, your cells effectively use fat instead of sugar, making you healthier in many ways. Is that a correct simplification?

Brent: And so, you know, a blood sugar. Or it can come in the form of fat. The cancer cells really feast off of the sugar. And they're not able to feast off of the fat. And in ketosis your cells are effectively using fat instead of sugar, which makes you much healthier and a whole bunch of different ways. Is that is that a is that a correct simplification?

Thomas: Yes. When fat breaks down, fatty acids go to the liver, which chops them up into water-soluble ketone bodies.

Thomas: Ketones can replace sugar for the brain and heart muscles. When burning ketones, you generate more ATP per breath of oxygen, making it a super-energetic fuel.

Thomas: We can survive longer and reduce entropy when burning ketones, but it's rare in modern society because elevated blood sugar prevents fat mobilization.

Thomas: The GKI tells you the ratio of glucose to ketone bodies. High glucose and low ketones yield a high GKI, which is unhealthy.

Thomas: If you reduce carbohydrate intake and exercise, your GKI drops. You are in complete charge of your destiny using this quantitative tool.

Thomas: Rather than debating specific diets, you can test what foods do to your GKI. If a food keeps your GKI low, it's fine; if it shoots it high, avoid it.

Thomas: If it lowers your GK, that's okay. If it makes your GK, I go high. Don't eat that. You know, it's it's becomes very clear.

Brent: Given all the complexity around diet recommendations, why isn't the ketogenic diet the primary recommendation?

Brent: We have a diet called the ketogenic diet. Why isn't that the answer? Why isn't that the recommendation?

Thomas: Because the word "diet" is a turn-off to the medical community; it implies ambiguity. We prefer the term "ketogenic metabolic therapy." You can achieve therapeutic ketosis through vegan, carnivore, pescatarian, or Mediterranean eating patterns, provided your GKI reaches target levels.

Thomas: By focusing on the bioenergetic outcome rather than named diets, individuals determine what works best for their unique physiology, age, culture, and lifestyle.

Thomas: That way we bring everybody down into the bio energetic profile so you don't have to talk about, oh, diet, this diet, that diet. It's what is it, what is what you're eating due to your guy and somebody says, oh, I eat fish. I got a low geeky great, you know, I eat meat, I get a little geeky, I eat plants, I get a low key.

Thomas: Everyone becomes their own experiment to see what brings them into metabolic homeostasis using the GKI as a quantitative marker.

Thomas: They're all influencers. On knowing what's going to bring you down to metabolic homeostasis. Using the glucose ketone index as a quantitative biomarker.

Brent: Can someone calculate their GKI currently with existing devices?

Thomas: Yes, devices like the Keto-Mojo meter calculate GKI from glucose and ketone blood strips. We are working on establishing clear health range correlations for these numbers so individuals can monitor their metabolic status easily.

Thomas: You push a button on the machine and it immediately gives you the key. So what we're in the process of doing is linking that number to various degrees of health. So that has not been done. So. But everybody right now you can go and measure your GQ. If you had the meter right now you could do that. The problem is you get a number and you'd say, what the hell does this number mean?

Thomas: So we're trying to integrate those numbers to show that they are related to your hemoglobin A1. See your C-reactive protein, your triglyceride levels, so you don't have to on a daily basis, go to the clinic and get all that kind of reading. When you can know that it's correlated with your GPI.

Brent: While "diet" is a complex term, it seems hard to have a high GKI on a low-carb, low-sugar diet.

Thomas: That's true. Water-only fasting is very effective for lowering GKI, but it's difficult for most people to maintain. Therefore, a low-carbohydrate transition is often more practical.

Thomas: Oh, yeah. It's really exciting. Let's talk about not eating. You know, you just pounded down a big burger. You know the issue here. Not try not eating for 3 or 4 days. And you see how fun, how much fun that is. It ain't fun. So. So we we developed the the low carb hydrate diet or food intake.

Thomas: Because glucose can be addictive, stepping down carbohydrate intake gradually over a week or ten days helps the body adjust to burning fat without the severity of abrupt fasting.

Thomas: I mean, you go a week or ten days without eating any carbs. Just say meat or fish or something. You notice it, but it's it's not as dramatically noticeable as if you went cold turkey and just drink water. So and you monitor your GPS as you're doing this. And you'll see after about 5 or 7 days, you'll see your guy go from 40 to 50 all the way down.

Brent: Lower is better on the GKI?

Thomas: Yes, lower is better.

Brent: You're referring to what people call the "keto flu"—the period where you feel worse before feeling better as you adapt.

Thomas: Every individual adapts differently. In cancer management, maintaining a low GKI helps target cancer cells because they require both glucose and glutamine to survive.

Thomas: Diet alone cannot lower glutamine, which is the most abundant amino acid in the body. Therefore, metabolic therapy pairs low glucose via dietary control with glutamine-targeting drugs.

Thomas: So we get geeky patients, get them low into a low GK, and then we hit them with the glucose glutamine targeting drugs. I don't know what it is on all these part podcasts. I always say there's no diet that can lower glutamine. You heard me say this, right? Yeah. Can you say, can you repeat what I just said?

Brent: There's no diet that lowers glutamine.

Thomas: Targeting glutamine effectively requires pharmacological interventions alongside glucose restriction.

Brent: These are prescription pharmacological interventions, not over-the-counter.

Thomas: Correct. One potent drug, 6-diazo-5-oxo-L-norleucine (DON), is not currently widely available for clinical use.

Brent: Is that in the U.S. or globally?

Thomas: Historically, DON was administered at doses that were too high without simultaneously lowering glucose, leading to toxicity. When paired with ketosis, chemotherapy and targeted drugs can be effective at significantly lower, less toxic doses.

Thomas: And if you don't know how to use the tools you have, sometimes you throw out good things. That could be very valuable. We're learning more and more now that many of these cancer drugs, work remarkably well when the body is in a local, GCS in a key toxic state. So we're poisoning these poor people and using too much drugs and stuff to manage cancer.

Thomas: By reducing drug dosages while maintaining the patient in therapeutic ketosis, we can achieve therapeutic efficacy with far less collateral toxicity.

Thomas: You know, they they just know how to do one thing. They know how to irradiate and poison you with high, high doses of things. And then they scratch their head and don't understand. Can't understand why you died if you took healthy people like you. Look like a healthy guy, right? I don't know, I hope.

Brent: Yeah, I think.

Thomas: If a healthy person received high-dose chemotherapy and radiation, they would become extremely ill. Standard oncology protocols often rely heavily on aggressive treatments without incorporating metabolic management.

Thomas: Cancer is a mitochondrial metabolic disease driven by glucose and glutamine, and cancer cells cannot switch over to using ketones or fatty acids effectively. That is the key vulnerability.

Brent: Would you recommend a water-only fast to enter ketosis for someone looking to lower their A1C or manage risk, despite the difficulty?

Brent: It's not enjoyable. There's some suffering involved.

Thomas: As a scientist, I do not offer medical advice. Fasting requires proper supervision and medical evaluation, particularly for individuals with metabolic dysregulation.

Thomas: Gradual carbohydrate reduction allows the body to adapt progressively before attempting longer fasts.

Thomas: And then when you make the last jump off the last step onto water, only fasting, it's not so traumatic for your body. You've already been. It's like working out, running a marathon. You know you're not going to take a couch potato. Who has who hasn't walked around the block in five years, put a tag on his chest, and now let's do the Boston Marathon.

Thomas: Tracking GKI provides quantitative feedback as metabolic markers like C-reactive protein, A1C, and triglycerides improve.

Thomas: Your C-reactive protein goes down, your AB one C goes down, triglycerides go down. You get into a state of new a new metabolic state. That's why it's so powerful.

Brent: What are the specifics of the diet that you are recommending in the studies that you're doing?

Thomas: Rather than enforcing a single diet, the goal is whichever dietary approach lowers an individual's GKI effectively.

Thomas: Again, it's the amount and the type of foods that you're eating that you bring down into the low guy.

Brent: But if you're doing studies with, you know, you've got these MDS and you've got these cancer patients and you're you're doing some research, you've got to be more prescriptive than just, hey, whatever lowers your guy, right?

Thomas: No, you don't, because whatever low is, that guy is up to the individual of what they can do. They will come to know that they can't eat certain foods. You drink a Coca Cola, you're going to see it's not going to be healthy for you. You can shot your guy up through the roof. Don't drink the Coca Cola.

Thomas: I mean, what the hell do you have to say to the guy? I mean, he's the one doing the experiment, not you. You're just telling him. Yeah. Okay. Are you going to keep a low gi? Oh, well, I you know, I really like to have a bowl of ice cream after dinner. Okay, have the bowl of ice cream and see what it does.

Thomas: You cheeky. If it shoots your cheek through the roof, then don't eat the bowl ice cream. Oh, but I love the ice cream. Well, the hell with you. You know, this is only for people that that are interested in their health. I'm not out there telling people what I'm just tell. I'm just giving them a tool to let them use the tool to help themselves.

Thomas: I'm not telling anybody what they should do and should and shouldn't do. Well, let me let.

Brent: Me ask the question a little bit differently. How often do you eat dessert?

Thomas: Maybe once a week or something like that. And also you have to. The other thing is, if you do that, what do you do to lower your cheek after you do that? Okay, we're not going to live in a Paleolithic lifestyle. Nobody wants that. I mean, we have breads and we have desserts, and we have all kinds of things that make our life enjoyable.

Thomas: The question is, if I do that and I shoot my cheek up to a stratospheric level, how fast can I bring it back down into the into the healthy zone again? Okay, it might take 24 hours. Oh, okay. I stop eating for 24 hours. The dessert that I had the night before, all of a sudden my GCS is back in the zone again.

Thomas: And that depends on how, insulin sensitivity, depends on a lot of physiological parameters in the individuals in the individual's body. So again, the GCS is simply a tool to allow a person to know what zone of health they're in and how long they would like to stay in those zones, and how how long it takes them to enter or exit the zone.

Thomas: So it's a complete. You then work your body into these, into these states. I have friends that are cancer patients that are alive, quite a long time when they were given terminal diagnoses and they used to measure their GPS all the time, every day. But after years of doing this, they more or less know how they feel.

Thomas: And they don't have to be doing this every day. So. But when they do it occasionally, they'll know exactly where they are. So it's again, your body is in is in a new physiological state of health. The GPS is simply a tool to allow the person to know where they are and how long they want to stay in these.

Thomas: Right now, the society has nothing. There is nothing out there available in this society like what I'm speaking about. They have continuous glucose monitors. That's good. But that only tells you what your blood sugar is. It doesn't tell you what your ketone levels are because it's the ketones. It is the ketones that are the super fuel. And when you lower glucose, you need to replace the something, something else.

Thomas: And that ketone body is the something else. And that's what generates the super energy efficiency within our cells. So lowering glucose is great. But you've got to balance it with an elevation of ketones. And we don't have a tool available now they're developing these tools continuous glucose ketone monitoring. They're just not available for the public at this point.

Brent: Doesn't it feel like the the the tide is turning a little bit in that the awareness of the ketogenic diet with, with all of its controversy has got to be at an all time high. People's awareness of their own biomarkers related to inflammation and related to blood sugar and related to cardiac health, that's got to be at an all time high.

Brent: People seeking alternatives to, you know, the the widely accepted dogma seems to be at an all time high. So don't you see the trend turning and in your direction related to related all this?

Thomas: Yeah, we started it all. People have to forget about that. We were the first ones to really put an emphasis on this. It was because we did it for cancer. Don't forget, I worked in the epilepsy field for decades before we started to switch deeper into the cancer. We were working on ketogenic diet for managing epileptic seizures, but it was kind of a niche in that group of children that have epileptic seizures.

Thomas: So we learned an awful lot about ketogenic diets for managing epileptic seizures, which are many, many children in the world are managing epileptic seizures using ketogenic diets when we switch to cancer. Oh my God, you can't do this. You can't do that. You know, it's it's hard. It's like dangerous. A cancer patient was told that if you switch to a it's dangerous and we're giving these little kids ketogenic diet to manage their seizures.

Thomas: It's dangerous. Compared to what? Doxorubicin and radiation. You think ketogenic diet is more dangerous than poisonous chemicals and radiation? What, are you crazy? You know, we don't know anybody who's died from therapeutic ketosis.

Brent: If I'm the top cancer doc at Sloan-Kettering and I'm listening to this and I'm disagreeing with you, why am I disagreeing with you? What am I thinking? What's going through my head?

Thomas: Okay, well, there's several reasons. Number one, you lack knowledge. You haven't read the science. That's number one. Number two, you don't believe in the science. That's that's another issue. And number three, you're not allowed to do it because the system will not allow you to do it.

Brent: I find your first two to be. Respectfully, they're not that charitable. And so the the let's the most charitable of the three is, hey, I'm not allowed to do it. I'm aware of the science, but I'm not allowed to do it. So you're telling me there's some set of rules at the hospital or the insurance company that say, hey, you cannot advise your patients to be on a ketogenic diet.

Thomas: It's sometimes not advisable for them, what they want to do invariably, is you must do, rigid standard of care. If you want to do a little keto on the side, that's great. But my, my, my argument is this if you did metabolic therapy upfront, you wouldn't need to do all that toxic stuff in the first place.

Thomas: And you would modify the toxic stuff so it wouldn't be so toxic.

Brent: Well, so you're saying if you could wave a magic wand and just change how I'm just picking Sloan-Kettering. I don't know anything about Sloan-Kettering. And you could change the way that we're treating cancer at some at some top cancer hospital, the patient would come in and you would say, hey, the first thing we're going to do is we're going to think about your blood glucose and your ketones and your glucosamine, and we're going to get that into a place where it's really healthy.

Brent: And then we are going to look at the more invasive treatment options instead of what's happening today, which is going straight to those in basement invasive treatment options.

Thomas: You're absolutely right.

Brent: But isn't the concern there that they that the cancer is metastasize. It's growing at a rate where I don't have the luxury of time.

Thomas: The cancer can't live without glucose and glutamine. So you would you would then immediately start. If once the patient gets into the nutritional ketosis, you go right after that. Glucose and glutamine don't forget that a nutritional ketosis reduces inflammation. Let me let me tell you something. They're arguing that, oh, the cancer is resistant to radiation and chemo and immunotherapies because it's so acidified and inflamed.

Thomas: And the reason the acidification and inflammation is coming from the waste products of glucose and glutamine fermentation metabolism. When the cell takes in large amounts of glucose, it craps out lactic acid into the microenvironment as a waste product. And now we have discovered sucks in acc acid as the waste product of the glutamate analysis pathway, the glutamine waste product, this succinate, those two are creating a resistance of that tumor cell against standards of care and yet you keep trying to break through the acidification when the acidification is caused by not targeting glucose and glutamine together.

Thomas: If you did that, the cancer cells become super vulnerable to low doses of chemo and small doses of radiation. So we understand very clearly how to manage cancer without toxicity. The problem is that the field is based on standards of care written in granite, and they will not allow metabolic therapy to come in, because if it works and it works really, really well, what the hell is going to happen to the whole cancer industry?

Brent: I understand that argument institutionally, but I don't if you if you talk to a medical oncologist, you know, they care. They want what's in the best interests of their patient. They're not just these drones that that are just exclusively focused on the bottom line. If I had to pretend to be one of them for a second, again, if we give them that benefit of the doubt, I might say something.

Brent: The effect of sure, this is fine if the patient adheres, but we know that patient adherence is really difficult. And so we have to use some of these more heavy handed therapies, because we just can't count on the patient to actually adopt this diet and to change their lifestyle. Well, I mean, what would you say to to that argument?

Thomas: We got 1700 people a day dying from cancer. What do you think you're doing? You think what you're doing right now is really helpful, and the people who you do save the millions of people who have been saved, pay a serious price for their health. They've got hormonal problems, digestive problems, they got bone density problem, neuropsychiatric problems. What are you talking about?

Thomas: This is nuts. You can't defend the current standard of care. It's undefended and defensible, except by the ideology that drives the field. We're not making any head roads. It's getting worse and worse year in, year out. This cancer, the only breakthrough we have had is the anti-smoking campaign from the 1990s. When they say we've made major advances in cancer, we've reduced death by 33%.

Thomas: It was because of the anti-smoking campaign. It wasn't because of any new drugs. Here's another term hypo progressive disease. This is where the drugs kill you before the cancer kills you. All right. This is an issue a lot with some of these immunotherapies. And I'm telling you what the immunotherapies are based on an incorrect theory. It's based on the somatic genetic theory of cancer.

Thomas: If cancer is not a genetic disease, any therapy that's based on that makes no sense. Brute force radiation and poisonous chemicals, they're trying to kill the cancer before they kill you. But if you so happen to survive, you pay a serious price for this. Yes, these guys would like to see their patients do better. Of course, that's why they're in there.

Thomas: But they're trapped in a system. Who would a radiant and poison somebody to make them healthy? This makes no damn sense. If you understand the biology and biochemistry of the disease you're working with, you say, why are you doing this? There's another way to get the job done without without doing this to the patient. We know the cancer cell can't live without glucose and glutamine.

Thomas: Why don't you target the glucose and glutamine simultaneously while you transition the body over to ketosis? Oh, we can't do that. It might be dangerous, but are you kidding me? Dangerous compared to what? What you're doing to these poor souls right now. I mean, people gotta wake up. This is the problem. They have all these arguments. Nothing has to do with the science.

Thomas: Why don't they talk about the people? Why don't you talk about the science that's driving the dysregulated growth? Why don't you talk about how metastatic cancer is disease from a fusion hybridization between your immune cell and a stem cell, and it's driven by glucose and glutamine. Why don't you target the glucose and glutamine simultaneous? Well, there's no clinical trial to do that.

Thomas: What do you mean? That's not a scientific argument. You just keep pushing the the kicking the can down the road because God forbid, you do metabolic therapy and these people live a lot longer with a higher quality of life. What the hell are you going to say then? And that's what's happening, which I'm I'm working. I write these case reports.

Thomas: You can understand the level of frustration. We see people that do metabolic therapy who are doing really, really well on small groups of people. Oh, you have to do more. But listen, when I worked in the epilepsy field, they said, oh, ketogenic diet, we got to use drugs to manage epileptic seizures. There's no evidence, no double blind crossover ketogenic clinical trial.

Thomas: We did those clinical trials in the United States and and in England. And still after we did that, the drug companies still want to push drugs, even though, you know, you have something that works. So clearly, even if we did these clinical trials, they would say, oh, we still have to use all these poisonous and expensive chemicals.

Brent: It strikes me that it's it's one of three things. And so my own personal bias is that I tend to find that the individual actors have the right incentives. Like if you just talk to a cancer doc, that and let me lay out all three that the cancer doc wants what's best for their patients. And you don't find that many bad people who are just greedy.

Brent: So, so, but maybe, maybe, maybe the individuals are bad actors. But that's just option one. Option two is the profit motive, the insurance companies and the way in which the money flows. It prefers these more invasive, invasive and less effective treatments because there's a lot of money there. And then number three, which my own personal instinct would be that it's some version of number three.

Brent: And maybe that's just me being an optimist, which is there's this irrational relationship with risk. We're seeing this in self driving. Oh my gosh, if one person dies from a self-driving car we got gotta we got to halt the whole effort. We got to think about the thing when really, you know, 30,000, 40,000 people are already dying. Anything below that we're going to be saving lives.

Brent: And is there some version of that here, which is okay if we switch people to this, to this, you know, this keto, approach that if there's even one case of some negative impact, somebody goes straight to the water only fasting, and it doesn't go as well as it would have otherwise. We just can't tolerate that type of risk.

Brent: And it's an irrational relationship with risk. Do you think it's number three or is it number two or number one?

Thomas: I mean, I think every one of the things you touched upon is, is part of the problem. I just think whenever you have a paradigm change, regardless of what it is, there's every kind of a reason why it shouldn't work or all of the all of the above that you just mentioned. There's no one thing. There's a huge profit margin.

Thomas: There's a huge desire to maintain the status quo for a multibillion dollar industry. And everybody is doing really, really well on here except the patients, except the cancer patients. So who wants to make the change? Is it kind of come from the top to say, oh, we made a terrible mistake thinking cancer was a genetic disease, when all along it was a mitochondrial metabolic disease.

Thomas: The physicians in medical schools get almost no training, on how to use food as medicine. So they're never there. They're never really trained to know the power of metabolism in the body to work with drugs. We're not we don't discount any of the tools that we have in the tool chest, for managing cancer. We we're not against not using radiation or poisonous chemicals or any of this kind of stuff.

Thomas: You just you just have to know how to use it and when to use it. Like, well, if we can pare down an angry, aggressive stage for cancer to something that's indolent, like we did for Pablo Kelly with the glioblastoma, he lived for ten years and disease and died from the fourth, the bulking surgery of a tumor that was considered initially inoperable.

Thomas: He never was cured, but he he lived with an aggressive cancer for for ten years, which he which normally gets 17 months. Is it possible that we can develop new therapeutic strategies that just rearrange the chairs, rearrange the the way we do things? That's the most logical way, because it then it takes advantage of our understanding of the science and using specific drugs and tools that are known to work but were used inappropriately and now can work even better.

Thomas: Our clinic in Istanbul, Turkey is doing exactly that. They're using much lower dosage when patients are in nutritional ketosis, the people are doing much, much better. Lowering toxicity and overall quality of life and overall survival are improving tremendously. But we're not throwing anything out. We just using what we have in a different way. That's the most logical and strategic way to manage this.

Thomas: So the paradigm shift is recognizing the power of metabolic therapy to improve the standards that we already have in place. That's the plan. The problem now is that will not be allowed in any of the major hospitals through the IRB. The institutional review boards. They demand that we use, standards of care first. And only if that doesn't work that we recommend or that we could possibly suggest something else.

Thomas: This is the back ass way to do it. No, you've got to do metabolic therapy up front, reduce the inflammation, reduce the anger, reduce that tumor down. Then we can come in strategically with with standards of care to finish off the surviving tumor cells.

Brent: So the IRB so basically the the bureaucratic process maybe for, for lack of a better term is says, hey, fine, you can use these quote unquote alternative methods, but only after the traditional methods have been exhausted. And your argument is, well, no, no, that's exactly the problem. The sequence here really matters. If we know the house is going to burn, well, let's get all the furniture and things out that are going to make it, you know, burn more, aggressively before the house burns.

Brent: And you're telling us we can only remove the furniture on and on after the house burns? If that analogy holds it all.

Thomas: Yes. Is that too difficult? It's not difficult to understand, right? No.

Brent: And it makes a lot of sense to me. I mean, I struggle sometimes with the argument that you don't get nutrition in medical school. We're seeing this with with what RFK is doing for me. I'm like, well, I think the I live in Boulder, Colorado. I'm it's a little higher than average, but the average person walking down the street knows the basic nutrient, like we know about nutrition.

Brent: They probably know something that's reasonable about keto, etc.. And so it seems it's more of the application of that in these settings than it is. Like doctors just don't know what good nutrition is. That's the only piece of the argument I struggle with sometimes.

Thomas: Well, I think you're right about that. I don't think they understand what good nutrition is. Don't forget, the food pyramid is why.

Brent: I'm saying the opposite. So you're saying that they don't know what good nutrition? I don't.

Thomas: Think so. I don't think so. Because many of the people who go to, oncology clinics to ask for metabolic therapy, most not all, they say don't make does make any difference what you eat. You're losing weight. And you're got to take, insurance of these sweet foods to get your weight back on. Why are you losing weight?

Thomas: Either from the tumor cell, from lexia or from being poisoned and irradiated? You know, people who are poisoned, irradiated, get sick. They can't eat, they lose weight. Cancer is a code where they mobilize proteins out of your muscle to feed the glutamine into the tumor. So. So, as I said, if you target glucose and glutamine, you eliminate a lot of these things.

Thomas: So, you don't have to worry about a lot. So. So, you know, I was down at Dana-Farber last year, which is the big cancer hospital here in Boston, and I saw some guy sitting there with a, with a, with a big liter of Coca Cola eating, a hamburger while being it, while having the bag of chemo infusing into his arm.

Thomas: I mean, this is nuts. I mean, this is absolutely nuts. So clearly, clearly, somebody doesn't know.

Brent: You'd probably be better off smoking a cigaret while sitting there.

Thomas: Yeah, well, you could do that to to top. That's your dessert. But but if.

Brent: You were to compare the two and you had to choose one, it seems you'd actually be better off smoking the cigaret. You know, just just to put in context how harmful it.

Thomas: Is, I think we just really need to reevaluate the whole thing. It would it would be one thing if it weren't so critical. But as I keep telling you, we got 70 people an hour dying from cancer in the United States. It this and it's getting worse and worse every year. It's not getting better. So let's do something to change the numbers.

Thomas: Let's drop the death rate. I tell you, if we did metabolic therapy the way we think it should be done, the way I and my group here think it should be done, we can drop this cancer death rate significantly in 5 to 10 years by a third, and we can drop it down in a down and down because it takes a reevaluation of what you're doing to be healthy.

Thomas: Glucose is a non essential nutrient in our body. It's not part of the the nutrients that we need okay. So and yet we're loaded with it and everything that we eat, almost everything that we eat, all of our foods are genetically engineered. That coming from everywhere on the planet. All the foods in the supermarkets are highly processed carbohydrates.

Thomas: We're sitting in cars, in traffic, screaming and yelling, and we're we're all freaked out. We got stress up the ying yang. We're not sleeping well. We're eating all bad foods. No exercise. What do you expect is going to happen? Chronic diseases are killing us as a nation. Half to be. We can't even get guys in the army anymore.

Thomas: They're too fat. They can't make their physical. What's going on here?

Brent: So where do we go to learn more? Preventatively. If I want to know more about about this preventatively if I am somebody who has cancer and I want to know more about it, where can we find you? Where can we find this work?

Thomas: Well, our work is always published open access. So anybody can look my name up and say, show me is publications. It's open for the public, which means anybody who has access to a computer can go on and look at our work. We get funding support through Travis Kristofferson's Foundation for Cancer, Metabolic Therapies. All my money to do all this research comes from, private foundations and philanthropy.

Thomas: You get people we're in the process of flipping a whole industry here. A whole paradigm is under the way. Like you said before us, there was none. None of this. We were the first ones to come out. We did water, only fasting, which which we thought at the beginning was, oh, people didn't want to hear about that. So that's why we went to the ketogenic diet, because I thought in my experience in the field of epilepsy, it wasn't so, outrageous to call, management of ketogenic diet for epilepsy.

Thomas: Oh, yeah. Yeah, that's works really good. But soon as we flipped it into the cancer field. Oh, you can't do that. It's harmful. They made it into a big brouhaha, but all it is is lowering glucose and elevating ketones. So. And the term diet and cancer has always been a great turnoff. So, so as you mentioned, good ad doesn't eat whatever you want.

Thomas: So then we realized and now people are going back to water only fasting is the most powerful way to do this. I said the whole the whole thing flipped upside down. But everything. Don't forget. Well, you go back and look. None of this talk. I wrote my book in 2012 where I really dug deep into this and put it out there, and then we started publishing all these papers where I tracked you can see our transition, how we transition from epilepsy into the cancer field.

Thomas: So we made this big splash in cancer only because of the foundational evidence that I had from working with epilepsy for decades, trying to figure out how to stop epileptic seizures. And we still don't know, how ketogenic diets really work to stop epileptic seizures. It's related to lowering glucose, for sure. The ketones elevation is a way to buffer the glucose.

Thomas: But for cancer, we have a clear, striking knowledge of how it's working. That's what's really exciting. So, And people now shoulder. The only thing too, about this is when you do metabolic therapy for cancer, the patient themselves are a major participant in this. You're not simply a bystander any longer and the family gets involved. We find that people that do the best are when the patient and their family are all pulling together and they're all working together.

Thomas: The outcomes are unbelievable, unbelievable success. It's when you have the patient that doesn't understand, doesn't want to understand, and gets all kinds of grief from the family or the friends. Oh, what are you doing? Why are you doing that doesn't work, you know, and all of a sudden, that patient, that individual does much, much less favorable outcome than the guys who understand.

Thomas: So we've seen enough of this over the years to know what works and what doesn't work. The problem the problem now is getting it out and a workable process. We published a monster paper with over 30 people on it, from dietitians to oncologists, scientists. We're starting a new society on cancer metabolic therapies. So the physicians want a lot of them want to get involved with this because they can see what an incredible outcome their patients are having.

Thomas: You don't lose your hair. You're not bald. Your your microbiome isn't blown to hell. You're starting to see. And these physicians are going, what the hell, man? Right there. And a lot of them say the ones I always say, the ones that kill me are the ones that say, I don't know what you're doing, but just keep on doing it.

Thomas: Don't you care what you're doing? Why it's working. No, no, no, I don't really care. You're just doing so well. They always. They always say we're miffed. We've never seen anything like this. Well, you never. You got to know what the biochemistry and biology is behind why you're seeing this. We understand this.

Brent: One. The beauty is you're not saying, hey, okay, here's this new, you know, million dollar a pill drug that if you take it, everything's going to be better. It's actually it's lower cost. It's very accessible. Strikes me is I don't understand how the how the docs are saying that. Pretty easy to understand what you're doing and and why it might be helpful.

Brent: And so hopefully all of that ends up being when that you're back at some point. I mean, changing the culture is hard, of course.

Thomas: Well, I think what you just said was the probably the biggest stumbling block, the lower cost. So we didn't we didn't go into this to make money. We went into this just to see what works. And can we prove the science? Can we prove the science with people living longer, with a higher quality of life? As a scientist, you like to know that your hypothesis can be effectively tested and and the outcome is, is what you would have predicted.

Thomas: If you understand the biology and biochemistry. So when I see people who do metabolic therapy and they live 4 or 5, seven times longer than they would have, that proves that we, our hypothesis was correct and that we understand the biology and biochemistry. I don't need to make $1 billion on that. I get satisfaction by knowing that my hypothesis was correct.

Thomas: The industry, of course, one of the things you have to do is you have to you have to find another way to generate revenue on this. Those are the entrepreneurs. They are a different breed than me. I'm already satisfied to know that what I, what I know from the biology and biochemistry actually is, is correct when people do it the right way.

Thomas: The problem is I all of this is by philanthropy and private foundations. We're not making any money on this. This is our big problem. Our big problem. Right? How do we do it? You how do we generate revenue? What is that?

Brent: And the system might actually you might, might make it harder for the system to adopt because there is a reduction in revenue. So it hits you on both sides.

Thomas: Yeah. Well there you go. You said it. It came from your mouth. It's you understand. You're starting to understand a little bit more about the challenges, aren't you.

Brent: Well, Doctor Siegfried, thank you so much for your work and everything you do. Clearly your passion here is going to be a driving force in in fighting. You know, this this David against Goliath battle that you're fighting. So thank you so much for for fighting it and for sharing with us.

Thomas: Well, thank you very much. It's it's always a pleasure to speak to people that have good, good questions and good discussion. Thank you.

Brent: Death Clock is recorded in Boulder, Colorado, produced by Patrick and Dino, music by Patrick Lee, and hosted by yours truly, Brent Franson, founder and CEO of Park.