Dr. Gonzalez dismantles the ketogenic diet for cancer
Dr. Gonzalez 排除生酮飲食用於癌症
In early 2012 I discovered the ketogenic diet for cancer. I’ve understood for many years that different diets work for different people, and I was intrigued by this as another possible dietary strategy to heal cancer, so naturally I shared information about it on this site, thinking it might be a viable option for some. At that time there were no other sites as large as mine talking about it.
In 2013, awareness of the keto diet exploded, mostly do to Dr. Mercola’s articles, interviews and endorsement of it. Since then, many others have jumped on the bandwagon. And at first glance, there is some very compelling science that presents the ketogenic diet as a method to starve cancer cells of their primary fuel, glucose, thus killing the cancer.
在2013年，興起了生酮飲食的意識，主要是Dr. Mercola的文章、採訪和支持，從那時起，許多人加入了這股潮流，乍看之下，有一些非常引人注目的學術將生酮飲食作為一種方法，使癌細胞缺乏主要燃料 - 葡萄糖而飢餓，進而殺死癌症。
Despite the zealous promoters of it, some of whom I have great respect for, my opinion of the ketogenic diet for cancer has changed.
It started with several long phone conversations and email exchanges I had with my friend Dr. Patrick Vickers of Northern Baja Gerson Center. He was adamant that the ketogenic diet did not work in healing cancer long term. This coincided with the recurrence of cancer in someone I knew that was promoting the ketogenic diet as effective.
從我與Northern Baja Gerson Center 的 Dr. Patrick Vickers 進行幾次長時間電話交談和電子郵件交流開始，他堅持認為生酮飲食不能長期地治癒癌症，這恰好與我所知道提倡生酮飲食有效的人再次復發癌症，有所吻合。
It appeared to have some positive short term results for some people (shrinking tumors), but I was beginning to have some doubts about it working long term. This persisted for many months and I could not shake it. So I finally made the decision to take down my very popular post and youtube video about it. To date, that is the only post I’ve ever taken down.
Then came the coup de grace from Dr. Nicholas Gonzalez.
接下來是來自 Dr. Nicholas Gonzalez 的致命一擊。
Dr. Gonzalez and his colleague Dr. Linda Isaacs have had remarkable success treating cancer patients with a non-toxic nutritional protocol that incorporates Gerson principles along with the late Dr. William Donald Kelley’s protocol which includes high doses of pancreatic enzymes and individualized diets depending on body type and cancer type. I have huge respect for them, not because of their theories, because they are getting results, including reversing “incurable” stage four cancers.
Dr. Gonzalez和他的同事Dr. Linda Isaacs用非毒性營養方案治療癌症患者，取得了顯著的成功，此方案結合了Gerson原則以及已故的Dr. William Donald Kelley的方法，其中包括高劑量的胰酶和個人化飲食，取決於體型和癌症類型。我非常敬重他們，不是因為他們的理論，而是因為他們取得了成果，包括扭轉「無法治癒」的四期癌症。
Recently Dr. Gonzalez wrote an eight part article series for Natural Health 365 on the history and failure of the ketogenic diet for cancer. Dr. Gonzalez’s nutritional cancer treatment expertise is much deeper than ANYONE currently promoting the ketogenic diet for cancer, because unlike anyone else promoting it, he actually treats cancer patients with nutrition every day. And that sealed the deal for me.
最近 Dr. Gonzalez 為 Natural Health 365 寫了八篇關於生酮飲食用於癌症的歷史和失敗的系列文章。Dr. Gonzalez 的營養癌症治療的專業知識，比任何目前推廣用生酮飲食治療癌症的人要深得多，因為與其他人不同，他實際上每天都在為癌症患者提供營養方案，這讓我達成了協議。
There are thousands of people out there who have healed cancer naturally. I meet natural survivors constantly and even share their stories on this site. Most natural cancer healing protocols involve a radical change of diet and lifestyle that includes overdosing on nutrition with juicing, lots of raw plant food, little to no animal food, supplements, and herbal cleanses along with detox protocols like the liver/gallbladder flush, coffee enemas, etc. Those are all time-tested methods validated by a large body of long term survivors.
I know a lot of long-term natural survivors, but I don’t know any long-term survivors who have used a ketogenic diet to heal. Like I said, there’s some really compelling science… but no long-term survivors. And that’s my big hang up.
I don’t care how good the science sounds. Survivors trump science. And until I see a substantial list of long term survivors, I have no choice but to retract my support of the ketogenic diet as a viable option for healing cancer. I am perfectly ok with being proven wrong, and if so, I will freely admit it, but it will be at least 5-10 years before that is possible.
Having said all that, if a protocol like the one I described above did not work, I would certainly be open to try to heal with a ketogenic diet over chemotherapy. It just wouldn’t be my first choice.
Here is a short video in which Dr. Gonzalez explains why he thinks a ketogenic diet doesn’t work for cancer. Just to recap, Dr. Gonzalez uses nutrition to heal cancer, putting his patients on a variety of diets based on their cancer and other factors. Simply put, if the ketogenic diet worked, he would be using it.
這是一段簡短的視頻，其中Dr. Gonzalez解釋了為什麼他認為生酮飲食不適用於癌症。簡單來說，Dr. Gonzalez利用營養來治癒癌症，根據癌症和其他因素為患者設立各種飲食。換句話說，如果生酮飲食有效，他就會使用它。
If you really want to dig in, Dr. Gonzalez masterfully dismantles the ketogenic diet for cancer in the lengthy article below. This is not a scientific rebuttal, quibbling ad infinitum over theories about Warburg, glycosis, cell respiration, and ATP, rather it is a thoughtful, well-reasoned reflection from a doctor in the trenches of nutritional cancer treatment for nearly three decades. His real world experience, historical perspective and common sense put him head and shoulders above the ivory tower theorizers.
Highly recommended for anyone who has read any pro-keto diet information.
Enter Dr. Nicholas Gonzalez.
進入Dr. Nicholas Gonzalez.
In this initial article, I’d like to begin by making the point that the world of cancer research and cancer medicine is littered with the discarded theories and rejected therapies thought at one time to be the next promising miracle, the final answer to this perplexing and deadly disease. In my own professional lifetime, I have witnessed a number of cancer miracles come and go, sometimes in quite dizzying succession and at times with extraordinarily dazzling hysteria.
I remember one of the first, from 1980 when I was a first year medical student at Cornell; in this case, it was, according to the press and the journals, the magic of interferon, an immune stimulant destined to bring cancer to its knees. Not too long afterward, interferon would turn out to be a bust, with its promise and fame rising and falling in roller coaster-like style.
I lived through a far more extraordinary situation just five years later. I had graduated medical school by that point and was living in Florida, finishing my immunology fellowship under Robert A. Good, MD, PhD, the famed “father of modern immunology” as he had been called.
五年後我經歷了一個更特殊的局面，那時我已從醫學院畢業了，並且住在佛羅里達州。在著名的「現代免疫學之父」Robert A. Good醫學博士之下，完成了我的免疫學研究。
It was late 1985 when the media broke the story about the next cancer miracle. I was sitting in my apartment overlooking beautiful Tampa Bay, when I read the initial front-page newspaper reports. Dr. Steven Rosenberg, already well-known as Ronald Reagan’s surgeon (the President had a malignant polyp), and a highly regarded basic science researcher running a section at the National Cancer Institute in Bethesda, Maryland, had just revealed to the world – at a press conference, as I remember – his preliminary pilot study results with a new immune modulator, interleukin-2, that would provoke an extraordinary media frenzy.
1985年底媒體打破了下一個關於癌症奇蹟的故事，我坐在我的公寓裡俯瞰著美麗的坦帕灣，閱讀著新聞頭版報導。Dr. Steven Rosenberg是羅納德里根著名的的外科醫生（主席患有惡性息肉），並且是一位高度重視基礎科學的研究員，在馬里蘭州貝塞斯達國家癌症研究所開設了一個部門。他剛剛向全世界透露 – 我記得在記者招待會上 – 他的初步試驗研究結果，一種新的免疫調節劑「白細胞介素-2」，激起了媒體的狂熱。
The initial pronouncements, released with such glowing enthusiasm, indicated that finally, yes finally, after so many disappointments we might actually be looking at a real, universal cancer cure. In both laboratory and preliminary human trials, interleukin-2 – like interferon before it, a natural product secreted by lymphocytes that stimulates other cancer-fighting immune cells into action – had performed almost magically against even the most aggressive of cancers, such as metastatic melanoma and metastatic kidney cancer.
如此熱烈地發布最初聲明，是的，最後在經歷那麼多的失望之後，我們確實正在尋找一種真正的、普遍的癌症治療方法。在實驗室和初步人體試驗中，白細胞介素-2 – 像之前的干擾素一樣，淋巴細胞分泌的天然產物，刺激其他抗癌免疫細胞發揮作用 – 幾乎神奇地對抗了極具攻擊性的癌症，如轉移性黑色素瘤和轉移性腎癌。
News of Dr. Rosenberg’s “miracle” was everywhere, in the print media, on the local and national news, and in an extended Newsweek story appearing December 16, 1985, with white-coated Dr. Rosenberg on the cover peering intently at the world. The article, titled “Search for A Cure” in large bold print went on for six pages, accompanied by photos of Dr. Rosenberg, one with a patient, another as the serious scientist in the lab. Elaborate, colorful artwork illustrated the narrative, showing the intricate mechanisms of the immune system, and pinpointing interleukin-2’s ability, under the guiding hand of Dr. Rosenberg, to fight malignant disease.
報章媒體、地方和國家新聞，Dr. Rosenberg’s的「奇蹟」消息無所不在，還有1985年12月16日出現的新聞周刊，穿著白袍的Dr. Rosenberg在封面上凝視著世界。這篇名為「尋找治療」的文章大篇幅的編寫了6頁，附上Dr. Rosenberg的照片，其中一張是和病人合照，另一張是在實驗室的嚴肅科學家。用精美、豐富多彩的藝術作品來敘事，展示了免疫系統複雜的機制，並在 Dr. Rosenberg的指導下，確定白細胞介素-2針對惡性疾病的能力。
A separate subsection headlined “The Rise of a Superstar, From Reagan’s surgery to the frontiers of research” chronicled the compelling life story of Dr. Rosenberg. You couldn’t buy better publicity than this.
一個單獨的小節標題為「超級巨星的崛起，從Reagan的手術到研究前沿」，記錄了 Dr. Rosenberg令人信服的生活故事。沒有比這更好地宣傳。
At the end of this piece, the writers did include a brief section titled “Interferon: A Cautionary Tale,“ reminding readers of the hoopla five years earlier over that other immune modulator, which too had been all the rage in the cancer research world. The essay, following the main laudatory articles, began:
To some ears, last week’s exultation over interleukin-2 has a familiar but discordant ring. Something similar happened about five years ago with a substance called interferon, the “magic bullet” of cancer research, featured on magazine covers and in articles with titles like “To Save Her Life – And Yours.” … But by 1984 the magic bullet had misfired; now the articles were called “The Myth of Interferon.”
對於某些人而言，上週對白細胞介素-2的歡欣有一個熟悉但不和諧的環節。大約五年前發生了一件類似的事件，一個癌症研究的「魔術子彈」，名為干擾素的物質，成為雜誌封面精選，還有像「拯救她的生命 – 和你的生命」等標題的文章；但到了1984年，魔術子彈已經點火失敗，現在那些文章被稱為「干擾素的神話」。
Over the years, I had become particularly familiar with the interferon story since my boss, Dr. Good, had done much of the original research linking it to a possible anti-cancer effect.
By that point, I knew Dr. Good quite well: during my second year of medical school, Dr. Good, at the time a professor at Cornell and Director of the Sloan-Kettering Institute, had begun guiding my fledgling research career. In 1982, during my third year of medical school, to my dismay the powers that be at Sloan pushed him out rather unceremoniously.
到那時為止，我非常了解Dr. Good：在醫學院的第二年，Dr. Good當時是康奈爾大學教授及Sloan-Kettering研究所所長，開始指導我剛剛起步的研究生涯。1982年，在我上醫學院的第三年，讓我沮喪的是，Sloan的勢力毫不客氣地推翻了他。
Subsequently, he spent some time at the University of Oklahoma, where he was hired to set up a cancer research division, before moving to All Children’s Hospital in St. Petersburg, where again he established a cancer research-bone marrow transplant unit.
之後他在俄克拉荷馬大學度過了一段時間，在那裡他被聘請成立癌症研究部門，在搬到聖彼得堡的兒童醫院之前，他又在那裡建立了一個癌症研究 - 骨髓移植單位。
When the news of interleukin-2 first hit the press, I discussed this new “miracle” with Dr. Good, who had grown quite cautious after years of experience and having witnessed many similar announcements followed by the inevitable letdown in the research community.
“Look at the data, always look at the data,” he said, “not the media reports.” I followed his advice, tracked down and studied the actual clinical data, which I found surprisingly unimpressive. As I recall, in the first uncontrolled trial, of more than 100 patients entered only three seemed to have experienced any significant or lasting response.
In subsequent months, reports of enormous toxicity, even patient deaths began to filter through the research community, serving to temper the initial hysteria. And it wasn’t cheap, as miracles go – the very toxic drug was so potentially dangerous it had to be administered in a hospital setting under very close supervision, with costs running in excess of $100,000 for a several-week course of treatment.
在之後的幾個月，有關劇毒性的報告甚至患者死亡，開始藉由研究界過濾，以緩和最初的歇斯底里。它並不便宜，就像奇蹟一樣 – 劇毒性的藥物非常危險，必須在非常密切監督的醫院環境中進行治療，費用超過10萬美元，為期數週的療程。
Despite the initial warning signs, the media continued its relentless promotion of interleukin-2 for a number of years. In 1992, perhaps due to political pressure more than scientific evidence, the FDA approved the drug for use against cancer, despite the lack of comprehensive controlled trials. Then in the late 1998 a clinical study – completed some 13 years after the initial reporting – showed that interleukin-2, at least with advanced kidney cancer, worked no better than placebo.
儘管有最初的警告信號，但媒體多年來持續不斷推廣白細胞介素-2。1992年，也許是政治壓力超過科學證據，FDA批准此藥用於抗癌，即使是缺乏全面的對照試驗。然後在1998年底進行的一項臨床研究 – 在初次報告後約13年完成 – 顯示白細胞介素-2在晚期腎癌上，並不比安慰劑好。
It’s still being used, though increasingly rarely, and no one I know talks about it with much enthusiasm.
By the 1990s, just as practicing oncologist were giving up on interleukin-2, bone marrow transplant (BMT) as a solution to poor prognosis or metastatic breast cancer started grabbing the headlines, touted as a cure for this most invidious of diseases striking so many women in the prime of life. Despite the lack of any compelling evidence it worked for this indication, bone marrow transplant was being pushed as a solution to deadly forms of breast malignancy. However, initially insurance companies refused to pay for this unproven and very expensive treatment, which could cost in those days up to $500,000 or more.
Nonetheless, enthusiastic oncologists joined with the media, portraying insurance companies as heartless, greedy bullies depriving women with breast cancer of a curative treatment. Not too long after, the trial lawyers got involved, orchestrating a series of lawsuits against various insurance companies on behalf of women wanting a BMT. In a particularly notable and telling case, Fox vs. HealthNet, the jury awarded the plaintiff, a woman diagnosed with breast cancer whose insurance carrier refused to cover the procedure, $89 million, including $77 million in punitive damages.
Under such threat, the insurance industry relented, finding it cheaper to pay the $100,000 or $200,000 or $500,000 per procedure then risk such catastrophic financial harm.
After some 40,000 women underwent the procedure – at a time when 10-30% of patients died from the treatment itself – it was eventually proven to be worthless. The one glowing positive study from 1995, the infamous South African study of Dr. Bezwoda, turned out on closer examination to be a complete fraud, with the creative researcher simply making up the data. The wonderful and frightening book False Hope describes the bone marrow transplant-breast cancer fiasco in great detail, for those with an interest.
大約40,000名婦女接受了這項醫療程序之後 – 當10~30％的患者死於治療本身時 – 最終證明這一過程毫無價值。1995年的一項炙手可熱的積極研究 – 臭名昭著的南非Dr. Bezwoda的研究，經過仔細檢查後被證實是一種完全的欺詐行為，開創的研究人員只是簡單地編制數據。這本精彩而令人恐懼的書False Hope詳細描述了骨髓移植- 乳腺癌的完全失敗，給那些有興趣的人。
As these battles waged in the early 1990s, I had long left Dr. Good’s group, having returned to New York and private practice. Nonetheless, this story had a personal ring to it, as had the interferon story, since Dr. Good had completed the first bone marrow transplant in history, in 1969, and long hoped this technology would be, yes, an answer to cancer.
這些戰鬥在1990年代初期，我長期離開了Dr. Good的團隊，回到紐約和私人診所。儘管如此，這個故事還有一個個人的挑戰，就像干擾素的故事一樣，因為Dr. Good在1969年完成了歷史上的第一次骨髓移植，並且長期以來希望這項技術能夠成為癌症的解答。
Under his direction, during my fellowship years I learned how to do this very tricky and often deadly procedure.
But no fear, there’s always a new miracle around the corner, and in 1998 the newspaper reporters and TV newscasters, having effortlessly drifted away from interferon and interleukin-2 and the bone marrow transplant craze, were all in a tizzy over the newest “final” solution to cancer, anti-angiogenesis, based on the pioneering work of the late Dr. Judah Folkman of Harvard. Dr. Folkman had spent decades studying the process of angiogenesis in cancer tissues, the formation of new blood vessels that allow tumors to grow quickly and invade through normal tissues and organs with deadly effect.
但不用擔心，角落總會出現一個新的奇蹟。1998年，報紙記者和電視新聞播報員毫不費力地遠離干擾素和白細胞介素-2以及骨髓移植的熱潮，基於已故哈佛大學的 Dr. Judah Folkman的開創性工作，他們對癌症、抗血管生成的最新「最終」解決方案感到不安。Dr. Folkman花了數十年的時間研究癌症組織中的血管生成過程，新血管的生成使腫瘤迅速生長並入侵正常組織和器官，產生致命的影響。
Without a rich blood supply, cancerous tumors cannot grow beyond a cubic centimeter.
Dr. Folkman had developed two drugs, angiostatin and endostatin, that in animal experiments reversed tumor growth by blocking new blood vessel formation, essentially starving out the cancer cells. In a November 1998, presentation of his work at the National Institutes of Health in Bethesda, Maryland, Dr. Folkman announced to the world that at least in mice, “we have not seen a tumor we cannot regress.”
Dr. Folkman開發了兩種藥物：血管抑制素和內皮抑素，在動物實驗中透過阻斷新血管生成來逆轉腫瘤生長，從根本上摧毀癌細胞。1998年11月，他在馬里蘭州貝塞斯達國立衛生研究院的工作發表中，Dr. Folkman向全世界宣布至少在老鼠身上，「我們還沒看到有我們無法消除的腫瘤」。
Though Dr. Folkman’s research was all based on laboratory experiments and animal studies, the powerful NCI publicity machine took up the cause, with the smell of “miracle” again in the air, despite the lack of any evidence that Folkman’s anti-angiogenesis drugs worked against human cancer. Nonetheless, with the NCI and NIH on board, the media, large and small, local and national, seemed transported into a state of frenzy.
儘管 Dr. Folkman的研究都是基於實驗室實驗和動物研究，但強大的NCI宣傳機器仍然採用了「奇蹟」的氛圍，即使是沒有任何證據能證明Folkman的抗血管生成藥物有效對抗人類癌症。雖然如此，隨著NCI和NIH的加入，大大小小的地區及國家媒體似乎陷入了瘋狂的狀態。
I recall so well, this time sitting in my mid-Manhattan office, reading that famous May 3, 1998 front page lead New York Times article (in the upper left of the page reserved for wars, revolutions, and, yes, miracles) by reporter Gina Kolata, announcing Folkman’s preliminary findings to the world, extolling anti-angiogenesis in a tone that one more skeptical writer, Jack Breibart, described as “breathless.”
我印象深刻，這一次坐在我的曼哈頓辦公室，閱讀著著名的1998年5月3日紐約時報頭版主題文章（頁面的左上角保留了戰爭、革命，以及奇蹟），作者Gina Kolata向全世界宣佈Folkman的初步調查結果，以一種持懷疑態度的作家Jack Breibart的語氣，用「無法呼吸」來頌揚抗血管生成。
Kolata quoted no less an authority than Dr. James Watson, the Nobel Laureate in 1962 for his discovery, with his colleague Frances Crick, of the structure of DNA, the basic genetic material. “Judah is going to cure cancer in two years,” Watson told Kolata. You couldn’t ask for a better source, making a more definitive claim.
Kolata 引用的權威，不僅僅是1962年諾貝爾得獎者Dr. James Watson與他的同事Frances Crick發現的基因遺傳物質DNA結構，Watson告訴Kolata：「Judah將在兩年內治癒癌症」。你沒有更好的資源來做出更明確的主張。
Kolata’s unrestrained reporting continued: “Dr. Watson said Dr. Folkman would be remembered along with scientists like Charles Darwin as someone who permanently altered civilization.”
Kolata放肆的繼續報導：「Dr. Watson說，Dr. Folkman會和Charles Darwin這樣的科學家一樣被記住，他們是永久改變文明的人。“
The writer also quoted an enthusiastic Richard Klausner, MD, at the time Director of the National Cancer Institute, who assured the world, “I am putting nothing on higher priority that getting this into clinical trials.”
The glowing TV stories followed, including a memorable prime time, one-hour special about the subject on ABC hosted by the late Peter Jennings. The other networks, in quick succession, picked up the cause. However, not too long after, word broke that Times’ reporter Kolata had been, through her agent, hawking to publishers an idea for a book about anti-angiogenesis and cancer.
Her agent, according to reports at the time, began circulating a book proposal the day after the Times story ran, asking for a $2 million dollar advance! The whole episode raised some eyebrows over a reporter seeking to benefit personally from a subject she was promoting in the news section of the Times. After a fair amount of criticism, Kolata withdrew her book proposal.
As Dr. Klausner promised, the National Cancer Institute, probably swept up in the national and international explosion of hope and enthusiasm, “fast tracked” a preliminary study of endostatin in human patients, intending to enroll, as I recall, 70 subjects very quickly.
But what surprised me – and what began to concern others I knew in the medical community – was some time later the deafening silence about the trial’s outcome, and what seemed to be a blackout about the actual data. Eventually, the study results were published indicating that 42 subjects had been ultimately recruited for the trial, not the planned 70, and not a single one of these had responded to the drug.
但讓我感到驚訝的是 – 開始關注我在醫學界知道的其他事情 – 一段時間之後，試驗結果鴉雀無聲，並對實際數據的看法似乎停滯不前。最後研究結果公佈，表明招募了42名受試者進行試驗，而不是計劃中的70名受試者，並且沒有一名受試者對該藥物有反應。
Ironically Jennings himself, who had promoted the therapy with unabashed enthusiasm, would die of lung cancer, only months after his diagnosis in 2005. Folkman too, has passed on, never to realize his hope of an anti-angiogenesis, cancer-free world.
Nevertheless, anti-angiogenesis as the answer to cancer remains a big driving force in “biotech” companies, who have developed a whole slew of angiostatin and endostatin offspring, including the drug Avastin, costing up to $10,000 a month, though it doesn’t work particularly well. The clinical studies aren’t impressive, usually reporting several months of improved survival in patients diagnosed with a variety of advanced cancers.
In a further ironic turn, in December 2010, after approving the drug for treatment of women diagnosed with breast cancer, the FDA rescinded its blessing of Avastin for this indication when clinical trials failed to show any significant benefit.
The anti-angiogenesis love affair not only affected conventional researchers and oncologists, but infiltrated deeply into the “alternative” cancer world. During the late 1990s, I read numerous articles lauding the anti-angiogenic effect of various herbs. Some ten years ago or more, a number of alternative physicians began promoting artemesinin, an herb from Africa long used as a treatment for malaria, as a “natural” anti-angiogenesis supplement.
But ten years after the initial burst of enthusiasm, few of my colleagues even mention it.
And so it goes. We as a culture, as a nation, as a world, are forever looking for miracles from our scientific and medical gurus, miracles that might finally bring cancer to its knees. And there will forever be miracles ripe for the picking. In the next article, I will discuss the “Ketogenic Craze.”
In 2012, Dr. Thomas Seyfried, a PhD basic science researcher, published the book, Cancer as a Metabolic Disease, announcing to the world that a high-fat, no carbohydrate ketogenic diet represents the solution to cancer prevention as well as to cancer treatment. His monograph has been greeted with much acclaim, though not yet at the level reached at the height of the interleukin-2 hysteria in 1985.
2012年，基礎科學研究員Dr. Thomas Seyfried發表了「癌症為代謝疾病」一書，向世界宣布高脂肪、無碳水化合物的生酮飲食作為癌症預防和癌症治療的解決方案。他的著作受到了很多好評，雖然尚未達到1985年白細胞介素-2的瘋狂高峰期水平。
Dr. Seyfried, whom I do not personally know, is hardly an “alternative” medical scientist, since judging by his credentials listed on the back cover of the book his pedigree seems conventionally academic:
THOMAS N. SEYFRIED, PHD, has taught and conducted research in the fields of neurogenetics, neurochemistry, and cancer for more than twenty-five years at Yale University and Boston College. He has published more than 150 scientific articles and book chapters …
THOMAS N. SEYFRIED博士，在耶魯大學和波士頓學院教授，並進行神經遺傳學、神經化學和癌症領域的研究超過25年，他發表了150多篇科學文章和書籍章節......
A closer look at Dr. Thomas Seyfried and his work.
仔細看看Dr. Thomas Seyfried和他的作品。
Certainly Dr. Seyfried has put together a most impressive achievement, chronicling in great detail his belief that cancer does not develop from genetic alterations – as is generally believed – but as a result of changes in fundamental cell physiology, specifically changes in energy production, that in turn lead to the cancer phenotype. In essence, the genes remain intact, but metabolism goes awry.
當然 Dr. Seyfried 匯集了一項最令人印象深刻的成就，他非常詳細地記錄了他的觀點：癌症不是由遺傳改變引起的 – 如同人們普遍認為的那樣 – 但是由於基礎細胞生理學的變化，特別是能量生產的變化，反過來導致癌症表型。從本質上講，基因保持不變，但新陳代謝出錯。
The book summarizes, then enlarges upon, the concepts of Otto Warburg, MD, the great German scientist who won the Nobel Prize in Medicine and Physiology in 1931 for his work on cellular oxidation and energy production. No scientist has ever been nominated more frequently for the cherished Prize than Dr. Warburg, but he lost his chance for a second win, according to some sources, in 1944 after Hitler ordered that no German scientist could accept the award.
這本書總結並擴大了醫學博士Otto Warburg的概念，他是1931年因細胞氧化和能量生產而獲得諾貝爾醫學和生理學獎的偉大德國科學家。根據一些消息來源，沒有一位科學家能夠比 Dr. Warburg 更頻繁地獲得的獎項提名，但在1944年希特勒命令德國科學家不能夠接受該獎項之後，他失去了獲得第二次獲獎的機會。
Who is Dr. Otto Warburg?
Dr. Otto Warburg是誰?
To sum up decades of Warburg briefly, mammalian cells create and store usable energy in the form of the adenosine triphosphate (ATP) molecule. Production of ATP is a complex affair involving three distinct and sequential series of cellular reactions that begin with the breakdown of the six-carbon sugar glucose. The first of these processes, glycolysis, does not require oxygen and occurs in the cytoplasm; the second, the citric acid cycle, occurs within the mitochondria, the oval shaped organelles dispersed within the cytoplasm, and requires oxygen; and the third, and most productive in terms of ATP generation, electron transport, proceeds in the membranes of mitochondria and also needs oxygen.
In normal mammalian cells, glycolysis represents the starting point of energy synthesis. Its end product, pyruvic acid, is in turn shunted first into the citric acid cycle, then ultimately into the electron transport chain. Along the way, a complex series of step-wise reactions releases multiple energy-rich ATP molecules.
Based on his years studying cellular metabolism, Dr. Warburg proposed that cancer cells, unlike normal cells, rely exclusively on anaerobic glycolysis for energy. Such cells do fine in the absence of oxygen, since the metabolic machinery of glycolysis doesn’t require it.
Warburg claimed that in these abnormal cells glycolysis actually uncouples from the citric acid cycle and electron transport, leaving the cells dependent solely on this rather inefficient mechanism for survival. Bacteria also synthesize their ATP energy exclusively from glycolysis, in the process we know as fermentation.
This uncoupling of glycolysis from the citric acid cycle and electron transport, and the supposed fundamental dependency of cancer cells on anaerobic metabolism, has been studied extensively since Warburg’s day, with many scientists around the world claiming to confirm, then adding to, Warburg’s hypothesis. As Dr. Seyfried correctly points out, in more recent times, cancer researchers have begun drifting away from the study of disordered cellular physiology, enamored as they are of genetic abnormality as the primary and only driving force in cancer formation and growth.
Warburg’s ideas about faulty metabolism seem to have been overshadowed by the elegance of, and fascination for, the “genetic cause of cancer.”
I agree Dr. Seyfried has done us all a great service by redefining, re-emphasizing and refining Dr. Warburg’s remarkable research from 80 years ago. He makes the case, using the contemporary basic science data, to support Warburg’s belief that cancer cells depend solely on glycolysis for survival, with his claim regarding the uncoupling of this sugar-fueled, oxygen-independent process from the citric acid cycle and the electron transport chain. But he goes a major step further, stating as fact that since cancer cells depend on anaerobic glucose metabolism for energy, they can be stopped in their tracks by depriving them of blood glucose.
我同意Dr. Seyfried透過重新定義、重新強調和改進Dr. Warburg在80年前的傑出研究，為我們提供了很好的服務。他利用現代基礎科學數據證明了Warburg認為癌細胞完全依賴糖酵解來維持生存的觀點，他提出關於從檸檬酸循環和電子傳遞鏈中以糖為燃料的解偶聯，過程不依賴氧氣的主張。但是他向前邁出了一大步，說明由於癌細胞依賴無氧葡萄糖代謝來獲取能量，因此可以透過剝奪它們的血糖來阻止它們。
Our normal healthy cells, be they situated in the brain or the skin of our feet, do prefer glucose as their primary energy source, obtained from the sugar circulating in the blood. That “blood sugar” comes from a variety of sources, including dietary carbohydrates occurring in fruits, starchy vegetables like potatoes, and grains. The complex carbohydrates in such foods are broken down into glucose during the digestive process, catalyzed by a variety of carb-specific enzymes like amylase.
We also maintain a certain amount of stored sugar as glycogen, found in the liver and muscle and formed when glucose molecules link up to one another in complex chains. In times of need and if deprived of dietary carbohydrates, our liver and muscle cells can break down glycogen into glucose for release into the bloodstream. Our liver cells can also, when necessary, convert certain amino acids such as alanine into glucose.
However, our glycogen supplies in the liver and muscle are quite limited, providing only an 8-12 hour emergency supply. So during a fast, or starvation, or on a diet providing no carbohydrates in any form, we quickly run out of glycogen. In this situation, through a variety of neural and hormonal signaling, our fat cells, or adipocytes, begin releasing free fatty acids into the blood stream. These fatty acids can in turn be used by our cells in the alternate ATP producing process of beta oxidation.
The end result of this series of reactions, acetyl coenzyme A, can then be shunted into the citric acid cycle and the electron transport chain, to produce maximum amounts of energy-rich ATP.
Though most of our cells can utilize fatty acids of all stripes via beta oxidation to create ATP energy, our central nervous system is at somewhat of a disadvantage. In fact, long chain fatty acids with 14 or more carbons, which can yield the most ATP from beta oxidation, do not cross the blood-brain barrier. However, in a state of prolonged dietary carbohydrate depletion, the liver begins converting acetyl coenzyme A into various ketone bodies, such as acetoacetate and beta hydroxy butyric acid, which easily penetrate into the brain and which can, like acetyl coenzyme A, be shunted into the citric acid cycle and then the electron transport chain, providing the brain with ATP.
On a low carb or no carb diet, our billions of cells in all our tissues and organs switch their energy mechanics from a process driven by glucose to one propelled by fatty acids and ketone bodies. The term “ketosis” simply means the state in which, in the absence of sufficient glucose, our liver synthesizes ketones from acetyl coenzyme A.
However, even on a no carb, all meat, high-fat diet, we will still be consuming some glucose in the form of glycogen stored in muscle and organ meats, and our livers will continue to convert some dietary amino acids into glucose, so blood sugar levels never hit zero on such a diet. But in such cases, the amounts produced will be minimal.
Though our normal cells do just fine in the absence of carbohydrates, cancer cells, Dr. Seyfried claims, do not. These cells, he says, can never use fatty acids or ketone bodies for any significant energy production, since the citric acid cycle and electron transport in them remain basically inactive. So, he proposes, as the culmination of his exegesis, that on a high fat, moderate protein, no carb diet, a cancer patient will deprive his or her deadly abnormal cells of their only useful source of energy, blood glucose, leading to apoptosis, or cell death.
It’s that simple. No dietary sugar, no cancer.
The science is impressive, the conclusion, to many it seems, extraordinarily promising. But, is this ketogenic diet really a “new” idea or simply an old one, repackaged for the 21st century? And, can history teach us anything about its efficacy against cancer, or any other disease?
During the first half of the 20th century, physicians and researchers studying the traditional Eskimo (Inuit) culture were amazed by the health of these people subsisting on a very peculiar – at least to the Western academic mind – high fat ketogenic diet. The famed Arctic explorer Stefansson first documented the traditional Eskimo diet, which was later studied in some detail in the early 1930s by a research team from McGill University in Montreal.
在20世紀上半葉，研究傳統愛斯基摩人（因紐特人）文化的醫生和研究人員對這些人的健康狀況感到驚訝，這些人的生活非常特殊 – 至少對西方學術思想來說 – 高脂肪生酮飲食。著名的北極探險家Stefansson首先記錄了傳統愛斯基摩人的飲食，後來由蒙特利爾麥吉爾大學的一個研究小組在1930年代早期，對其進行了詳細研究。
To the surprise of these investigators – at the time no Western scientist believed any human could survive on nothing but meat – this Eskimo diet consisted of virtually 100% animal products, 80% in the form of fat, with much of it saturated, 20% protein, but essentially no carbohydrates. From cradle to grave these traditional Eskimos lived in a state of ketosis.
令這些調查人員感到驚訝的是 – 當時沒有任何西方科學家認為人類能在只有肉的情況下生存 – 而愛斯基摩人的飲食幾乎100％是動物產品，其中脂肪形式佔了80％，大部分是飽和脂肪，而蛋白質佔20％，但基本上沒有碳水化合物。從出生到死亡，這些傳統的愛斯基摩人生活在酮症狀態。
In retrospect, it makes sense that in the Arctic the Eskimos, in order to survive, would have adjusted to their high fat, moderate protein, no carb diet. With its brief summer and lacking soils suitable for crops, the region provides insufficient plant foods suitable for human consumption but does offer an abundance of fatty animal food both on land and in the sea. If the Eskimos hadn’t adapted to such food, living as they did in such a difficult, extreme part of the world, they simply would have died off.
Interestingly, as Stefansson pointed out, the Eskimos he studied and lived with for ten years knew that their exclusive animal food diet must be high fat, with moderately low protein. They warned a diet lacking sufficient fat (or as a corollary in Western scientific terms, high protein), would lead to sickness and eventually death.
As Stefansson and later scientists learned, the Eskimos living on their high fat, ketogenic diet seemed free from the typical degenerative diseases including cancer and heart disease, already becoming rampant in the Western world during the early decades of the 20th century. In 1960, the elderly Stefansson – was quite a celebrity by that time for his adventures to far away places – wrote a book entitled Cancer: Disease of Civilization?, in which he made the case that the typical Eskimo diet offered complete protection from this frightening malady.
正如Stefansson及後來的科學家們所了解的那樣，生活在高脂肪、生酮飲食中的愛斯基摩人似乎沒有典型退化性疾病，包括癌症和心臟病，而在20世紀初期，西方世界早已猖獗。1960年，老年的Stefansson – 當時因為他在遙遠的地方冒險而成名 – 寫了一本名為「癌症：文明病」的書，他在書中提到典型的愛斯基摩人飲食提供完全保護，免受這種可怕的疾病。
In a number of his best-selling books, Stefansson argued strongly that we should all be living like Eskimos, indulging in high fat, moderate protein, no carb diets – that is, if we wanted superb, enduring good health.
在他的一些暢銷書中，Stefansson強烈主張我們都應該像愛斯基摩人一樣生活，沉迷於高脂肪、中等蛋白質、無碳水化合物飲食 – 意思是說，如果我們想要極好、持久的健康。
Blake Donaldson, MD, who ran a general practice for decades on Long Island, New York, began prescribing a ketogenic diet in the 1920s. Donaldson, who was quite familiar with Stefansson’s reports on the Eskimo diet, began recommending an all-meat, high-fat regimen for his patients diagnosed with a variety of complaints such as obesity, diabetes, and heart disease, though he doesn’t appear to have treated cancer specifically. In his 1961 book, Strong Medicine, Dr. Donaldson summarized his findings and his many years of experience recommending a high fat diet.
醫學博士Blake Donaldson，在紐約長島職業幾十年的全科醫生，他在1920年代開始以生酮飲食為處方。Donaldson對Stefansson的愛斯基摩飲食報告非常熟悉，他開始為診斷患有肥胖、糖尿病和心臟病等疾病的患者推薦一種全肉、高脂肪的治療方案，雖然他沒有特別治療過癌症。Dr. Donaldson 在1961年出版的「強醫學」一書中總結了他的發現，以及他多年推薦高脂肪飲食的經驗。
More recently, the famed New York diet doctor, Robert Atkins, MD, popularized the ketogenic diet, not for cancer, but as the ultimate weight loss plan with his books over the decades selling in the tens of millions of copies. The original version of the Diet Revolution published in 1972 sold at one point more than 100,000 hard copies a week, in those days the fastest selling book in the history of United States publishing.
As the years passed, Dr. Atkins, a cardiologist by training, began to see in the ketogenic diet the answer to many of the problems of Western civilization beyond obesity, including heart disease, diabetes, hypertension – and yes, even cancer.
隨著時間，心臟病專家Dr. Atkins開始在生酮飲食中，看到了西方文明除了肥胖以外的許多問題的解答，包括心臟病、糖尿病、高血壓 – 甚至癌症。
The traditional Atkins’ Diet was certainly high fat, in the range of 70% or more, nearly all from animal sources, and with minimal dietary carbs, less than 10%. Dr. Atkins, famed for his all-encompassing emphasis on ketosis during his early years as a diet doctor, insisted his patients routinely check the levels of ketone bodies in their urine several times a day, using special “ketone strips.”
In his books and in his office working with his own patients, Dr. Atkins warned that to reap the benefits of his diet, one must reach and stay in a state of ketosis, much like the traditional Eskimos. Even a slight deviation from the diet, some ill-advised cheating with a cookie or candy, could stop ketosis in its tracks, and with it, the value of the diet.
I knew Bob quite well, and considered him a friend. We first met when I interviewed him for a nutrition story during my journalism days, and later on while I was a medical student, we kept in close contact. During my freshman year at Cornell Medical School – from which Bob had received his own medical degree – I arranged for him to speak as part of a lecture series I had set up on alternative approaches to disease.
我很了解Bob ，並把他當作朋友。我們第一次見面是在我從事新聞期間，我採訪他的營養故事，後來當我是醫科學生時，我們保持密切聯繫。在康奈爾大學醫學院的大一學年 – Bob在那裡取得自己的醫學學位 – 我安排他作為我為疾病替代方法所設立的系列講座中的部分演說者。
After I finished my conventional immunology training under Dr. Good, in 1987 Bob graciously offered me a job in his clinic, not to work with patients seeking dietary or general nutritional advice, but to help supervise a cancer unit he was then in the process of establishing. Though I was grateful for the proposal, I turned him down, determined to set up my own practice.
Bob had achieved great success as a diet doctor, with an estimated wealth at the time of his death in 2003 in the range of $350 million. He was also a very driven and very smart physician, who clearly saw in cancer, and not in obesity, the ultimate challenge in medicine.
Bob, who knew Stefansson’s work well, told me during more than one dinner together in the late 1980s that the ketogenic diet might represent the ultimate solution to cancer. He thought, as Donaldson and Stefansson had claimed before him, that all humans should be following a ketogenic diet to achieve ultimate ideal health. But were they right? Or was there another, perhaps more accurate way, to look at the human dietary condition?
Nathan Pritikin believed, and fanatically so, that all humans were genetically and metabolically programmed to follow a high carb, very low fat, exclusively plant-based diet, which if applied diligently would protect us from all the major degenerative disease killers, such as diabetes, heart disease, hypertension – and perhaps, even cancer.
Nathan Pritikin相信並狂熱地認為，所有人類的基因和代謝程序都遵循著高碳水化合物、極低脂肪，完全植物性飲食，如果積極應用，將保護我們免受所有主要的退化性疾病，如糖尿病、心臟病、高血壓 – 甚至癌症。
The traditional Pritikin diet was literally a mirror image of the Atkins’ Diet, with about 70-75% of all calories derived from carbohydrates, 15-20% from protein, all from plant sources, and 8% or less from fat, again all plant-derived.
After Pritikin’s death in 1985, Dr. Dean Ornish of San Francisco would pick up the Pritikin mantle, eventually testing a similar diet in patients diagnosed with heart disease as well as in patients with prostate cancer.
1985年當Pritikin去世後，舊金山的Dr. Dean Ornish接下Pritikin的責任，最後在診斷患有心臟病和前列腺癌患者中測試類似的飲食。
The nutritional world then, as it is today, was surely confusing, with various scientists, physicians, and lay authors promoting one diet or another, often – as in the case of Atkins and Pritikin – offering completely contradictory dietary recommendations. Fortunately, when in 1987 Dr. Atkins offered me a job, I had already found what I thought represented a solution to the dilemma of dueling dietary dogma.
然後如同今日，營養世界確實令人困惑，各種科學家、醫生和非專業作者推廣一種或另一種飲食，通常 – 如Atkins和Pritikin的情況 – 提供完全相互矛盾的飲食建議。幸運的是， Dr. Atkins在1987年給了我一份工作，我找到了我認為能夠解決飲食教條互鬥困境的方法。
By the time I began medical school in 1979 I had read the pioneering work of Weston A. Price, DDS, the American dentist and researcher. Beginning in the late 1920s, Dr. Price, accompanied by his wife, spent seven years traveling the world evaluating isolated groups of people living and eating according to long-standing tradition. Today such a study would be impossible, since just about everyone everywhere has adopted the “Western” way of living and eating, down to jeans and junk food.
1979年當我開始學習醫學時，我讀過美國牙醫及研究員 – Weston A. Price，齒外科醫師 – 的開創性工作。1920年代末期開始，Dr. Price在他的妻子陪同下，花了7年時間在世界各地旅行，根據悠久的傳統評估孤立群體的生活和飲食。在今天，這樣的研究是不可能的，因為幾乎每個地方都採用了「西方」的生活和飲食方式，牛仔褲和垃圾食物。
But in Dr. Price’s day, many groups living in many different locations still lived according to tradition largely untouched by modern Western influence. Price’s travels took him from the Eskimos of the Arctic, to the descendents of the Incas living in the high Andes, to the Masai on the plains of Kenya, to isolated Swiss herders in the Alpine mountain valleys, to Polynesians living on pristine tropical islands. The variety of diets around the world.
Each of these groups Dr. Price studied seemed well adapted to the available food supply. The Eskimos, as Stefansson earlier had reported and as Price confirmed, thrived on their high fat, no carb, animal-based diet. The Inca descendents, on the other hand, had done quite well consuming grains like quinoa, along with tubers, fruits, and some animal protein and dairy. The Masai flourished on a rather extreme diet consisting, for an adult warrior, of a gallon of raw milk a day with some blood and occasional meat, but no fruits, vegetables, nuts, seeds, or grains.
The Swiss herders did just fine living on raw pastured cow milk and cheese accompanied by a nutrient-dense, whole grain bread. The Polynesian diet centered around coconut in all its incarnations, the milk, meat, and cream, creatively used in a variety of ways, along with fish, some wild animal meat, and fruits. These diets could not be more different; an Eskimo never drank milk or ate a coconut, the Inca descendents never saw a coconut or whale blubber, a Masai never ate coconut or grains, the Polynesians never consumed grains, never drank milk, and never ate cheese.
However different these diets might be, each of these groups, and the many other traditional peoples Price studied, enjoyed excellent enduring health, free from the diseases of civilization – cancer, diabetes, heart disease, and hypertension. In his extraordinary and very detailed 1945 book Nutrition and Physical Degeneration, Dr. Price documented his thesis that we humans over the millennium adapted to and thrived on not one, as the experts usually claim, but a variety of different diets.
然而這些飲食可能不同，但每一個群體以及其他許多Price研究的傳統人群，都享有良好的持久健康，不受文明疾病 – 癌症、糖尿病、心臟病和高血壓的影響。在他1945年非凡且非常詳細的「營養與物理退化」一書中，Dr. Price記錄了他的論點，我們人類千年來的適應和繁榮，不是一般專家所說的，而是各種不同的飲食。
There were some commonalities among the diets, of course; all these traditional people ate some animal products, and all consumed a fair amount of fat, whether from plant or animal sources. All the food was, of course, locally grown, locally harvested, or locally hunted, since these isolated groups lacked access to the industrialized food of modern “civilization.”
The food had to be local. And all these groups ate some food in its raw, uncooked form, which they believed possessed special nutritional value.
Having first read Dr. Price’s book during my journalism days, I knew that according to his exhaustive work, humans were a varied species, in the past living in and adapting to all ecological niches excepting the Antarctic, offering a variety of food sources. To me, his work offered a solution to the conflicting dietary advice even then being offered to the world. It didn’t make sense as Nathan Pritikin insisted or as Bob Atkins argued, that all humans should follow one specific type of diet: It just didn’t seem reasonable, to me at least.
在我做新聞的期間首次閱讀Dr. Price的書時，我知道根據他的詳盡工作，人類是一個多樣化的物種，過去生活並適應除了南極以外的所有生態位，提供各種食物來源。對我來說，他的工作為衝突的飲食建議提供給全世界一個解決方案。這不像Nathan Pritikin的堅持認為，或者如Bob Atkins所說，所有人都應該遵循一種特定的飲食方式，這沒有任何意義：至少對我來說這似乎不合理。
I would receive further support for my thinking during the summer of 1981, after completing my second year of medical school. That July, through one of my journalism contacts from my previous life, I had the opportunity to meet the controversial alternative cancer practitioner, the dentist Dr. William Donald Kelley. Over a 20 year period beginning in the early 1960s, Kelley had developed a very intensive nutritional approach to cancer that came under harsh public scrutiny and media attention when he agreed to treat Steve McQueen.
在我完成第二年醫學院學習後，我在1981年夏天得到進一步的支持。那年七月，透過我以前接觸過的新聞，我有機會見到有爭議的替代癌症從業者，牙醫Dr. William Donald Kelley。從1960年代早期開始的20多年期間裡，Kelley開發了採用非常密集的營養方法治療癌症，當他同意治療Steve McQueen時，受到了嚴酷的全民監督和媒體關注。
Steve McQueen was diagnosed with advanced mesothelioma, a particularly deadly form of cancer associated with asbestos exposure, sought out Kelley after the conventional approaches, radiation and immunotherapy, failed to halt the progression of his disease. Though he seemed to rally initially, McQueen, according to accounts of those involved with his care, was not particularly compliant, and appeared at the time he first consulted Kelley too sick for any therapy to work. He would eventually die at a Mexican clinic under the condemning gaze of the media for his choice of an alternative method.
My writer friend had been in touch with Dr. Kelley, thinking that with all the attention around him he might make a good subject for a successful book. But she wanted me to meet in person with Kelley, who happened to be in New York to discuss her book project. Frankly, as she explained to me, she needed my take on the man, whom she really couldn’t decipher – was he truly onto something useful and extraordinary with his odd therapy, or was he simply a huckster, taking advantage of vulnerable cancer patients, as the media had been insisting.
我的作家朋友與Dr. Kelley保持聯繫，他認為，在他周遭所有的注意力下，他可能成為一本成功書籍的好主題。但她希望我和Kelley親自見面，Kelley正巧在紐約討論她的書籍計畫。坦白說，正如她向我解釋的那樣，她需要我對那個她無法真正解讀的男人的看法 – 他是否真的透過異常的療法，做出了有用並異於尋常的事情，或者他只是一個商人，利用脆弱的癌症患者，正如媒體一直堅持的那樣。
Though initially reluctant, I agreed to meet with Kelley, who turned out to be far different from what I expected. I found him to be very shy, very thoughtful, and clearly very smart. And, I could see that he was passionately devoted to his nutritional approach to cancer.
During that first meeting, Kelley described in some detail the tenets of his therapy. In summary, it involved three basic components: individualized diet, individualized supplement programs with large doses of pancreatic enzymes Kelley believed had an anti-cancer effect, and detoxification routines such as the coffee enemas. He fervently believed that each patient required a protocol designed for his or her particular metabolic, physiologic, and biochemical needs, and that one diet would never be suitable for all.
As I was to learn, the diets Dr. Kelley prescribed ranged from largely plant-based high-carb to an Atkins-like diet, with patients prescribed fatty meat several times daily. In general Kelley believed patients diagnosed with the typical solid tumors – cancers of the breast, lung, stomach, pancreas, colon, liver, uterus, ovary, prostate – did best adhering to a plant-based, high carb type diet, low in animal protein and animal fat.
正如我了解的那樣，Dr. Kelley 規定的飲食範圍很大，從基於植物的高碳水化合物，到類似阿金飲食，患者每天多次攝取肥肉。一般來說，Kelley認為診斷患有典型實體瘤的患者 – 乳腺癌、肺癌、胃癌、胰腺癌、結腸癌、肝癌、子宮癌，卵巢癌、前列腺癌 – 最好堅持植物性高碳水化合物型飲食，低動物性蛋白質和低動物脂肪。
Patients diagnosed with the immune based “blood cancers” like leukemia, lymphoma, and myeloma, as well as the sarcomas, a type of connective tissue malignancy, required a lower carb, high animal fat, moderate animal protein diet. Other patients, usually with problems other than cancer, thrived on a more “balanced” diet, incorporating a variety of plant and animal foods.
But all his patients ate some carbs in the form of fruit and carrot juice, the amounts allowed varying according to the underlying metabolic makeup. All this resonated with me, having studied the work of Weston Price so intently.
After my original lengthy conversation with Dr. Kelley, my research mentor Dr. Good suggested that during my summer break I begin an informal review of Kelley’s patient charts located in his Dallas office. From my first day in Dallas, I found among Kelley’s records patient after patient with appropriately diagnosed poor prognosis or what would be considered terminal disease such as metastatic pancreatic and metastatic breast cancer, who had done well under his care for many years, often with documented regression of his disease.
在我與Dr. Kelley進行最初的冗長談話後，我的研究導師Dr. Good建議我在暑假期間，開始對Kelley位於達拉斯工作室的患者病歷進行非正式審查。從我在達拉斯的第一天開始，在Kelley的記錄中找到了一些患者，患者經過適當診斷預後不良，或者被認為是轉移性胰腺癌和轉移性乳腺癌等末期疾病的患者，這些患者多年來在他的護理下表現良好，時常記錄的病情。
These preliminary findings spurred Dr. Good to encourage a more thorough investigation of Kelley’s methods and results. As the project grew in scope, I continued my “Kelley Study” in my spare time during the last two years of medical school, and ultimately brought it to completion while pursuing my immunology fellowship training under Dr. Good at All Childrens’ Hospital in St. Petersburg.
這些初步研究結果促使Dr. Good鼓勵對Kelley的方法和結果進行更徹底的調查。隨著項目範圍擴大，我在醫學院最後兩年裡，用課餘時間繼續我的「Kelley研究」，並且最後在聖彼得堡兒童醫院的Dr. Good底下進行免疫學獎學金培訓時，完成了這項工作。
For the study I reviewed thousands of Kelley’s charts, interviewed over a thousand of his patients, and evaluated 455 of them in some detail. I eventually put my information into monograph form under Dr. Good’s direction, including 50 lengthy case reports of patients with 26 different types of appropriately diagnosed, poor-prognosis cancer who had responded to Kelley’s nutritional regimen.
One of these patients, a woman from Appleton, Wisconsin, had been diagnosed in the summer of 1982 with stage IV pancreatic adenocarcinoma, the most aggressive form of this most aggressive disease. A liver biopsy during exploratory surgery confirmed the diagnosis of metastatic cancer, which the Mayo Clinic would later confirm. When the Mayo oncologist on the case said there was nothing that could be done, the patient being looking into alternative approaches, learned about Kelley’s work, and began his therapy.
Thirty-one years later, she is alive and well, having seen her children – and now her grandchildren – graduate college. To put this case in perspective, I know of no patient in the history of medicine with stage IV pancreatic cancer and biopsy proven liver metastases who has lived this long.
31年後，她活得很好，看著她的孩子成長 – 到現在她的孫子 – 完成大學學位。為了正確看待這個案例，我知道在IV期胰腺癌和活檢證實肝轉移的醫學史上，沒有患者長期存活。
Another memorable patient written up for the book had been diagnosed with what was thought to be localized endometrial cancer in 1969. After a course of radiation to shrink her large tumor, she underwent hysterectomy, and was told they “got it all.” Over the next few years, however, her health began to deteriorate: she experienced persistent fatigue, malaise, pelvic pain, and weight loss.
Though she returned to her primary care physician repeatedly, he dismissed her complaints as “nerves,” suggesting only a tranquilizer. Eventually, in 1975 she developed a palpable mass the size of a grapefruit in her pelvis, thought by her doctors – finally taking her seriously – to be an indication of obvious recurrent disease. A chest x-ray at the time revealed multiple nodules in both lungs, consistent with widely metastatic cancer.
雖然她多次回到基層醫療醫生那裡，但醫師認為她的抱怨是「神經敏感」，只建議用鎮靜劑。後來在1975年，她在骨盆發現一個可觸及到的葡萄柚大小腫塊，她的醫生認為 – 終於認真對待 – 明顯是一種疾病復發的跡象。當時胸部X光檢查顯示兩個肺都有多個結節，與廣泛的癌症轉移一致。
Though told her situation was dire and her cancer incurable, she underwent surgery to remove the large pelvic tumor, to avoid an impending intestinal obstruction. Shortly afterwards she began a synthetic progesterone used at the time as a treatment for metastatic uterine cancer.
Her doctors admitted the drug would not be curative, but hopefully might extend her life a few months. However, she stopped the medication after a few weeks because of serious side effects, and with no other conventional options in sight she began looking into alternative approaches.
She learned about Kelley’s work, began the program, regained her health, and avoided all conventional doctors for many years. In 1984, nine years after coming under Kelley’s care, she returned to her primary care physician who was quite perplexed she was still alive after all this time. A chest x-ray showed total resolution of her once widespread lung metastases.
This patient eventually lived until 2009 when she died at age 95, having survived 34 years from her diagnosis of recurrent metastatic uterine cancer.
Although Kelley did prescribe a variety of diets for his cancer patients, these two exemplary patients followed a plant-based eating plan, high in carbohydrates with a minimum each day of four glasses of carrot juice, dense in nutrients but also dense in natural sugar. Each of these diets allowed considerable fruit and whole grain products, foods again loaded with carbs. According to Seyfried’s hypothesis, both should have died quick miserable deaths.
At the time I finished my monograph in 1986, I hoped that with its publication, fair-minded researchers might begin taking Dr. Kelley and his nutritional therapy seriously. As I was to learn, I completely and rather naively misjudged the animus of the scientific community toward unconventional cancer treatment approaches that didn’t fit the “accepted” model. Even with Dr. Good’s support, after two years of trying I could not get the book published, either in its entirety, or in the form of individual case reports appropriate for the conventional medical journals.
當我在1986年完成我的專著時，我希望透過這出版物，公正的研究人員可能會開始認真看待Dr. Kelley 及他的營養治療方法。如同我所學習的那樣，我完全天真地錯誤判斷了科學界對非傳統癌症治療方法的敵意，這種方法不適合「公認」模式。即使有Dr. Good的支持，經過兩年的嘗試，我無法全部或以適合傳統醫學期刊的個案報告形式出版此書。
Editors responded with disbelief, claiming the results couldn’t be real since a non-toxic nutritional therapy could never be useful against advanced cancer. I found the logic, “it couldn’t be true because it couldn’t be true” perplexing, for editors of scientific journals. In any event, the book would finally be published, in a rewritten and updated form, in 2010.
Discouraged by our failure to get the results of my five-year effort into the world, in 1987 Kelley closed down his practice and more or less went off the deep end, disappearing from sight for a number of years. After we parted in 1987, he and I would never speak again.
In 2005, he would eventually die with his dream of academic acceptance unrealized. But my colleague Dr. Linda Isaacs and I have worked diligently over the past 26 years, keeping the Kelley idea alive, that different people may require completely different diets. In the next installment, I will address my own experience treating patients diagnosed with advanced cancer with a Kelley based approach. Our therapy involves, oftentimes, diets high in carbohydrates, which proponents of the ketogenic diet would predict should fuel, not stop, cancer.
2005年，他最後因未實現學術接受的夢想而死去，但我和我的同事Dr. Linda Isaacs在過去26年裡一直在努力工作，維持Kelley的想法，不同的人可能需要完全不同的飲食。在下一部分中，我將介紹我自己使用基於Kelley的方法，為癌症末期患者治療診斷的經驗。我們的治療方法通常是高碳水化合物飲食，生酮飲食的支持者會預測癌症應該是加重，而不是停止。
After Kelly closed down his practice, in late 1987 I returned to New York and began treating patients with advanced cancer, using a Kelley-based enzyme approach, with immediate good results. One of the first patients who consulted me had been diagnosed two years earlier, after a series of mishaps, with inflammatory breast cancer, the most aggressive form of the disease.
This patient had a very unfortunate story: by the time of her original diagnosis in 1985, her breast tumor was too large to allow for surgery, so her doctors recommended a course of radiation to the chest, hoping to shrink the tumor and allow for mastectomy.
She proceeded with the planned radiation, but at surgery the tumor was still quite large at 8 cm, with 18 of 18 lymph nodes involved with cancer.
Her doctors informed her that her disease would inevitably prove fatal, but suggested aggressive chemotherapy to hold off the cancer as long as possible. She again followed her doctor’s advice, beginning multi-agent chemo.
In the fall of 1987, two years into treatment, she developed evidence of new metastatic disease in the bone. At that point, she began looking into alternative approaches, learned about our work from a social worker she knew, and came under my care only a couple of months after I had begun in private practice.
To summarize her nearly 26 years of treatment with me, she has been disease-free for years as per bone scan studies, continues on her nutritional program, and continues leading a normal, cancer-free life.
By the standards of conventional oncology, this patient’s complete regression of metastatic disease and very long-term survival must be considered remarkable.
One of my favorite patients, whom I have discussed at times in my lectures, was diagnosed in August 1991 with stage IV pancreatic cancer, with multiple metastases into the liver, into the lung, into both adrenals, and into the bone. After a lung biopsy confirmed adenocarcinoma, his doctors discouraged chemotherapy, telling him and his wife conventional treatments would only ruin his quality of life while offering no benefit.
He was given, as he would later tell me, two months to live.
The patient’s wife, a former college professor with an interest in nutritional medicine, learned about our approach from an article she read in an alternative health journal, and in the fall of 1991 he began treatment with me. Some fifteen months later, repeat CT scans showed stabilization of disease. Since he felt fine at the time, following his program religiously, he decided against any further conventional testing until 1998, seven years after he had started with me, when a series of CT scans confirmed total resolution of his once extensive cancer.
This patient would eventually die at age 85 in 2006, 15 years after his diagnosis, from the residual effects of a serious automobile accident.
To put his case in perspective, I know of no similar case with documented stage IV pancreatic cancer that had spread at the time of diagnosis into multiple organs who survived 15 years after diagnosis with confirmed total resolution of his disease.
For both these patients, in the traditions of the Kelley system I prescribed a plant-based, high carb diet, including multiple servings of fruit, with its content of natural sugar, along with four glasses of carrot juice daily. By Seyfried’s hypothesis, both of these patients should have died quick, miserable deaths under my care.
Currently, after more than 25 years in practice, I am writing a two-volume set consisting of detailed case histories of our own patients, like the two mentioned above, to make the point that the therapy works in practice. For those diagnosed with poor-prognosis solid tumors, many now alive in excess of 10 years, I have prescribed a high carbohydrate diet, in total contradiction to what Dr. Seyfried proposes as the ideal anti-cancer approach.
目前經過超過25年的實踐，我正在編寫一套兩冊，包括我們患者的詳細病歷，例如上面提到的兩個，以表明治療在實踐中有效。對於那些被診斷為預後不良的實體腫瘤，許多人到現在存活超過10年，我開了高碳水化合物飲食，完全與 Dr. Seyfried提出的理想抗癌方法相矛盾。
Just this week as I write this, one of my newer patients, a wonderful, creative inventor and computer whiz from the Washington, DC area, came into my office for his regularly scheduled six month re-evaluation appointment. When he started with me in January 2010, three and a half years ago, he had been diagnosed with stage IV metastatic squamous cell carcinoma of the lung, with multiple tumors in both lungs and with evidence of metastases in his ribs. His local doctors in DC had explained he had terminal disease, for which chemotherapy would be useless.
His rib lesions were causing him so much misery his doctors did suggest a course of radiation for palliative pain control. However, he had learned about my work from a mutual friend who recommended he dispense with all conventional treatments and instead pursue my regimen.
He followed her advice, refused radiation, came to see me, and over the years he has proven to be a very vigilant, determined and compliant patient. Within a year on his nutritional program, which includes a high carb diet, his pain had resolved, his energy, stamina, and concentration had improved, and scans confirmed total resolution of all his original extensive disease – in complete contradiction to what Dr. Seyfried would predict or claim possible.
他聽從了她的建議，拒絕了放射治療後來找我，多年來他一直被證明是個非常警惕、堅定和順從的病人。一年內，在包括高碳水化合物飲食的營養計劃下，他的疼痛已經解決，他的能量、耐力和注意力得到改善，掃描證實他所有原始廣泛疾病已完全消退 – 完全與Dr. Seyfried預測或聲稱的可能相矛盾 。
When I saw the patient in my office during this recent visit, he remarked that over the preceding months, he had been craving more carbs than ever before, so in response he had significantly increased his daily intake of carrot juice, fruits, and starchy vegetables, foods allowed on his diet with no limitation.
With this increased carb intake, he has actually lost 16 pounds of excess weight, and his energy is better than it has been in 30 years. And, he remains cancer free. According to Dr. Seyfried, on this high-carb regimen his cancer, thriving as he claims on sugars, should long ago have exploded with deadly results.
Despite my experience, is there any data to support Dr. Seyfried’s concept that all cancer patients should follow a strict ketogenic diet? In the next article, I will discuss just this issue, looking first to those who have prescribed the diet in the past.
Despite Kelley’s and my own positive experience treating cancer patients with non-ketogenic, often high-carb diets, can I muster any data, past or present to support what Seyfried claims? What does past experience and current data show, about the miracle of the ketogenic diet for cancer?
In my previous articles, I discussed my friend, the late Dr. Robert Atkins, the famed diet doctor, who long before Dr. Seyfried appeared on the scene hoped his “ketogenic” diet might be an answer to cancer. During the late 1980s and right through most of the 1990s, Dr. Atkins treated hundreds of cancer patients, many, though not all, with a ketogenic diet, along with a variety of supplements and intravenous vitamin C.
在我先前的文章中，我討論到我的朋友，已故的著名飲食醫生 Dr. Robert Atkins，他早在Dr. Seyfried出現之前就希望他的「生酮」飲食可能會是癌症的解答。在1980年代後期及90年代的大部分時間裡，Dr. Atkins治療了數百名癌症患者，其中許多（儘管不是全部）執行生酮飲食，以及各種補充劑和靜脈注射維生素C。
It was 1992, when his chief IV nurse, who had been with him for years, called me, wishing to take me to lunch. I knew him through my friendship with Dr. Atkins, and in fact he had been quietly referring a number of patients to me from the clinic, patients who were not responding to the Atkins’ treatment.
We did meet for lunch several days later, and I was surprised that after some general chatter, he asked me point blank if there was any chance he could work for me! He seemed quite serious, but I explained that my colleague Dr. Linda Isaacs and I didn’t use IV treatments so I would have no use for his particular skills.
幾天後我們在午餐時間碰面了，經過一些普通的交談後，他直接地問我他是否有機會為我工作，我很驚訝！他似乎很認真，但我解釋說我和同事 Dr. Linda Isaacs沒有使用靜脈注射治療，所以他的特殊技能對我毫無用處。
Now intrigued, I asked why he would want to change jobs, since our practice was by design slower paced, whereas Bob ran a very busy clinic and active IV unit which would seem perfectly suited for this nurse’s expertise. He then explained, with obvious disappointment, that none of the hundreds of cancer patients they had treated or had been treating had responded to any significant degree, with the exception of those he had referred to me.
The failures had taken an emotional toll on the nurse, who was ready for a change.
Though I would see Bob occasionally at conferences, I never mentioned any of this to him. Some years later we met for lunch in Washington, DC, at a conference where we were both scheduled to speak. To my astonishment, he told me he was closing down his cancer unit completely, to concentrate on his traditional area of expertise – obesity, diabetes, heart disease, hypoglycemia, the metabolic syndrome – problems for which he knew his nutritional approach with the ketogenic diet worked quite effectively.
雖然我偶爾在會議上會看到Bob，但我從來沒有向他提過這些。幾年後，我們在華盛頓哥倫比亞特區的一個會議上聚會，我們兩人都準備發言。令我驚訝的是，他告訴我他正在結束他的癌症部門，專注於他的傳統專業領域 – 肥胖、糖尿病、心臟病、低血糖、代謝綜合症 – 他知道他的生酮飲食營養方法對於這些問題非常有效。
In terms of cancer, after more than ten years of trying on hundreds of patients, his treatment had been a disappointment. I certainly appreciated his honesty, and was gratified when he expressed his admiration for what he had been hearing about my successes.
I think it was still hard for him to accept that many cancer patients, and many humans without cancer, did best on a plant-based, high carb diet, so foreign to his way of thinking. Though he had heard me expound on the Kelley approach many times over the years, it was to him implausible that humans as a species had adopted to a variety of diets, some high fat, some high carb, some more balanced, and that in medical practice, we as physicians had to be aware that different patients might require completely different diets for optimal health.
To his grave, as far as I know, he believed that all humans should be on a high fat diet with minimal carbs.
In my opinion, Bob Atkins knew more about the theory and practice of the ketogenic diet, its benefits and limitations, including as applied to cancer patients, than anyone in the history of medicine. For him, the concept was hardly the musings of a PhD laboratory scientist, but the practical observations of a physician who treated thousands of patients over decades. And for cancer, the ketogenic diet just did not seem to work.
Bob wasn’t the only physician, his clinic not the only place, where the ketogenic diet has been applied in modern times. At the Johns Hopkins Medical Center, for many years a group of researchers and neurologists have prescribed a very strict ketogenic diet for children with intractable seizures, that is, seizures unresponsive to currently available medications. For this particular indication, in adults as well as children, the diet works quite well.
Bob 並不是唯一的醫生，他的診所不是唯一一個現代應用生酮飲食的地方。Johns Hopkins 醫學中心多年來，一群研究人員和神經科醫生為頑固性癲癇發作的兒童開了非常嚴格的生酮飲食，癲癇發作目前沒有可用的藥物。對於這種特殊適應症，在成人和兒童中，飲食效果很好。
So, what evidence does Dr. Seyfried himself provide to prove his point that the best diet for all cancer patients, whatever the type, is the ketogenic, high fat, no carb diet? Well, very little. Certainly the 400 plus pages of elaborate biochemistry and theory are impressive and informative. But in terms of practicalities, that is, results with actual human patients diagnosed with cancer, there is next to no evidence.
Dr. Seyfried does include a chapter toward the book’s end entitled “Case Studies and Personal Experiences in using the Ketogenic Diet for Cancer Management.” Here, Dr. Seyfried provides a description of a pilot study, written by the investigators themselves, discussing the use of the ketogenic diet in children with inoperable brain cancer. However, the authors admit the study was intended only to evaluate the diet’s tolerability and effect on glucose metabolism as determined by PET scanning, not treatment benefit or survival.
Dr. Seyfried確實在書的最後一章寫了一篇題為「使用生酮飲食治療癌症的案例研究和個人經驗」的章節。在這裡，Dr. Seyfried提供一份由研究人員撰寫的試驗研究，討論了生酮飲食在患有無法手術的腦癌病童的應用。然而作者承認，該研究僅用於評估飲食對葡萄糖代謝的耐受性和影響，通過PET掃描確定，而不是治療效果或存活。
As the authors write, “the protocol was not designed to reverse tumor growth or treat specific types of cancer.” The researchers also acknowledge the patient numbers were too small to allow for meaningful statistical evaluation, even for the avowed purposes. Overall, the discussion centers on the practicalities of implementing the diet and the results of the PET scans.
Interesting information, but hardly useful in terms of treatment effect.
In this same chapter, there are also two case reports, neither very impressive. The first, written by the mother, tells the story of a four-year old child diagnosed in 2004 with a low-grade (less aggressive) but quite large and inoperable brain tumor. The parents, as the mother writes, entrusted their child into the hands of the experts, who prescribed the usual “gold standard” treatments, which are not clearly described initially but presumably mean chemotherapy and perhaps radiation.
In subsequent years, the boy continued on aggressive conventional therapeutics, when in 2007, the parents learned of the preliminary research of Dr. Seyfried. While continuing low-dose chemotherapy combined with the ketogenic diet, the patient experienced a “15%” reduction in tumor size. The chemo was eventually discontinued while the parents maintained their son on the ketogenic diet, and the child, sadly, eventually died.
In my monograph One Man Alone, I included a case report of a patient treated by Kelley, diagnosed with an inoperable and very aggressive form of brain cancer that had spread into the spinal canal. After failing radiation, the patient began treatment with Dr. Kelley in 1981. At the time, the patient’s wife actually had to administer the treatment, even the coffee enemas, since the patient himself was largely incoherent and wheelchair bound.
在我的專著「One Man Alone」中，我收錄了Kelley治療的一名患者的病例報告，該患者被診斷出患有無法手術且非常具有攻擊性的腦癌，並已擴散到脊椎管內。在放射治療失敗後，患者於1981年開始接受Dr. Kelley的治療。當時，其實患者的妻子不得不接受治療，甚至是咖啡灌腸，因為患者基本上已語無倫次並坐在輪椅上。
As I wrote in my book, “Nevertheless on the therapy [Kelley’s] he slowly began to improve, to the point his mental status normalized and over a period of a year, he progressed from a wheelchair to a walker to a cane.” When I completed my study in 1987, he had survived 5 years and was in excellent health, with no evidence of cancer in his brain or spinal canal.
A second brief report in Seyfried’s “Case Studies” chapter, this time written by the patient himself, describes a physician who had been diagnosed in 2009 with multiple myeloma, a cancer affecting the bone and bone marrow. The diagnosis came about when the physician fractured his arm while lifting weights.
After scouring the literature, he became quite attracted to the “good science” behind the ketogenic hypothesis, so under Dr. Seyfried’s direct supervision, he began the diet. Though the patient seems quite enthusiastic about his response, he admits in his note that with the diet there has been “no progression,” presumably in terms of x-ray studies, and some improvement in the blood studies. He still considers his disease as “incurable.”
First of all, myeloma patients, even when diagnosed with an aggressive form, often linger for years before the disease advances. I would never have included such a two-year survivor in One Man Alone, or in any other book I have written or plan to write – unless, possibly, there has been documented significant regression of disease, not apparent in this case. I do include a case of multiple myeloma treated by Dr. Kelley in my monograph, a woman diagnosed with extensive cancer throughout her skeleton with evidence of multiple fractures.
首先，骨髓瘤患者即使被診斷為具有侵襲性形式，也經常在疾病惡化前停留數年。我永遠不會將這樣一個兩年的存活者放進One Man Alone中，或者我寫過或計劃寫的任何其他書中 - 除非有可能記錄到疾病的顯著退化，在這種情況下並不明顯。我確實在我的專著中納入了一例由Dr. Kelley治療的多發性骨髓瘤，一名女性被診斷出在她的骨骼中患有廣泛的癌症，有多處骨折的證據。
When she first consulted with Dr. Kelley in 1977 she was in a near terminal state after having failed intensive chemotherapy. Nonetheless, despite her dire situation within a year she had experienced complete regression of her extensive bony lesions, as documented by x-ray studies. Though in subsequent years her compliance with her nutritional regimen would waver and her disease would in turn recur, invariably when she resumed Kelley’s treatment the myeloma would go into remission.
1977年，當她第一次諮詢Dr. Kelley 時，她因強化化療失敗而處於末期狀態。即便如此，儘管她的情況在一年內變得很糟糕，但她經歷了廣泛骨性病變的完全消退，如同X射線研究記錄的那樣。雖然在隨後的幾年裡，她對營養方案的依從性有動搖，她的疾病會反復發作，但當她恢復Kelley的治療時，骨髓瘤會進入緩解階段。
At the time I finished the monograph in 1987, she had survived 11 years. I found this case acceptable for my Kelley report, but a two-year survivor with no evidence of disease regression but lots of enthusiasm, I would never had included.
I might add that for myeloma patients, Dr. Kelley prescribed, and I prescribe, a high fat diet – but never ketogenic.
我可能會補充一點，對於骨髓瘤患者，Dr. Kelley和我都會開一種高脂肪飲食 - 但不是生酮。
Why, one wonders, if Dr. Seyfried’s actual data is so thin, have so many physicians, scientists, and writers jumped on the ketogenic bandwagon?
Let me say out front I have no problem with scientists who propose a theory, in short papers or in the case of Dr. Seyfried, in long, detailed books. I do have a problem when scientists go a step further, insisting in the absence of any significant human data or even impressive case histories they have unraveled the mystery of cancer. I am also quite surprised, in the case of Dr. Seyfried, that both alternative and conventional practitioners have risen up in a loud chorus of enthusiasm, as if indeed Dr. Seyfried’s theories are correct, and that he has solved the cancer riddle.
我先聲明，對於提出理論的科學家、簡短的論文或Dr. Seyfried的案例、長篇詳盡的書籍，我都沒有意見。我只有一個疑問，當科學家更進一步，堅持沒有任何重要的人類數據，甚至令人印象深刻的案例史，他們揭開了癌症的神秘面紗。在Dr. Seyfried的案例中，我也非常驚訝的是，替代和傳統的從業者都熱情高漲，好像 Dr. Seyfried的理論確實是正確的，並且他已經解決了癌症之謎。
I found a typical response to Seyfried’s book in a review on Amazon, written by the esteemed conventional oncologist Dr. Stephen Strum:
I am a board-certified medical oncologist with 30 years experience in caring for cancer patients and another 20 years of research in cancer medicine dating back to 1963. Seyfried’s “Cancer as a Metabolic Disease” is the most significant book I have read in my 50 years in this field. It should be required reading of all cancer specialists, physicians in general, scientific researchers in the field of cancer and for medical students. I cannot overstate what a valuable contribution Thomas Seyfried has made in writing this masterpiece.
我在亞馬遜的一篇評論中找到了對Seyfried的書的典型回應，由著名的傳統腫瘤學家Dr. Stephen Strum撰寫：
From the alternative front, on his website read literally by millions, Dr. Joseph Mercola has been an enthusiastic supporter of Dr. Seyfried and his ketogenic thesis. In two lengthy articles Dr. Mercola proposes that the ketogenic is an answer to cancer.
從另一方面來看，他的網站有數百萬人閱讀，Dr. Joseph Mercola一直是Dr. Seyfried及生酮論的熱心支持者。Dr. Mercola在兩篇冗長的文章中提出，生酮是癌症的一種解答。
In the first posting appearing on his site June 16, 2013, based on an interview with Dr. Seyfried, Dr. Mercola writes in his introductory paragraph:
Could a ketogenic diet eventually be a “standard of care” drug-free treatment for cancer? Personally, I believe it’s absolutely crucial, for whatever type of cancer you’re trying to address, and hopefully someday it will be adopted as a first line of treatment.
2013年6月16日出現在他的網站上的第一篇文章中，根據對Dr. Seyfried的採訪，Dr. Mercola在介紹性段落中寫道：
In a second article from June 30, 2013, entitled “The Ketogenic Diet – An Excellent Approach to Cancer Prevention and Treatment,” Dr. Mercola discusses the work of Dr. Dominic D’Agostino, PhD, another basic scientist, this time from Florida, who enthusiastically reports his animal and laboratory work with the ketogenic diet.
在2013年6月30日發表的題為「生酮飲食 - 一種極好的癌症預防和治療方法」的第二篇文章中，Dr. Mercola士討論了另一位基礎科學家Dr. Dominic D'Agostino的工作，他來自佛羅里達州 ，熱情地報告他的動物和實驗室與生酮飲食的工作。
As I ponder this enthusiasm, I have to think that perhaps I am just a little slower, or more cautious, than most. The day after I first met Dr. Kelley in New York in July 1981, I was on a plane to Dallas to begin my review of Kelley’s charts. As previously discussed, I quickly found among Kelley’s records case after case of appropriately diagnosed poor-prognosis and/or terminal cancer, patients alive five, ten, even 15 years later, with no possible explanation for such survival other than Kelley’s odd nutritional treatment.
當我思考這種熱情時我不得不認為，或許我只是比大多數人更慢或更謹慎。1981年7月我第一次在紐約遇見Dr. Kelley後的第二天，我在飛往達拉斯的飛機上開始瀏覽 Kelley的紀錄。如前所述，我很快在Kelley的病例中找到了經過適當診斷的預後不良和/或癌症末期的病例，患者活了5年、10年，甚至15年後，除了Kelley奇怪的營養治療之外沒有可能的解釋。
After I returned to New York some three weeks later carrying with me copies of dozens of patient records, and after reviewing my findings with Dr. Good, I knew Kelley was on to something. One thing for sure, at the time I didn’t, as I easily could have with my journalism contacts, think about “explosive” news stories, or a book contract.
Quite the contrary, as I discussed in a previous article, I met Kelley through a journalist friend who thought he might make an excellent subject for a potboiler, a wealth-generating best seller. After only a few days in Kelley’s Dallas office, I quickly realized that he, as odd as he may have seemed to some, as peculiar as his therapy might be to conventional researchers, had put together a potentially useful, non-toxic, nutritional cancer treatment.
I also quickly understood that for his approach to gain academic acceptance, Kelley must back off completely from involvement with popular controversial books and media hysteria. When I expressed my opinion about such things to him, he accepted the wisdom of my position unconditionally. When he then told my writer friend in a rather difficult phone call that he had no interest in pursuing the book she had suggested, she was, to say the least, livid with me – especially since she had brought Kelley and me together in the first place, seeking my opinion about his authenticity.
我也很快明白，為了獲得學術上的認可，Kelley必須完全退出參與有爭議的書籍和瘋狂媒體。當我向他表達我對這些事情的看法時，他無條件地接受了我的智慧立場。然後，當他在電話中告訴我的作家朋友他沒有興趣推行她建議的那本書時，她對我很生氣 - 特別是因為她起初把Kelley和我找來一起，尋求我對他的真實看法。
Ironically, because I thought him to be possibly legitimate, I had instructed him to avoid involvement with any popular book including hers. My writer friend would not speak to me for 16 years, until we met at a conference in New York. We hugged, after all those years, and made up.
Only after interviewing 1,000 of Dr. Kelley’s patients, and evaluating 455 of them at length over a five-year period, did I even begin to think about the book that would be written – not a popular potboiler, not a tome expounding his elaborate theories, but a serious academic monograph about our findings. It is just not in my makeup to put out a book with lovely theory and two case reports, however inspiring they might be.
只有在採訪了 Dr. Kelley的1000名患者，並在五年內詳細評估了其中的455名患者之後，我才開始考慮將要寫的書 - 不是一本受歡迎的作品，不是一本闡述了他精湛理論的書，而是關於我們研究結果的嚴肅學術專著。它不是在我的編造中推出一本有可愛理論和兩個案例報告的書，無論它們多麼鼓舞人心。
I do have a challenge, a gentlemanly academic challenge of course, to Dr. Seyfried.
The three from my practice include the stage IV 25-year survivor of metastatic inflammatory breast cancer, my 15 year survivor of stage IV pancreatic cancer, and my three and a half year survivor of stage IV lung cancer that has totally regressed on my therapy.
With the exception of the myeloma patient, all the other six patients, both Kelley’s and mine, followed a high carb, plant-based diet, replete with frequent servings of fruit and multiple glasses daily of sugar-rich carrot juice. I challenge, for the benefit of science, Dr. Seyfried to match these seven simple straightforward cases. In my experience, no one else has been able to meet the challenge, so I question whether Dr. Seyfried can either.
除骨髓瘤患者外，所有其他六位患者，無論是Kelley's還是我的，都遵循高碳水化合物，以植物為基礎的飲食，經常大量的水果和每日多杯富含糖的胡蘿蔔汁。為了科學的利益，我挑戰Dr. Seyfried，以配合這七個簡單明瞭的案例。根據我的經驗，沒有其他人能夠迎接挑戰，所以我質疑Dr. Seyfried博士是否可以。
The point I’m trying to make is simple. In science, as in most walks of life, a little caution certainly goes a long way. In my practice, I am already receiving letters and faxes and calls from prospective patients diagnosed with advanced cancer of a variety of types, who with great enthusiasm jumped on the ketogenic diet bandwagon – with poor results.
我想說的很簡單。在科學上，就像在大多數人的生活中一樣，稍微謹慎一定能走很遠。在我的實踐中，我收到來自被診斷患有各種類型癌症末期的潛在患者的信件、傳真以及來電，他們熱衷於生酮飲食的潮流 - 效果不佳。
In my next and final article in this series on the ketogenic diet as a cancer treatment, I will offer my suggestions as to why the diet most likely won’t work for most people, based on past epidemiological research and current biochemical thinking.
First, as Weston Price proved 70 years ago in his exhaustive epidemiological study, over the millennia different groups of humans adjusted to different types of diets, depending on the locale in which they lived and the available food therein, ranging from high carb to virtual no carb. Though Dr. Price was not evaluating dietary treatments as such for disease, his point should nonetheless be well taken – different humans (for optimal health) need different diets.
首先，正如Weston Price在70年前的詳盡流行病學研究中所證實的那樣，幾千年來不同的人類群體根據他們生活的地點和當地可用的食物進行調整，從高碳水化合物到無碳水化合物。雖然Dr. Price沒有評估飲食治療對疾病的影響，但他的觀點應該得到充分考慮 – 不同的人需要不同的飲食（為了最佳健康）。
In terms of our specific discussion, diet as cancer treatment, Dr. Kelley demonstrated more recently in his Dallas, Texas, and Winthrop, Washington offices, no one diet suits all patients diagnosed with the disease, quite the contrary. Over a 20 year period working in the trenches treating many thousands of people, Dr. Kelley came to learn that each patient who walked into his office required a diet designed specifically for his or her metabolic needs, and these dietary requirements could vary enormously from patient to patient.
就我們的具體討論而言，飲食作為癌症治療，Dr. Kelley最近在他的德克薩斯州達拉斯和華盛頓州的Winthrop辦公室展示，沒有一種飲食適合所有被診斷患有疾病的患者，恰恰相反。在治療成千上萬人的戰壕中工作了20多年，Dr. Kelley博士知道，每個走進辦公室的病人都需要專門為他/她的新陳代謝需要而設計飲食，這些飲食要求可能因患者而異。
Unknown to most, even within the alternative world, my friend Bob Atkins tried the ketogenic diet for some 12 years on many of his cancer patients, with no significant success as he reported to me. As a telling point, under the name “Dr. Robert Atkins” on Amazon, one will find dozens of books he authored including his original diet book, its many incarnations and editions, along with books on vitamins, minerals – but glaringly absent, no book on cancer. Yes, the ketogenic diet has been tried before, with cancer patients, and without success.
大多數人都不知道，即使在替代療法世界中，我的朋友Bob Atkins對他的許多癌症患者嘗試了約12年的生酮飲食，但他沒有給我報告，也沒有取得重大成功。作為一個有說服力的觀點，在亞馬遜上名為「Dr. Robert Atkins」，人們會發現他撰寫的數十本書，包括他的原始飲食書，有許多型態和版本，以及關於維生素、礦物質的書籍 - 但是明顯缺漏，沒有關於癌症的書。是的，癌症患者先前已嘗試過生酮飲食，並沒有成功。
I also might offer a thought as to why, from a more esoteric, more biochemical perspective, for most people diagnosed with cancer the ketogenic diet might not work. For the past 150 years, researchers have approached cancer as a disease in which perfectly happy, normal mature cells sitting in some tissue somewhere suddenly go awry, lose their normal regulatory restraint, develop a primitive, undifferentiated appearance or phenotype, begin proliferating without restraint, begin invading through tissues and organs, begin migrating, spreading, creating new blood vessels along the way to feed the rapacious appetite of cancer. But over the past 15 years, gradually, a new, more productive, and I believe more truthful hypothesis has emerged, spearheaded particularly by Dr. Max Wicha at the University of Michigan. Scientists such as Dr. Wicha have discovered that cancer may be a little more complicated than we have thought these long decades.
我也可以想想為什麼，從更深奧、更生化的角度來看，對於大多數被診斷患有癌症的人來說，生酮飲食可能不起作用。在過去的150年裡，研究人員將癌症視為一種非常幸運疾病，在某些組織的某個地方，正常成熟細胞突然出錯，失去正常的調節限制，發展出原始未分化的外觀或表型，開始無限制地增生，開始侵入組織和器官，開始轉移、擴散，沿途創造新的血管，以滿足癌症貪婪的慾望。但在過去的15年裡，逐漸出現了一種新的、更有成效的、我認為更真實的假設，特別是由密歇根大學的Dr. Max Wicha帶領。像Dr. Wicha博士這樣的科學家已經發現，癌症可能比我們幾十年來所想像的要複雜很多。
In recent years stem cells have been a hot topic in the research world, and a hot topic, for better or worse, in the media. These headline-grabbing stem cells are primitive undifferentiated cells, located as nests in every tissue and organ in the body, that serve as a reserve supply to replace cells in the tissue or organ lost due to normal turnover (as in the bone marrow or along the intestinal lining), disease, injury, or cell death.
In this way, stem cells allow complex life to exist and continue, providing tissue replacements as needed, appropriate for the tissue in which they live. That is, liver stem cells will create new liver cells as needed, bone marrow stem cells will create new bone marrow clones as required, intestinal stem cells will form, as necessary, intestinal lining cells. In this way, the developmental capacity of stem cells seems to be governed by the local environment.
After stem cells were discovered in the 1960s, scientists initially thought that they had a limited repertoire, that is, liver stem cells can only create more liver cells, but not bone marrow or intestinal cells, bone marrow stem cells can only create more bone marrow cells, but not liver cells, and so on. But we now know that isn’t the case.
Stem cells, wherever they may be found, can adapt quite nicely, and are far more flexible than originally believed. In laboratory animals, a liver stem cell placed into the bone marrow starts creating not liver, but bone marrow cells, a bone marrow stem cell transplanted into the liver begins to generate not bone marrow, but liver cells. The environment appears to be the key, ultimately determining the direction of stem cell development.
In terms of cancer specifically, many scientists believe that the disease does not develop from normal healthy cells that for some reason go molecularly berserk, but from stem cells that have lost their normal regulatory controls, creating in turn the disease we know as cancer.
Like any normal tissue or organ, in a tumor these cancer stem cells generate a variety of cell types that can mature to some extent, but the stem cells remain always primitive, undifferentiated, capable of replicating endlessly, capable of killing eventually. Most standard therapies fail, Dr. Wicha and his associates believe, because they attack the more mature tumor line, not the essential tumor stem cells, the actual engines of cancer creation.
Dr. Seyfried makes the case that normal stem cells, like cancer cells, are obligatory glucose consumers, relying solely on anaerobic glycolysis for the energy needed for survival. I agree, to a point. But I will also make the case that as with normal stem cells, cancer stem cells are very flexible, capable of adjusting to the local environment.
If deprived of oxygen, stem cells happily will turn to glycolysis as the main source of ATP energy. In an oxygen rich environment, I believe these stem cells can adapt accordingly, recoupling at least to some extent glycolysis to the citric acid cycle and electron transport, with great efficiency, and in terms of cancer, with deadly results.
Some years ago, a patient of mine, a professor at a well-known university, became interested in oxygenation therapies for cancer, used widely in the Mexican Clinics. These “oxygen” treatments were an offshoot of Dr. Warburg’s work, i.e., that cancer cells as obligatory anaerobes can synthesize needed energy supplies only via glycolysis. Therefore, the theory goes, in the presence of oxygen, particularly ozone, a form of hyped up oxygen, cancers cells, unlike normal cells, will be poisoned.
幾年前，我的一位患者，一位知名大學的教授，對癌症的氧合療法產生興趣，在墨西哥診所廣泛使用。這些「氧氣」治療是 Dr. Warburg工作的一個分支，即癌細胞作為強制性厭氧菌，只能通過糖酵解合成所需的能量供應。因此該理論認為，在有氧氣的情況下，特別是臭氧(一種活躍的氧氣形式)，癌細胞與正常細胞不同，它會中毒。
My professor patient seemed quite taken by the ozone approach, which he thought I should start implementing in my practice. However, I become somewhat doubtful about the theory, and the use of ozone as a treatment for cancer. At the time I had already taken care of dozens of patients who prior to consulting with me had been to the Mexican Clinics to receive ozone along with other treatments.
All seemed to have initial good responses followed by explosive return of their malignancy. I explained to my professor patient that I believed cancer stem cells could quickly adapt to oxygen, despite what the Warburgians might claim.
At about this time, ironically, this professor’s dog developed a very aggressive sarcoma, for which standard treatments were of no avail. Enchanted by oxygenation therapies, he actually bought an ozone generating machine meant for rectal installation, which he began, against my advice, using on his most patient dog.
After two weeks, the large tumors, quite evident to the naked eye, regressed substantially, to the professor’s great joy. He called me with the good news, and in a collegial sense, suggested he might be teaching me, the cancer expert, something new. I told him to wait before we came to a conclusion.
Unfortunately, some four weeks later, the professor called me again, reporting sadly that after the initial miraculous response, the tumors had recurred with a vengeance, and the dog had quickly succumbed.
It’s an interesting story but of course just that, a story that I fully acknowledge proves nothing, though in my mind it does illustrate how adaptable cancer cells, specifically cancer stem cells can be. It is a good lesson, for all of us, before we tout the next great cancer miracle.
-Dr. Nicholas Gonzalez, MD