Oncologists' Perspectives on Ketogenic Diets in Pediatric Brain Cancer: Potential, Challenges, and the Path Forward

Area of Science:

• Pediatric Oncology
• Nutritional Therapy
• Metabolic Therapies

Background:

• Pediatric brain tumors present treatment challenges with conventional therapies causing collateral damage.
• Ketogenic diets (KDs) are explored as adjuncts, potentially limiting glucose for tumor cells and providing ketones as an alternative energy source.
• Limited awareness and understanding contribute to hesitancy in recommending KDs for pediatric cancer patients.

Purpose of the Study:

• To assess oncologists' knowledge and perceptions of ketogenic diet (KD) use in pediatric brain cancer patients in Saudi Arabia.
• To evaluate oncologists' understanding of KD safety, feasibility, and perceived efficacy in this patient population.

Main Methods:

• A cross-sectional survey was administered to 94 oncologists across five major healthcare centers in Riyadh, Saudi Arabia.
• The survey examined oncologists' knowledge, safety concerns, perceived feasibility, and efficacy of ketogenic diets in pediatric brain cancer.

Main Results:

• While 67% understood KD composition, 43% held neutral views on safety, with common concerns about malnutrition and side effects.
• Adherence challenges were noted by 53%, yet 48.9% believed KDs could enhance outcomes alongside standard treatments.
• Knowledge and perception varied, with consultants and internationally trained oncologists generally more positive than fellows.

Conclusions:

• A significant lack of consensus exists among oncologists regarding the safety, feasibility, and benefits of ketogenic diets for pediatric brain tumors.
• Findings highlight the need for enhanced education, clearer clinical guidelines, and interdisciplinary collaboration for informed decision-making.
• Tailoring KD recommendations to individual patient factors is crucial for effective integration into pediatric oncology care.