Ketogenic and Low-Carbohydrate Diets in Prostate Cancer: Metabolic Rationale, Preclinical Evidence, and Preliminary...

Area of Science:

• Oncology
• Metabolic Research
• Nutritional Science

Background:

• Prostate cancer (PCa) is a leading cause of cancer mortality, with metabolic syndrome components influencing its development and progression.
• Standard PCa treatments like androgen deprivation therapy (ADT) can cause adverse metabolic effects, impacting patient quality of life.
• Androgen receptor (AR) signaling, crucial in PCa, is linked to cellular metabolic reprogramming, suggesting metabolism as a therapeutic target.

Purpose of the Study:

• To evaluate and synthesize evidence on the ketogenic diet (KD) in prostate cancer (PCa) management.
• To explore the interaction of KD with hormonal therapies and its metabolic/endocrine mechanisms.
• To assess the potential of KD as an adjunctive strategy in integrated oncologic care.

Main Methods:

• Systematic review and synthesis of preclinical and clinical evidence on ketogenic diet interventions in prostate cancer.
• Analysis of metabolic and endocrine effects of KD, including ketosis, glucose, insulin, and IGF-1 levels.
• Evaluation of KD's impact on tumor growth, oncogenic pathways (e.g., PI3K/AKT/mTOR), and survival in PCa models.

Main Results:

• Preclinical studies show KD slows PCa tumor growth, modulates oncogenic pathways, reduces insulin signaling, and enhances survival.
• Emerging clinical data suggest low-carbohydrate diets may improve metabolic parameters and delay PSA progression, but results are heterogeneous.
• KD induces ketosis, reducing glucose and insulin, potentially counteracting PCa-associated metabolic alterations and treatment side effects.

Conclusions:

• The ketogenic diet (KD) is a promising, yet experimental, strategy for prostate cancer (PCa) management.
• Careful nutritional supervision is essential to mitigate risks like unintended weight loss or sarcopenia.
• Well-designed randomized clinical trials are necessary to establish the safety, efficacy, and role of KD in routine PCa care.