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Is It Safe To Take Letrozole After Weight Loss When On Ketogenic Diet?

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Posted on Mon, 9 Mar 2015
Question: Hi my mum is 52 years old and has been taking tamoxifen for the last year for metastatic breast cancer in her spine and her medication is being changed to Letrozole as there has been increased activity in the spine since her last scan. She is going to start back on the ketogenic diet again as this showed to slow down the progression previously, she only changed her diet over the last 3 months as she had lost a lot of weight on the ketogenic diet. My question is, is it safe for her to take 17g of bicarbonate soda per day in water her weight is 57kg. The aim being to try to increase alkalinity in the blood to make the environment less acidic for the cancer cells to thrive on and also improve ketone bodies in the blood.
doctor
Answered by Dr. Robert Galamaga (1 hour later)
Brief Answer:
Followup

Detailed Answer:
Thanks for your question,

I am not aware of any randomized controlled clinical trials which support the use of alkalynizing agents in the setting of breast cancer. My concern is that alkalynization may also alter the effectiveness of the hormone directed therapy.

In light of this I would not recommend increasing bicarbonate supplementation in the diet as there is currently no evidence in the literature that this improves outcomes. In order to be accepted in practice, an intervention needs to be tested in a randomized trial comparing patients who receive the intervention to those who dont in order to demonstrate if there is a difference.

I would encourage her to continue to follow up with her medical oncologist otherwise as scheduled.

Thanks again for sharing your health care concern with us.

Dr. Galamaga
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Robert Galamaga (41 minutes later)
Ok well is there evidence to say that bicarbonate soda interferes with the effectiveness of letrozole?

Cancer being such a multi factorial issue, it's impossible to have RCT's for every element ie nutrition, supplements and so on but does that mean that potential beneficial strategies should be overlooked?

If there is reason for you to be concerned over the synergy with hormone therapy I would like physiological justification for your concern please as I have just paid 35 pounds for this brief predictable answer!
doctor
Answered by Dr. Robert Galamaga (8 minutes later)
Brief Answer:
Followup.

Detailed Answer:
Thanks for the followup,

My concern is that altering the pH of the body has not been proven to be an effective way to manage malignancy. To assume this is effective is quite dangerous in my opinion. There is no way to provide physiological justification regarding synergy as this simply has not been studied.

I appreciate your concern and frustration and would invite you to request a refund and perhaps resubmit your question until you receive an acceptable answer.
Note: For further queries related to kidney problems Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Robert Galamaga

Oncologist

Practicing since :2002

Answered : 2635 Questions

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Is It Safe To Take Letrozole After Weight Loss When On Ketogenic Diet?

Brief Answer: Followup Detailed Answer: Thanks for your question, I am not aware of any randomized controlled clinical trials which support the use of alkalynizing agents in the setting of breast cancer. My concern is that alkalynization may also alter the effectiveness of the hormone directed therapy. In light of this I would not recommend increasing bicarbonate supplementation in the diet as there is currently no evidence in the literature that this improves outcomes. In order to be accepted in practice, an intervention needs to be tested in a randomized trial comparing patients who receive the intervention to those who dont in order to demonstrate if there is a difference. I would encourage her to continue to follow up with her medical oncologist otherwise as scheduled. Thanks again for sharing your health care concern with us. Dr. Galamaga