Treatment of hepatic cancer patients with a gluconeogenic diet: report of a case with hepatic metastases of malignant melanoma

A case of malignant melanoma with metastases mainly to the liver and the right ilium was treated with a gluconeogenic diet. The carbohydrate content of the diet was finally reduced to 5∼10 g per day and the remaining calories were derived from protein and fat. Increased blood citrate and NEFA concentrations, increased ketone body formation and the maintenance of a reasonable level of blood sugar confirmed the attainment of a gluconeogenic metabolic state. Definite improvements in size of a hepatic tumor, serum alkaline phosphatase activity and the general condition were observed transient1y during the dietary therapy. Growth of the tumor resumed despite the continued gluconeogenic therapy, and the patient died of cardiac failure. Concentrations of gluconeogenic enzymes, fructose-1, 6-diphosphatase, glutamic oxaloacetic transaminase and glutamic pyruvic transaminase, were all found to be very low in the tumor tissue as expected.