[endothrowho333]

I sympathise with your wife's predicament. Good or sub-par treatment, doctors still get paid.

If you're not opposed to eschewing professional recommendations to not complicate treatment, there are two things that may be worth looking into:

1). Metformin: Helps control blood glucose by significantly increasing sensitivity of insulin receptors, i.e more glucose is shuttled out of the blood stream per insulin molecule. Not scheduled and very cheap. Also trials are being done on it for cancer prevention -- exactly because of Warburg's phenomenon (cancer cells and glucose)

2). Ketosis: Hit or miss. By abstaining from carbohydrate consumption, the result should be drastically reduced blood glucose levels. However, in some people (e.g type 2 diabetics) it may elevate blood glucose due to metabolic disfunction. In any case, caloric restriction in general have the effect of both increasing insulin sensitivity and decreasing blood glucose -- regardless of macronutrient profile

[sjg007]

The doctor though should be able to provide access to a clinical dietician to help think plan the diet and think through the implications. I imagine some chemo and targeted drugs could interfere with lipid metabolism and there is also a risk of acidosis. So I would ask the doctor. It will probably be a case of "we don't know" but diet is basically the one variable under your control besides listening to the doctor.

There's one paper on it from a completed clinical trial. https://www.ncbi.nlm.nih.gov/pubmed/27525031?dopt=Abstract

Also clinical trials using metaformin during cancer treatment. You might consider enrolling in one of these if it is feasible.

https://www.cancer.gov/about-cancer/treatment/clinical-trial...

[jcims]

Awesome suggestions thank you. I had to go to Care Oncology to get a metformin prescription which just arrived at the house today.

I tried going the A1C route to justify intervention but anemia and transfusions both push A1C low. I also just got a prescription for a Freestyle Libre to monitor blood glucose.

We’ve never got quite to the level of ketogenic but have tried focusing on fats and proteins for calories and keeping carbs between 50-100/day.