Dramatic Regression of Metastatic Lesions Following Alkalization Therapy in Pancreatic Cancer: A Case Series

Shion Kachi; Kazuyuki Suzuki; Reo Hamaguchi; Ryoko Narui; Hiromasa Morikawa; Toshihiro Okamoto; Hiromi Wada

Abstract

Background: Pancreatic ductal adenocarcinoma (PDAC) is characterized by rapid progression and poor prognosis, particularly in clinical stage IV disease. A hallmark of cancer metabolism, known as the Warburg effect, involves the production of lactic acid even under aerobic conditions, resulting in acidification of the tumor microenvironment. This acidic environment is associated with tumor progression and resistance to conventional therapies. Alkalinization therapy, including dietary modifications aimed at reducing the potential renal acid load (PRAL), seeks to counteract tumor acidity and modulate the tumor microenvironment. Case Description: Alkalinization therapy was administered to four patients with metastatic pancreatic cancer. The intervention consisted primarily of PRAL-reducing dietary modifications and oral supplementation with bicarbonate or citrate salts. The aim was to increase urinary pH and counteract tumor acidity. In all four cases, therapy was associated with marked regression of metastatic lesions. Conclusions: These findings suggest that alkalinization therapy may play a supportive role in the management of metastatic pancreatic cancer by altering the tumor microenvironment. Further clinical investigations are warranted to elucidate its therapeutic potential and underlying mechanisms.

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