Cancer: disease of civilisation

Part 5: Cancers Are Sugar Junkies

If you search the Internet using the words 'cancer' and 'sugar', the name Otto Warburg will come up time after time.

It's now more than 70 years since Otto Warburg, Ph.D. won the 1931 Nobel Prize in medicine for discovering that cancer cells have a fundamentally different energy metabolism compared to healthy cells. The crux of his Nobel thesis was that malignant tumours frequently exhibit an increase in anaerobic metabolism compared to normal tissues. In other words, they don't like oxygen.[1]

The significance of this is that fat and ketone bodies as a source of energy require oxygen while glucose doesn't. And that in turn which means that cancer cells are dependent on glucose for growth. All cells can use glucose, but cancer cells consume as much as 4 or 5 times more than normal, healthy cells. In fact, cancer cells seem to have great difficulty surviving without glucose. A study carried out by Johns Hopkins researchers found evidence that some cancer cells are such incredible sugar junkies that they'll self-destruct when deprived of glucose.[2]

'The change when we took away glucose was dramatic,' said Dr Chi Van Dang, director of haematology . . . we knew very quickly that the cells we had altered to resemble cancers were dying off in large numbers . . . Scientists have long suspected that the cancer cells' heavy reliance on glucose — its main source of strength and vitality — could also be one of its great weaknesses.'

Normal body cells can use fat and ketone bodies derived from fats metabolised aerobically for energy. The waste products of the process are carbon dioxide and water which are excreted. The process by which cancer cells derive their energy is one of anaerobic fermentation of glucose with lactic acid as a waste product. The large amount of lactic acid produced is then transported to the liver where it is processed into glucose ensuring the cancer cells have a constant supply of energy.

This pathway for energy metabolism is very inefficient in that it extracts only about 5% of the available energy in the food supply and the body's calorie stores. The cancer is wasting energy, and the patient becomes tired and undernourished. This vicious cycle increases body wasting,[3] which is one reason some 40% of patients die from malnutrition (cachexia).[4]

In addition to being dependent on glucose, most tumours also have abnormalities in the number and function of their mitochondria.[5] These abnormalities prevent the tumour cells from using ketone bodies, which require functional mitochondria for their oxidation.

As cancers thrive on glucose, cancer therapies should encompass regulating blood-glucose levels. This is best done via diet, supplements, and non-oral solutions for those patients who lose their appetite, with the aim of starving the cancer and simultaneously bolstering immune function. Intravenous feeding, of course, should not use standard glucose-based formulae.

Can low-carb diets prevent cancer?

If cancers cannot survive without glucose, surely it follows that a low-carb, high-fat diet is likely to prevent a cancer starting in the first place. Just that piece of knowledge could stop all the heartbreak, pain and misery that cancer causes — not to say the huge cost to the NHS. I say low-carb, not low-sugar, because we must keep in mind that the body breaks down all dietary carbohydrates into glucose.

Two of the most common cancers are breast cancer which, incidentally, is not confined to women, and lung cancer. In the context of blood sugar and cancer risk, it may be significant that UK research suggests that people with coeliac disease — and who, as a consequence, don't eat wheat and other cereals — have only about one-third the risk of either of these cancers.[6] This adds more weight to the other evidence that it is carbs that increase cancer risk.

Furthermore, an epidemiological study in 21 modern countries in Europe, North America, and Asia, revealed that sugar intake is a strong risk factor that contributes to higher breast cancer rates, particularly in older women.[7] Another 4-year study at the National Institute of Public Health and Environmental Protection in the Netherlands found that cancer risk associated with the intake of sugars, independent of other energy sources, more than doubled for cancer patients.[8]

As cancers need glucose so much, cutting off the source of that energy is similar to cutting off the blood supply — though not quite as drastic for the rest of the body.

Cancer patients don't need carbs

One of the biggest obstacles to using sugar- and starch-reduced treatment in cancer patients in the past has been that it was generally believed that the brain couldn't function properly without glucose. But a study published in May 2003 showed that the brain can use ketone bodies made from fats just as other normal cells do.[9] It was also shown nearly 70 years ago that ATP, which is our body cells' real source of energy, is delivered from the liver to the brain by red blood cells.[10] So there is absolutely no need to worry about the brain being starved of energy if we cut carbohydrates out of the diet.

Ketogenic diet therapy of brain cancer

A low-carb, high-fat (ketogenic) diet may be the best way to attack brain cancers. Just like other body cells, normal brain cells can oxidise ketone bodies as well as glucose for energy. And, in a similar way to cancer cells in other parts of the body, brain tumours lack that metabolic flexibility and are largely dependent on glucose for energy.[11 - 17] Although some brain cancers do metabolise ketone bodies, we needn't worry about it as this metabolism is largely for synthesis of fats rather than for energy production.[18 - 19]

In a recent paper, Drs Thomas Seyfried and Purna Mukherjee of the Biology Department, Boston College, Chestnut Hill, Massachusetts, describe how new therapeutic approaches, which lower circulating glucose and elevate ketone bodies target brain tumours while enhancing the metabolic efficiency of normal brain cells.[20] They say:

'In addition to increasing ATP production while reducing oxygen consumption, ketone body metabolism can also reduce production of damaging free radicals. . . . The reduction of free radicals through ketone body metabolism will also reduce tissue inflammation provoked by reactive oxygen species. Thus, ketone bodies are not only a more efficient metabolic fuel than glucose, but also possess anti-inflammatory potential.

Discussing a trial published in 1995 of a low-carb, high-fat diet in patients with brain tumours, the two doctors go on the say that although radiation and chemotherapy had caused severe life threatening adverse effects to the patients, they responded remarkably well to the ketogenic diet and experienced long-term tumour management without further chemotherapy or radiation. Then came the bad news which was that, despite the logic of these studies and the dramatic findings, no further human studies or clinical trials had been conducted on the therapeutic efficacy of the ketogenic diet for brain cancer. Why not? Seyfried and Mukherjee say that:

'The reason . . . may reflect a preference of the major Brain Tumor Consortia for using "hand-me-down" drug therapies from other cancer studies rather than exploring more effective biological or non-chemotherapeutic approaches. This is unfortunate as our recent findings in brain tumor animal models show that the therapeutic potential of the restricted [ketogenic diet], . . . is likely to be greater than that for any current brain tumor chemotherapy.'

In other words, this potentially effective cancer therapy won't be used simply because it doesn't fit with current 'politically correct' medical thinking.

Carbs and cancer

Cancer patients and those wishing to avoid the disease don't need to cut out all foods that contain carbs. If care is taken the less concentrated carbohydrate foods may still be consumed.

Sugars are considerably worse than starches as far as damage to the immune system is concerned. There is also evidence that the same may apply in the case of cancer. A study of rats fed diets with equal amounts of calories from sugars or starches found the animals on the high-sugar diet developed more cases of breast cancer than those on the high-starch diet.[21] The Glycaemic Index (GI) can a useful tool in guiding the cancer patient toward a healthier diet, but it has flaws. It seems advisable that cancer patients should avoid not only all processed foods whatever their GI, but fresh foods with a GI over 40, and also all fruit. Fresh green leafy vegetables may be eaten freely and some of the starchier root vegetables with a low GI, such as carrot, may be eaten in moderation. Foods from animal sources, with their fat, which have a GI of zero, should, of course, form the basis of all meals.

Conclusion

The truth is that the more cancer research has focussed on a cure for existing disease, rather than its prevention, the less seems to have been achieved. Despite the countless billions that have been devoted to alleviating the suffering caused by cancer, we are no closer to a cure now in the first years of the twenty-first century than we were in the first years of the twentieth.

Isn't it about time we concentrated on prevention rather than cure? And to this end, the relatively unsophisticated research of the nineteenth century seems to be far more useful than all the very expensive research of the last 100 years put together.

It is beyond doubt that it is highly processed foods that are the major dietary cause of cancer, particularly as they are inevitably based on cheap concentrated carbohydrates. Most of these are the processed foods mentioned above, but some are those that are promoted today as 'healthy'. Specific examples of these will be discussed in later chapters.

In his book, Dr. Berglas emphasised that carcinogens in modern foods were not immediately harmful. 'As a rule', he wrote, 'a relatively long latency period of carcinogenesis, often lasting several years, is observed in man.' Using similar logic, if we revert to healthier practices today, it could still be many years before cancer is eradicated. But we have to start somewhere and the sooner we start, the sooner cancer will no longer blight our lives.

To fight any disease, surely it makes sense to remove anything that might support that disease. The point is that if you cut off a cancer's energy supply by reducing blood glucose levels to a bare minimum, cancer cells have been shown to slow their rate of growth, stop growing altogether or even die off — and critically, there are no adverse side effects whatsoever.

So, instead of spending billions of dollars, pounds and other currencies developing one form of toxic chemotherapy after another — which by and large don't work — why aren't we telling cancer patients: 'Stop eating sugar immediately'? And, as prevention in this case is definitely better than cure, why are we still telling people to eat large quantities of carbohydrate-rich foods?

The refusal of the cancer industry to consider further research into a low-carb, high-fat ketogenic diet as a treatment for brain cancer, reported by Drs Seyfried and Mukherjee, if true, is, I believe, utterly reprehensible. It should also be trialled in other cancers, particularly as the standard treatments for cancer have such an abysmally poor record.

Cancer Research UK's Mission Statement says that its 'vision is to conquer cancer through world-class research, aiming to control the disease within two generations', to 'carry out world-class research into the biology and causes of cancer' and 'to reduce the number of people. These might look to be laudable aims, yet they spend practically nothing on preventing cancer. They, like the rest of the 'health industry', seem to me to be more intent on keeping their jobs by ensuring they don't eliminate cancers and, thus, make themselves redundant.

There are 4 aspects of modern 'lifestyle' that increase the risk of a cancer. The first is a carb-based diet, the second is polyunsaturated vegetable oils and margarines, the third is a low blood cholesterol level the last is lack of sunshine. In other words, all the 'healthy' things we are advised to do increase cancer risk.

In his book, Cancer: Disease Of Civilization, Stefansson suggests the line to be followed in the 'fight against cancer':[22]

Learn how men formerly lived where diligent and competent search for generations has revealed little or no cancer.
On the frontier, pay heed to what the changes were that took place through the several decades which preceded the first detection of cancer, and to those changes which took place thereafter during the rise of cancer toward its present dread frequency.
Likewise, in our cities and rural communities, observe how those groups now live who are least afflicted by cancer, and how those live that are most afflicted.

Let's face it. Cancer doesn't look like being cured once it has affected someone. If we really are serious about defeating the scourge of cancer, the only real answer is to prevent it. And as there are (or at least were) many cultures in which cancer was completely absent, we could do a lot worse than to study them and their diets. Books such as Stefansson's Cancer and Dr Weston A Price's Nutrition and Physical Degeneration are invaluable in this respect. They should be required reading for all who profess to practise 'health'. In the meantime, the government and cancer charities should warn about the potential for the foods to cause or exacerbate cancers, rather than promoting them.

References

[1]. Warburg O. On the origin of cancer cells. Science 1956; 123: 309-14.
[2]. Proceedings of the National Academy of Sciences USA, 1998; 95: 1511-1516.
[3]. Rossi-Fanelli F, et al. Abnormal substrate metabolism and nutritional strategies in cancer management. J Parenter Enteral Nutr 1991; 15: 680-3.
[4]. Grant JP. Proper use and recognized role of TPN in the cancer patient. Nutrition 1990; 6 (4 Suppl): 6S-7S, 10S.
[5]. Pedersen PL. Tumor mitochondria and the bioenergetics of cancer cells. Prog Exp Tumor Res 1978, 22:190-274.
[6]. West J, Logan RF, Smith CJ, et al. Malignancy and mortality in people with coeliac disease: population based cohort study. BMJ 2004; 329: 716-9.
[7]. Seeley S. Diet and breast cancer: the possible connection with sugar consumption. Med Hyp 1983; 11: 319-27.
[8]. Moerman CJ, et al. Dietary sugar intake in the aetiology of biliary tract cancer. Int J Epidemiol 1993; 22: 207-14.
[9]. Takenaka T, et al. Fatty acids as an energy source for the operation of axoplasmic transport. Brain Res 2003; 972, 1-2: 38-43.
[10]. Hockerts T, Hingerty D. Medizinische 1937; 289. Cited by Werner E. Mschr f Kinderheilk 1960; 1: 5.
[11]. Roslin M, et al. Baseline levels of glucose metabolites, glutamate and glycerol in malignant glioma assessed by stereotactic microdialysis. J Neurooncol 2003; 61: 151-160.
[12]. Oudard S, et al. Gliomas are driven by glycolysis: putative roles of hexokinase, oxidative phosphorylation and mitochondrial ultrastructure. Anticancer Res 1997; 17: 1903-1911.
13]. Nagamatsu S, et al. Rat C6 glioma cell growth is related to glucose transport and metabolism. Biochem J 1996; 319: 477-482.
[14]. Mies G, et al. Relationship between of blood flow, glucose metabolism, protein synthesis, glucose and ATP content in experimentally-induced glioma (RG1 2.2) of rat brain. J Neurooncol 1990; 9: 17-28.
[15]. Floridi A, et al. Modulation of glycolysis in neuroepithelial tumors. J Neurosurg Sci 1989; 33: 55-64.
[16]. Galarraga J, et al. Glucose metabolism in human gliomas: correspondence of in situ and in vitro metabolic rates and altered energy metabolism. Metab Brain Dis 1986; 1:279-291.
[17]. Rhodes CG, et al. In vivo disturbance of the oxidative metabolism of glucose in human cerebral gliomas. Ann Neurol 1983; 14: 614-626.
[18]. Patel MS, et al. Ketone-body metabolism in glioma and neuroblastoma cells. Proc Natl Acad Sci USA 1981; 78: 7214-7218.
[19]. Roeder LM, et al. Utilization of ketone bodies and glucose by established neural cell lines. J Neurosci Res 1982; 8: 671-682.
[20]. Seyfried TN, Mukherjee P. Targeting energy metabolism in brain cancer: review and hypothesis. Nutr Metab 2005; 2: 30.
[21]. Hoehn SK, et al. Complex versus simple carbohydrates and mammary tumors in mice. Nutr Cancer 1979; 1: 27.
[22]. Stefansson V. Cancer: Disease Of Civilization? American Book-Stratford Press, Inc, 1960. pp 163-4

Part 1; Part 2; Part 3; Part 4: Part 5

Last updated 1 August 2008

"One must attend in medical practice not primarily to plausible theories but to experience combined with reason." Hippocrates

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