Cancer as a Metabolic Disease: On the Origin, Management, and Prevention of Cancer
By Thomas N. Seyfried
The first question cancer victims may ask is, “Why did I get cancer?” The answer is usually sympathetic silence. There is still no concrete answer. In the U.S., cancer is becoming the number-one cause of death. Researchers are far from finding a cure, despite the War on Cancer and billions of dollars of research money poured into labs around the country since 1971. The majority of cancer deaths (90 percent) are the result of metastasis, or spread of cancer, yet most research does not involve metastasis and much of what is known comes from cells that have more in common with non-cancerous tumors than with metastatic ones.
In his groundbreaking book, Cancer as a Metabolic Disease, which is supported by evidence from more than one thousand scientific and clinical studies, Thomas Seyfried, PhD, explains the ins and outs of cancer development, how it metastasizes, where it goes and why. Dr. Seyfried is a professor of biology at Boston College who has conducted research on such topics as gene-environment interactions, lipid biochemistry, neurodegeneration, and cancer and metabolism—the focus of this book. Seyfried demonstrates that cancer is best defined as a mitochondrial metabolic disease and, more importantly, that more effective prevention and management of cancer is possible. His concepts have noteworthy implications for the development of new non-toxic cancer therapies.
For many years, the leading dogma surrounding cancer—which persists largely without modification—explains cancer as “cells gone wild” due to genetic mutations. This “somatic mutation theory” seeks to identify and treat every random genetic aberration that occurs in cancer cells. The main result of this research are ineffective medications that generate dangerous side effects.
Dr. Seyfried unmasks and unravels the mystery at the heart of the “Big C” and argues that cancer is a disease of defective metabolism. From this perspective, the genetic mutations observed in cancer are a side effect rather than the cause. Seyfried provides detailed evidence that the traditional view of cancer as a genetic disease has been responsible for the failure to develop preventive strategies and effective therapies that can save lives. Seyfried reevaluates the origins of cancer based on the latest research findings as well as several decades of studies exploring the defects in tumor cell energy metabolism. Approaching cancer as a metabolic disease, Seyfried argues, can lead to better understanding and management of all aspects of the disease, including inflammation, vascularization, cell death, drug resistance and genomic instability.
The dysfunction in metabolism that leads to cancer happens in the energy-making equipment in the mitochondria in our cells, which fails for a number of reasons. Ordinarily, when cells divide and make more cells, the new versions have all the parts that the original cells did, including the same chromosomes and DNA arrangements. When not enough energy is available to complete the cell division process, however, the new cell can become defective and abnormal. The mutated cell may contain any number of chromosomes, which could be more or less than the required thirty-two pairs of specifically organized chromosomes. This abnormal cell is mostly unable to use the oxidative phosphorylation pathway, which produces the lion’s share of a normal cell’s energy requirements. Instead the damaged cell undergoes glycolysis (the metabolic breakdown of glucose) without oxygen, in essence using fermentation to produce a smaller amount of energy. This process is called the Warburg Effect, named after Otto Warburg, a German scientist who won the Nobel Prize in physiology and medicine in 1931. (Dr. Warburg would have received a second Nobel Prize in 1944 for his work with B vitamins, had Hitler not decreed that no German citizen could accept the prize.)
The cancer cell is continually on a quest for more and more energy, which it finds by gobbling up glucose so that it can maintain and reproduce abnormal cells like itself, sometimes at a rapid pace, eventually forming a tumor. Cancer cells basically dine on high amounts of glucose in the blood; the more glucose in the blood, the more food the cancer cells have. Seyfried delves into new treatment strategies that target tumor cell energy metabolism, including the ketogenic diet. The diet’s main principle is that a diet high in fat and low in protein and carbohydrates will produce ketones, which cancer cells cannot use, thus hastening cancer cell death. In other words, a diet low in sugars and starches will reduce the amount of glucose available to fuel cancer cells. (Note that proteins—and not just carbs—can produce glucose through a process called gluconeogenesis.)
It is possible to test ketone levels in the blood using a ketone meter, which can also test glucose. Urine strips and a breath meter also can test ketone levels. Nutritional ketosis is defined as ketone levels ranging from 0.5 to 3.0 millimoles per liter (mmol/L). When levels are in the nutritional ketosis range, glucose levels will be low. On the other hand, diabetic ketoacidosis, a complication of type 1 diabetes, is characterized by ketone levels of 8 mmol/L and higher, in addition to elevated glucose levels. A good website to consult regarding the ketogenic diet (including recipes and additional information) is dietdoctor.com.
Normally the body has mechanisms to destroy defective cells, and it does so daily. With cancer, the energy source is compromised and the process of apoptosis (programmed cell death) does not function. Cancer cells thus have an unlimited ability to keep replicating, which only stops when the host dies. In fact, most cancer cells used for modern cancer research come from a woman named Henrietta Lacks, whose cells (called HeLa cells) have continued to replicate since her death in 1951. The Immortal Life of Henrietta Lacks, a book by Rebecca Skloot, traces the fascinating history of Henrietta and her cancer cells.
Chapters 17-20 in Cancer as a Metabolic Disease are the most consumer-friendly, offering practical information about strategies to prevent and deal with cancer. Seyfried discusses diet, lifestyle, the role of insulin as a prime driver in cancer formation, and other major components of prevention and treatment—the ketogenic diet, ketones, glucose, insulin, caloric restriction (energy reduction), intermittent fasting, glutamine, hyperbaric oxygen treatment, and metformin, a medication used for glucose management. (Clinical trials have found that the natural supplement berberine is even more effective than metformin, with no side effects.)
The book benefits from its inclusion of case studies and physician, patient and caregiver points of view. Readers learn about real-life patients and families who share their results with the ketogenic diet. The nutritionist Miriam Kalamian treated her son Raffi with the ketogenic diet and wrote a forthcoming book with a foreword by Seyfried called Keto for Cancer: Ketogenic Metabolic Therapy as a Targeted Nutritional Strategy (Chelsea Green, October 2017). Seyfried’s book also inspired Travis Christofferson to write Tripping over the Truth: How the Metabolic Theory of Cancer Is Overturning One of Medicine’s Most Entrenched Paradigms (Chelsea Green, 2017). A summary of Christofferson’s book is available free for those who subscribe to Kindle Unlimited or for purchase at Amazon.
Cancer as a Metabolic Disease is essential reading for cancer researchers, clinicians, health and public health professionals and the science-mindedgeneral public—anyone interested in a more promising path to understand the origins of cancer and develop more effective strategies to treat and prevent it. The print version is a bit pricey (roughly $96 on Amazon for purchase or about $54 to rent). I obtained it at my local library through an interlibrary loan (at no cost). Readers also can elect to read the first two chapters free and view the table of contents and index at Amazon. A 2010 paper by Dr. Seyfried and biologist Laura M. Shelton, published under the same name as the book (“Cancer as a Metabolic Disease”), is available online for free in the open access journal, Nutrition and Metabolism (http://bit.ly/2gjhpFS). Finally, a one-hour presentation by Dr. Seyfried for the Florida Institute for Human & Machine Cognition (IHMC) Evening Lecture Series is available on YouTube (http://bit.ly/2emiMPE) and has received over one hundred thousand views.
I give this book a strong thumbs-UP. I highly recommend it for everyone who is curious and wants to take a big bite into the metabolic theory of cancer.
This article appeared in Wise Traditions in Food, Farming and the Healing Arts, the quarterly magazine of the Weston A. Price Foundation, Fall 2017.