An Old Idea, Revived: Starve Cancer to Death

May 15, 2016 · 120 comments
EV (Virginia)
Cutting sugar out of a diet is certainly a good thing to do, but if the goal is to avoid insulin sensitivity in the first place, then cutting out saturated fats and animal proteins is far more important, as it these foods that are most closely associated with insulin response. Sugar spikes in the blood are a symptom of fat in the cells inhibiting proper metabolism, something that is well known to science but for some reason is ignored by MD's and a carbophobic public intent on finding any reason to keep eating their steaks and saturated fat laden "healthy" chicken breasts. Maybe this explains why Asian populations that consume far less animal products have dramatically lower cancer rates.
Tourist (upstate New York)
Thought-provoking article which I've sent on to quite a few folks already. My brother, a holistic chiropractor, always said "you are what you eat". He, and his family, ate out of their own garden as much as possible. They also used plant-based herbal remedies for common maladies. None of them got ill other than an occasional sniffle. Books like Sugar Blues helped to inform him back in the seventies so this article would just represent common sense to him, and an ongoing repression of knowledge from the powers that be. Wherever possible, he lived off the grid - back to the earth.
Lisa Woods (London)
The SAD (Standard American Diet) is killing us. I few up in the 80s and 90s before being vegetarian was hip. As an African American, it was totally uncool to eat that way. But as Seventh Day Adventists, we were taught that eating poorly does cause cancer (in the early 1900s) and that changing ones diet could help reverse the course of illness. In America there is a place called the "Blue Zone" -- where people live past there 90s in healthy condition. It's been featured on several major news outlets. These people abstain from meats, dairy, and to a large degree sugar. I hope that Americans can change their ways. I've seen too much needless suffering, expensive cancer treatments, and people's quality of life stolen away by morbid obesity & type II diabetes. All of this truly is preventable, but the Sugar and Food industry, like Big Tobacco will exert all of its lobbying influence to keep America obese, cancer-prone, diabetic and pharmaceutical dependent.
jazz one (wisconsin)
I should have been a doctor! "Dr. Watson takes metforim for cancer prevention." Gee, I'd like to too, as well as enjoy the benefits of lower insulin, etc., as age and other factors make that more challenging. But, unlikely I'll get a script for that from any doctor I know. And then there's insurance.
Then again, I really should have been a doctor (had I been smart enough) so I could have a handy and always current stash of personal end-of-life meds.
paul m (boston ma)
Fasting ? Low sugar diets ? No money there , no need for specialization and hyper microscopic data discovery, therefore contemporary medical professionals will do all in their power to deny its validity - my sister received radiation therapy for a chest cancer that burned a whole in her spine and disabled her - instead of zapping her for thousands of dollars , they should have sent her home to fast and otherwise to eat a sugar free diet but no money in that - oh these well mannered professionals all said that they showed great caution and conservative diagnosis and application in the radiation therapy (after many bouts of chemo) and that the burn should not have happened (they first denied the radiation could have caused it) , but now they all return to their condos and Porches , and my sister lives with her disability - may this information on non radiation non chemo non surgery against cancer go far and wide to the decimation of the for profit cancer 'treatment' mega business
Tom Wyrick (Missouri, USA)
According to the research presented in the article, systematically consuming more food than our body needs poses negative consequences for our health. In other words, the human body evolved to consume in moderation, and nature weeds out the gluttons in order to maintain the species in 'fighting condition.'

If that view is true, then nature would treat other species that persistently over-eat in much the same way. For example, cows, hogs and chickens kept in feeder pens and given all they can eat should eventually develop cancers -- if they weren't slaughtered before living long enough to experience the ill effects of their diets.

For religious people who don't believe in evolution, the findings reported in the article suggest that God means to rid us of gluttons -- if our social policies (food and health subsidies) don't get in His way.
Miss Ley (New York)
About the same time that Otto Warburg was making an important scientific breakthrough, an American graduated from Bryn Mawr in 1909 and took up the study of sea urchins. Ethel Browne (later Harvey) from Baltimore became a notable scientist before she had the right to vote.

She apparently should have won a prestigious award and it became a source of controversy between a panel of scientists at the time. I never met her, nor my maternal grandfather, one of her two brothers. She died in 1965 of a ruptured appendix.

She went down in history as one of the notable American women of the 20th century but her work on stem cell research has been forgotten.
Maurie Beck (Reseda, CA)
This article emphathizes the association between cellular metabolism of cancer. Notice how I said "association". An association is the basis of correlation between 2 or more phenomena. As most people know, correlation does not establish causation.

The proposed hypothesis is that cancer is fundamentally a metabolic disease; that altered cellular metabolism causes cancer. However, an alternate hypothesis is that cancer (i.e., uncontrolled cellular proliferation) is the cause of altered metabolism, not the effect caused by metabolic dysfunction.

In favor of the alternate hypothesis that cancer causes changes in cellular metabolism is that cell replication is a very expensive process. The way to pay for the added expense is for cells to either become more efficient in energy use or to alter metabolism to supply that extra energy.

I'm not promoting 1 hypothesis over another. In fact, cancer implies an inextricable link between cell division and metabolism. Biology is all about feedback loops, not either or.
Edward Watson (Minneapolis)
this thought, " if he could identify the mutations that lead a cell to eat more glucose than it should, it would go a long way toward explaining how the Warburg effect and cancer begin" - reflects the limited thinking exemplified by most researchers. There are several physiological and physical conditions (literally around the space of cells, tissues) which directly hamper cellular respiration. The limited thinking frames problems of respiration/physiology and cancer as a one way controlled process, e.g. "inaccurate cell division" (see graphic on page 44 of this issue). For example, Thompson the researcher thinks the road toward a cell's increased fermentation *results sometimes from a mutation *. Ignoring the conditions of the blood‘s zeta potential among CONDITIONS of the environment around cells/tissues is paramount - and 101 fundamental - for understanding how "top down" pressure alters not only the function of cells, but there structure. Known changes of the environment *around* cells indisputably alter gene expression. Thus you have just read a short description that a two way street exists and why most modern cancer researchers fail to understand the greater picture. This is why monotherapeutic drug treatments often fail for treating Alzheimer's for example. Warburg and others in the past saw the body more clearly as a metabolic system ... which is why Warburg himself was able to conceive his hypothesis in the first place.
Ai Ki (Right Here)
and what are you contributions to science or medicine (apart from criticizing others)?
Catherine (San Diego)
"In 1953, James Watson and Francis Crick pieced together the structure of the DNA molecule ..."
and Rosalind Franklin, of course. Although Dr Franklin missed out on receiving the Nobel prize due to her untimely death, there is no reason to further the erasure of her name from one of the most important discoveries of the 20th century.
Echo (Rochester NY)
Thank you, thank you for pointing this out! I thought the same thing -- yet another missed opportunity to credit Rosalind Franklin, in what will undoubtedly be a widely-read article.
Arnab Sarkar (NYC)
A great read on the theory and validation of theories by experimentation. The dedication of Mr. Warburg in spite of difficulties is admirable. His work inspires students across the World towards working relentlessly to solve tough scientific problems.
Richard57 (Texas)
Nice article. In Life magazine's August 1980 issue, a Dr with bone cancer wrote about being ostracized. He picked up a hitchhiker, a hippie, who said he had a cure, a macrobiotic diet...after two years on the low protein diet he was cured. Harvard performed a study in 1989-3 diets with varied protein for cancer patients--spectacular remission rates for macro diet...Response from american medicine? ignored. First symptom of cancer-loss of appetite. you cannot make money off diet cures or quick cures...where is that Cuban vaccine for lung cancer? not reported in the NYT?huh, not important i guess. Western medicine is big business. PLEASE VOTE!
Tourist (upstate New York)
There is a book, Recalled by Life written by Anthony J. Sattilaro, who was the MD/CEO of the Methodist Hospital in Philadelphia. I believe him to be the same individual as referred to in the Life magazine article. The book was just grounded in this mans' facts which spoke for themselves. He wasn't 'hawking' any product. Very inspirational on many levels. Definitely helped to convince me that 'you are what you eat' often times.
Samer Mattar (Portland, OR)
Excellent article that highlights the central carcinogenic role of altered metabolics. It helps explain the observed phenomenon linking insulin resistance, diabetes, and obesity to the elevated incidence of cancers that continue to plague us.
Boot (Dice)
Exactly why we need more women in Science. Women tend to be much better multitaskers whereas men are good at focusing on one task (idea) at a time. Just because a new idea like gene therapy appears, there should be no reason to completely dismiss another idea like Warburg's mutated cell energy disrupting theory. The dismissal of William Coley's cancer fighting Immunotherapy treatments in the 1800's when radiation therapy appeared in the early 1900's is another example. Maybe if we don't have to wait for the single-focus opponents of a competing idea to die but, rather, allow for a number of ideas to coexist we can find patterns and solutions more quickly.
Dallee (Florida)
Always thought this theory made a great deal of sense -- the increased cell growth in cancer requires extra energy, after all.

It would be interesting if a scientist took a look at the reported increased incidence of cancer after bariatric surgery -- which is often accompanied by decreased food consumption and specialized nutritional cocktails immediately after surgery and thereafter, which would jar a metabolism's normal operation.
Suzanne (Denver)
Cows treated with Monsanto's bovine somatotropin make much more milk than normal cows. And, their milk contains elevated levels of IGF-1. Just sayin'.
Detlef Diesing (Germany)
A nice article. The author successfully reveals the intricate pathways of scientific development.
Trisha (Delhi)
In alternative medicine, fasting on a regular basis is recommended for preventing and treating a host of diseases. The idea is to not feed the disease, especially after you know it's taken root. Of course, the trick is to not weaken yourself too much during the starvation process. But theoretically, it is entirely plausible that if you can shut down the supply of resources adequately, the disease will die before you do.
It's always incredible to me how littleof mainstream treatment comes with any serious diet related prescription.
Warburg's story has a certain malicious ring to it. His research would have eventually led the science down a range of lifestyle and nutrition based research on cancer. Which might have been bad news for those in the business of engineering chemicals to treat diseases.
Anyway, great read!
Max (West of the MIssissippi)
As a newly diagnosed 62 year old with a "tiny" amount of colon cancer, this greatly interests me. I've been off sugar (other than from fruit), flour and processed foods for 5 years trying to stave off diabetes and maintain all-around good health with a healthy weight. The past year I've been a vegetarian and with the diagnosis went all the way and am now vegan. It was a little disappointing to get the news about the cancer but I remain optimistic with a positive mental attitude. I think a PMA needs to be employed in the effort to stay healthy, cancer diagnosis or not.
Soledad Miranda-Rottmann (Montreal)
A pleasure to read well done scientific journalism. the idea of metabolism and cancer may have been almost forgotten in research circles but it was alive and kicking in the alternative medicine circles with endless fraudulent treatments claiming to cure cancer by starve tumors with a diet without sugar. http://naturalsociety.com/starving-cancer-death-removing.../
Mary Stromquist (Florence, OR)
Back in the 80's, prompted by the deaths of several co-workers who contracted cancer, I read vociferously what was available, including heterodox theories. This one was not infrequently mentioned. Not being scientists, I...and others...had no means of verification, so we experimented on our own. Our anecdotal data/experience molded the behaviors of many of us.

We humans fall in love with the new, the exciting. The Human Genome project's results were anticipated as the be-all-and-end-all of health issues....until it wasn't. But that didn't stop us from putting the majority of our efforts into genetic solutions, with results occasionally positive, often, meh.

Personally, I cling to the statements (have no idea where I saw them so cannot attribute, but I did not create them) "Keep an open mind. Just not so open your brains fall out."
jtolisano (Willow, NY)
Cancer hospitals and research centers tout their passionate commitment to finding innovative solutions to the big "C". But, my experience watching the most significant person in my life slowly fade into eternity inside one of these institutions led me to feel there is really very little creativity in play. This article is a very important kick in the right direction. Business as usual (cut-poison-burn) is helping some people hang on a bit longer than they might otherwise have done. But, ignoring basic cellular functions seems almost too obvious. Let's hope this conversation can move the obvious back into the mainstream.
Richard Spring (Boca Raton, Florida)
Do diabetics have a higher incidence of CANCER?
Tom Storm (Australia)
Superb work. Wisdom and insight from the past - may we not be so arrogant to assume our forbearers were brick thick troglodites.
Gazbo (NYC)
Sugar is a drug that should be used sparingly. It is responsible for more deaths and illness than all illegal narcotics combined. As a nation we are addicted to it. Please thank the sugar lobby for keeping it a mainstay in most of our foods.
Portia2708 (Reading, PA)
The world lost so very much due to our stupid wars and the genius of so many German/Jewish scientists that would probably have changed our world in positive ways today.
John Chitty (Boulder CO)
Recommend "Tripping Over the Truth: The Return of the Metabolic Theory of Cancer Illuminates a New and Hopeful Path to a Cure" by Travis Christofferson.
Mo (Redmond)
This could very well be the 'cure' to cancer - eat healthy - no sugar, get exercise plenty of water - to flush the body of toxins through sweating and aerate your cells.

Too bad big pharma can't make any money via this approach.
JC (Beaverton, Oregon)
I felt very odd that the word "ego" used twice in the article. In fact, the "rediscovery" of this work was most likely caused by the ego of many other scientists promoting their own theories. I felt that he was judged because he stayed.
We are only human and scientists are definitely not "pure". They tend to form their own "special interest groups". These groups control fundings and publications in many top notch journals. Ironically, when NYT report some of their works (such as the synthetic genome), we didn't read about the "track record" of those people.
There were at least two major impacts on the business side of the "rediscovery". (1) molecular diagnosis of cancer is becoming a BIG business. However, It is likely that scientists are barking at the wrong tree! (2) a pill already available may reduce the risk of cancer.
I am afraid that a few special interest groups will try hard to "bury" the theory!
Entropic Decline (NYC)
Cancer loves sugar. How many other potential treatments have been blacklisted because they are not part of the sacred troika of surgery, radiation, and chemotherapy?
ED (Charlottesville, VA)
Interesting anecdote: my friend's mother-in-law was given a diagnosis of advanced ovarian cancer 35 years ago. A single mom of a 10-year-old boy, she was given a matter of months to live. She undertook a protocol (alternative medicine? self-created? I have no idea) to beat the cancer and is alive and well 35 years later. Her protocol? Her daughter-in-law said that she "basically stopped eating for two years." I've never quizzed her, but I think that she really only ate vegetables and ingested no carbohydrates in any form. Her approach, as well as the ideas in this article, are consistent with the methodology contained in the book "Anticancer: A New Way of Life," a good read that I give to anyone I know who is diagnosed with cancer.
Jed Maitland-Carter (Toronto/New Jersey)
With this scenario about interrupting the energy input into the cancer metabolism as a pathway to eradicating the cancer by starving it, the lack of appetite in patients from chemo and radiation may need to seen not just as a side effect but may be the ultimate source of remission.
It may be possible to move away from chemo and radiation, which have immune system suppression side effects, as primary front line treatments. We may see appetite suppression as a first choice treatment, using whatever alternate methods can be brought to bear.
Ai Ki (Right Here)
oh lord, so wrong on so many levels.
dennis willows (Friday Harbor, WA)
The thing I especially like about this piece is the tortuous path it takes to get from things "we didn't know, we didn't know" to fertile ideas that may actually lead out of the weeds. Recognizing the linkage between Boveri's and Warburg's discoveries would never have been picked up by a study section at NIH or NSF had they existed at the time. Progress seems to take very smart, sometimes difficult individuals, curiosity, competition, and insane amounts of work. And sea urchins.
Daydreamer (Philly)
What greatly concerns me is the fact that Warburg's theory was so easily dismissed. Is it any surprise that Robert Weinberg is "cool to certain aspects of the cancer-metabolism revival"? He pioneered the discovery of cancer-causing genes. Thousands of women have had their breasts removed in advance of a cancer diagnosis because they had such genes. Oops. We've known for 15 - 20 years that cancer research is stuck, and perhaps wrongheaded. It’s time to shift gears. Whether cancer-metabolism research yields enormous advancements or not doesn’t matter. What does matter is finding out quickly. Think of it as the Manhattan Project, where an atomic bomb was built from scratch in the early 1940’s in less than 3 years. We need that level of effort to make real headway against cancer. 1500 people die in America alone every single day. Please don’t preach to me about how rushing through cancer research can be dangerous to people. Researchers and doctors are dangerous as we speak using the slow-and-steady method. Chop chop! Let’s go. Start treating cancer as an emergency.
Jon Harrison (Poultney, VT)
Fascinating article indeed.

Let me suggest that the author (or someone else) also look into a cancer treatment that, though unorthodox, proved highly effective in the early 20th century. This consisted of inducing severe infections in patients with inoperable cancer. In a surprisingly high percentage of cases, the patient's immune system cured both the infection and the cancer. Given the contemporary interest in immunotherapy for treating cancer, these old cases ought to be reviewed.
Rodrian Roadeye (Pottsville,PA)
Wow So we are back to square one. I had read with interest that depriving cancer cells of oxygen might halt them. Then I read that sugar fuels obesity and cancer. Now we are examining the role of cancer cells reproducing without oxygen by utilizing insulin, and the possibility that if you deprive them of that they may use fat. Which makes sense because fat and sugar, especially simple carbs, are so easy to break down for energy. In a roundabout way, there really is nothing new and exciting here. Cancer cells depend on the same things that normal cells do. They need fuel in the form of oxygen, fat, and sugar. Next we'll find out that they can also use protein which is harder to break down. In the end it is a killer disease that has so many ways to do it's job and there is no one solution fits all. Joe Jackson was right... "Everything gives you cancer."
https://www.youtube.com/watch?v=WsQyru5ACmA
NS (NC)
Protein is not harder to break down. In fact after sugars, cancer cells would go to proteins, because of their conversion to glucose through gluconeogenesis. It is fats that are much less likely to be used in fermentation. The comment in the article about fatty acids being a potential source of energy for fermentation in cancer cells was just a wild speculation.
MH (NY)
Unmentioned is the hint that inflammation, as a higher cellular energy state, is reduced by medications such as aspirin (acetalsalicylic acid)-- chronic consumption of aspirin to reduce cardiac risk is correlated to a reduced incidence of some cancers such as colorectal.
Jamespb4 (Canton)
I liked the way the author intertwined the personalities of the researchers with the research. Having had (and may still have) prostate cancer (surgery), it will be a remarkable time when medical research finds a cure to cancer, and Alzheimers.
I wish we could take maybe just $100 billion out of the $1 trillion military/defense/war budget and redirect it to finding a cure for cancer. Most of us will will be killed by cancer, not by ISIS. Terrorists don't scare me in the least. Cancer and Alzheimers do. Can you imagine what the $1 trillion we spent in Iraq could have accomplished in a NASA-like program to find a cure for some of the diseases that currently plague us.
Lily Quinones (Binghamton, NY)
This an important article. I just hope that in influences people into looking at their diet as a possible source of eventual cancer. Thank you!
Stan (Mansfield, OH)
German research scientist Dr Johanna Budwig used the principle of the Warburg effect in designing her cancer treatment protocol, which is not toxic to healthy cells. It actually has proven very successful for many patients.
Communal Award (Tokyo)
Dennis Embry"as (Tucson, AZ)
As a scientist and a cancer survivor, this makes much sense.
Tim (Tappan, NY)
I can't argue the merits of this story, but I can tell you that I'm personally running out of time. I read and watch, bemused, of the next great cancer cure, usually never to hear about it again. And this, to me, is another in a long line of "we're going to cure cancer" stories. Well... I hope so. The clock is ticking.
Stephen Kimura (Santa Barbara)
Cool
Tom (Wild)
It's interesting that the concept of linking diet to cancer was explored that long ago. After reading The China Study, I've come to believe there is probably a strong link. Thanks for the article.
Richard (Honolulu)
I have prostate cancer. In recent years, Metformin has emerged as one of the most promising drugs for decreasing mortality. As reported in the Journal of Clinical Oncology, a study of 3,837 men with diabetes after being diagnosed with prostate cancer, revealed that men who took Metformin showed a 24% decrease in dying of that cancer! Clinical trials are now being conducted to determine whether men without diabetes showed the same results. Yes, ol' Otto might really have been on to something!!! We're hoping!
Paul Spencer (Connecticut)
Does this mean that a Ketogenic/Atkins diet might actually be a cancer deterrent?
Margaret (Brooklyn)
Many cancer patients are now pursuing a ketogenic diet.
EV (Virginia)
Not necessarily. Saturated fat found in meat is one of the causes of insulin sensitivity which causes high blood sugar. Cutting off sugar cures the symptom, not the cause.
Carlotta Tyler (Salem, Ma)
In the article about starving cancer it is stated that "James Watson and Francis Crick pieced together the structure of the DNA molecule" It is important to include attribution to the British woman scientist whose research defined the DNA double helix structure, research known to Watson & Frick. Not a minor point, this exclusion is at the core of how women's talents are made invisible.
Niamey Wilson MD (Hartford, CT)
Excellent article, brings to light the idea that glucose metabolism is connected to carcinogenesis. There are several upcoming studies evaluating the role of metformin in breast cancer incidence, which certainly has some biological plausibility as per the Warburg effect. Many of my patients ask about eliminating sugar from their diets as a way to combat their breast cancer; these discussions will now become ever more intricate as more of these studies are published.
Kat (Kentucky)
How fascinating! This could explain so much, why cancer patients lose weight (to starve cancer cells?), why alcohol, fat and being overweight dramatically increase the likelihood of cancer, I could go on and I'm sure the researchers cited here will continue to do so.
Derek Davis (Rural NY)
In 1984 Michio Kushi and Alex Jack published "The Cancer Prevention Diet", followed up in 2009 with the Revised and Updated 25th Anniversary Edition. Quoting the International Agency for Research in Cancer they state: "Eighty to ninety percent of human cancer is determined environmentally and thus theoretically avoidable.These include the modern diet high in animal products and low in whole grains, fresh fruits, and vegetables; excessive exposure to sunlight, workplace hazards, pollution, toxic products; artificial electromagnetic radiation; and exposure to medical procedures and pharmaceuticals." The authors then offer this observation by Dr Robert Sharpe: "In our culture, treating disease is enormously profitable...(T)he market in cancer therapies in the United States, Europe, and Japan makes tens of billions of dollars profit annually...(P)reventing the disease benefits no one except the patient. Just as the drug industry thrives on the 'pill for every ill' mentality, so many of the leading medical charities are financially sustained by the dream of a miracle cure, just around the corner."
So knowing this, why would we push Metformin rather than addressing the cause of the increased levels of insulin due to the choices of an unhealthy and globally unsustainable diet and lifestyle?
Harold (Winter Park, FL)
Excellent article, especially for those of us who have survived cancer. One of my doctors stated to me once that "cancers love sugar". One of the tests I underwent was designed to find 'hot spots' that indicated that cells were consuming inordinate amounts of sugar.

So, I have reduced my consumption to only what I get from fruits and other unavoidable sources. Hope it helps.
Anita Ung (Illinois)
A truly well written synthesis, with strong implications for everyday life. Given that cancer development and growth are encouraged by high levels of glucose and insulin, each person's food/drink/exercise choices make a huge difference in their risk of developing cancer.

I would be curious to know whether intermittent fasting/calorie deficit lowers cancers risk, by lowering general glucose/insulin availability, thereby slowing any precancerous cells metabolically and allowing immune mechanisms more time to wipe out precancerous lesions while they are relatively dormant.
Bill (Toronto)
Thank you. Please continue to follow up on this development.

I really wish a section could have considered another component - that whole plant based nutrition is a non drug approach to starving cancer.

Animal proteins have a pivotal role in triggering the cell's glucose binging process. Plant based protein does not.

The plant based nutrition approach has completely transformed my health.
And it is financially viable for our entire species.
Gary Z (St Paul)
I wonder if this overlooked approach somehow is within the emerging treatment of certain cancers using the patients own immune system to fight cancer
Edward Watson (Minneapolis)
That was covered when it another article in this issue on Andrew ... the boy whose family refused a 2nd transplant. Explicitly ... the purpose of the transplant is to get one's own T cells to take over the elimination of cancer cells.
Charles Callaghan (Pennsylvania)
This is an excellent story and accolades go to the writers for the explanation of the concepts used to discuss the importance of research for cancer with its relationship to overall health. As one diagnosed with both diabetes and melanoma this feels right as an explanation to the daily challenges of living a healthy life. This story coupled with the importance of maintaining a healthy diet and controlling weight is useful to the daily concerns of physical self and mostly it explains how many involved in cancer research attempt in the test tube environment to understand the daily challenge of a human life. It is a well defined story, Thank you, CC
Jay (Norwich, VT)
This is very well known now in the cancer literature and it is all well and good but this represents one fraction of one type of cancer. It's a bit more difficult applying this approach to all cancers especially cancers that do not rely on IDH. Starving cancer to death will work in some cases but it will also likely lead to starving the whole body to death.
Mike (San Diego)
“The book that my students have to use for their cancer biology course has no mention of cancer metabolism.”

I'm just a lowly BS Zoology degree holder but - WOW!

Absence of metabolic study is freely admitted by a teaching professional? Almost sounds like a brag. Is it possible for medical schools to do better?
Steve (MA)
There is one caution that we need to all keep in mind. It is an
assumption that chemical in your body that causes trouble
comes from eating that chemical. Therefore, not eating that
chemical may not be a cure for what ails you.

The low fat diet is a case in point. The fat in your arteries
that causes Atherosclerosis does not come from eating fat
in your diet. It comes from the liver processing the carbs
in your diet. So cutting out fat in the diet and replacing that
with carbs was exactly the wrong thing to do.

Just because an hypothesis is plausible, it isn't necessarily
correct. An hypothesis needs to be experimentally verified
before you should bet your life on it.
Harriet Sugar Miller (Montreal, Quebec)
There are two separate concerns--what causes cancer and what causes cancer to grow and spread. What causes cancer, from the genomic viewpoint, is damage to DNA in a cell’s nucleus; the metabolic camp suggests that the initial damage is to a cell's mitochondria, which in turn damages DNA. From both viewpoints, the initiator is the same---free radicals.

What causes cancer to proliferate is a separate question, and both camps agree that damage to the underlying cell signaling process results in faulty messaging that supports cancer's penchant for eternal growth. In this age of nutrigenomics, many scientists who study how nutrition can influence the expression of genes are focusing on how diet affects cell messaging—how it turn on signals that tell cells to keep growing and never die, like every good cell should. Others are looking at phytonutrients that inhibit faulty signaling or impede a cancer cell's ability to use glucose, amino or fatty acids as fuel.

As a health journalist and cancer survivor, I've been following the science since 2010 when our Canadian hero, Dr. Tak Mak, generated this newspaper headline: "Target Metabolic Pathways, not Cancer Genes." We're always weighing risks, including the gravity of taking one path or another in the face of uncertain evidence. What's the potential harm in switching to a plant-based diet that emphasizes promising phytonutrients? What's the potential gravity of not taking that route? https://eatandbeatcancer.com/
James (Northampton Mass)
Much to understand..but the increase in consumption correlated with the increase in cancer may be more than a coincidence.
Barbyr (Northern Illinois)
". . . the cells begin to do what every single-celled organism will do in the presence of food: eat as much as it can and make as many copies of itself as possible."

I might add that many multi-celled organisms, e.g., Homo sapiens, act the same way. Indeed, isn't this the very definition of life as we know it?
DavidMorris (Bellingham, WA)
This is a very interesting, informative and stimulating article. It is enjoyable to read and has caused me to explore a number of issues related to cancer prevention. This article and ones like it should be circulated more to the general public to empower and motivate people to be pro-active in cancer prevention for themselves and their families.
Piberman (Norwalk,ct)
Warburg might have found it troubling that virtually all cancer researchers believe any human cell can transform into cancer. Plus the success of chemo and other treatments that have had unexpected success in reducing or halting the growth of tumors. Warburg harks back to an older day when cancer was thought to be receptive to the "magic bullet" solution. Alas, we know that's not likely. In a real sense a study of Warburg illustrates just how far we've come in understanding cancer's bedeviling challenges.
Rich (walnut Creek CA)
This article is misleading. Drug companies already have approved cancer medications that attack metabolism, such as anti-VEGF (vascular epithelial growth factor). It is unfortunate that too many people are getting their information from these type of articles and ignoring the real documented benefits that are occurring in cancer research and are instead using pseudo science to make their medical decisions. and Warburg's Plank quote, that is accurate, people may die because they for-go science for oxygen therapy or some other false "truth".
NI (Westchester, NY)
Wow! So fascinating! The Germans should have put politics aside and be proud that a German had won the Nobel Prize again in 1944. By sidelining Warburg we seem to missed decades in finding a cure to cancer. There is a debate now whether some cancers like thyroid cancer should not even be termed cancer just as some cancers are CURED. The cure may have been right in front of us but remained elusive because it was too simplistic. Increasing insulin levels maybe the key. Increased blood sugar levels in diabetics and people ingesting lot of sugar like sugar rich sodas might be feeding the tiger. It is a known fact that incidence of cancer increase with obesity, diabetes, states where blood sugars get elevated. Now that research has started again with the Warburg model we may find the solution which has been elusive. Maybe, Mayor Bloomberg might have had an intuition about this when he went after sugared sodas.
jwp-nyc (new york)
In truth, Max Planck's quote seems to be broadly applicable to the revolution that has been underway at MSK and in medical science more generally. A generation that was in power has left the stage and once again the ideas that they may have repressed have come to the fore of research along with fascinating new findings including immune response therapies and blockers of specific receptors, and with these hope for cancer patients.

“A new scientific truth does not triumph by convincing its opponents and making them see the light, but rather because its opponents eventually die.”
Nina G (Manhattan,NY)
Thank you, NYT, for this fascinating article! I'm almost tempted to break out my old A&P textbook and re-memorize the Krebbs cycle (almost.)
Three months ago I started the practice of intermittent fasting, mainly for diabetes prevention and weight loss. Dr. Michael Mosley's book on the practice laid out many clinical studies showing fasting's stabilizing effect on insulin sensitivity and IGF. It made sense to me. The claims that it might also prevent cancers I sort of dismissed as unlikely. But now I'm not so sure.
rochsann (Denver)
Thank you for explaining this key information for the layperson. It gives me hope.
Lois steinberg (Urbana, IL)
Perhaps there is some truth to macrobiotic diets for cancer treatment.
Rebekah Levy (Santa Fe, NM)
It's time for everybody who's GENUINELY interested in research on the origins of cancer to read the recent book by James E. Strick, "Wilhelm Reich, Biologist" (Harvard Press).
Philip (Canada)

While James Watson is partly correct that finding cancer genes has been "remarkably unhelpful", it is now reliably known from a report in Nature in May that the Sanger Institute has found a total of 63 breast cancer genes from all the known different types of human breast cancer. At least, therefore, these genes can be now screened in any woman to indicate future possible risk, although treatment methods will still remain the same.
Marie (Fort Bragg)
Great atricle. Interesting that so many breakthroughs in science and health have to do with eating well.
DMutchler (NE Ohio)
Lots of information here, and I'm glad to see the work being done on cancers, but I cringe, knowing what is sure to be the comments to come, e.g., carbohydrates are BAD!; everyone should be taking metformin as a prophylactic; etc.

And, just as was done in this article, the potential truth(s) will be dismissed: processed food is loaded with chemicals; pesticides, herbicides, and more (a pharmaceutical cornucopia) pollute our waters and plants, and we consume it all on a daily basis.

Yes, too many chemicals in the environmental mix to really do anything about it, but on the other hand, when "agribusiness" is little more than food chemistry (with a bit of Frankenstein thrown in), we could do something about it.

No GMO. Eat organic.

Gosh, could this be such a simple way to prevent many cancers?

I doubt we'll ever know.
Ocean Blue (Los Angeles)
Common sense. Our bodies do not need sugar, yet we consume it by the cupfuls in soda, sugary snacks and desserts. Wean yourself off sugar and you will find you don't crave it. Eat honey instead---it's a natural anti-inflammatory and has been eaten for thousands of years. Essentially, look at food as "medicine"---we all have an opportunity three times per day to take good medicine, like vegetables and pure foods without additives, or we can consume foods that will kill us. Also, note the layout of supermarkets. The pure, simple foods are along the back and side walls, so you have to pass by the Cheez-wiz, potato chips and Coke to get to them. There's no profit in veggies and yogurt. Our government isn't helping---their attitude is, the Free Market is king, and buyer beware, which means we are on our own. Why do I pay taxes, if it's not for the government to protect us against toxins and poisons in our food and water?
Harriet Sugar Miller (Montreal, Quebec)
Thank goodness the NyTimes is finally giving the metabolic scientists the attention they deserve! If cancer cells suck up glucose and glutamine and fatty acids as fuels, then phytonutrients that keep cancer cells from utilizing those nutrients as fuel are key. Many flavonoids seem particularly promising--kaempferol, quercetin, apigenin and luteolin and the EGCG in green tea, for example. https://eatandbeatcancer.com/2016/02/04/part-3-whats-on-and-off-your-ant...
NS (NC)
The comment about cancer cells using fatty acids was only a speculation not based on any evidence.
Dan (Philadelphia)
The neglect that first met Warburg's hypothesis reminds me of Kuhn's description of scientific paradigms: that the competition between competing paradigms cannot be resolved by proofs.
Nevertheless, how heartening that some researchers can set aside the current zeitgeist (already under revision) and make progress in investigating our precarious physical nature.
Casey (California)
Once again we are seeing that, in addition to cigarettes, sugar is also a "coffin nail". Yet the government has not really launched campaigns against sugar like it did against smoking.

I'm starting to become very impressed with the courage it took to take on the tobacco industry which seems to be lacking now that sugar has been identified as being deadly as well.
Ryan Darwish (Eugene, Oregon)
Great article!
Sallie K. (Italy)
Metformin- a drug that might slow the growth of already present cancer cells? Has that been tested? Could it be used as a palliative treatment for a patient who does not want aggressive chemo or organ removal?
Gandhian (NJ)
If Metformin could help slow down cancer, would Avandia or Actos increase the probability because they allow glucose to enter the cells?
Ashutosh (Chapel Hill, NC)
The realization of the importance of energy and metabolism as opposed to genetics for the maintenance and dysfunction of cells has been growing in recent years. In fact work by evolutionary biochemists has even unearthed energy rather than genetics as the central tipping point in the early evolution of life. Just like primitive cells morphed into more complex ones when they learnt to amplify their energy efficiency, so do cancer cells proliferate when the similarly harness energy from the environment through unexpected means.

The lessons for biology and medicine are now clear: as important as the gene is, it tells living organisms what to do. But how they do it is in the domain of metabolism and energy, and discoveries such as this one are going to prove crucial to understanding the workings of cells in both health and diseases like cancer.
babymf (CA)
Here's a study published in 2014 which goes right along with this:

"Among the major effects of fasting relevant to aging and diseases are changes in the levels of IGF-1, IGFBP1, glucose, and insulin. Fasting for 3 or more days causes a 30% or more decrease in circulating insulin and glucose, as well as rapid decline in the levels of insulin-like growth factor 1 (IGF-1), the major growth factor in mammals, which together with insulin is associated with accelerated aging and cancer (Fontana et al., 2010)."

"Fasting: Molecular Mechanisms and Clinical Applications"
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3946160/
Diana Sturgis (Brooklyn NY)
Thank you for continuing to treat me with respect by publishing such a well written, informative and exciting article.
Sebastien Murat (Marvels Lab)
Nice read, but just a heads-up: 'starving-out' the bad-guys by the host shifting to an alternate substrate an/or cranking-up the internal conditions to extremes, like acidic pH or cold, be it to suppress, eject or kill pathogens, like cancer or infection (e.g., parasites and viruses), is a ubiquitous strategy in nature, across all orders, and merely onvolves going into extended and, ideally, profound metabolic torpor, e.g., estivation, hibernation. In fact, in this state the host is generally more resistant to all matter of drugs, toxins, and even chemo- and radiotherapy. Furthermore, in this slow metabolic and hostile state there's a switch from carbos (glucose) to near-100% fat-burning and tumors stop growing. You don't even have to mount a fight, merely wait them out until they leave because they can bear it as well as normal cells! Big question: can humans do this? Cut-the-chase workin [sic] on it. Scientific references: on-demand.
Norburt (New York, NY)
The main problem is decreasing blood glucose sufficient to starve cancer cells without starving the patient. Eating anything helps fuel cancer, so every meal becomes a negotiation with oneself about balancing energy needs with cancer fear.

There have been many proponents (almost none of them from the conventional cancer treatment establishment) of eliminating sugar and rapidly metabolized white starches from the diets of cancer patients in order to decrease insulin surging and force cells to use protein and fats for energy (low glycemic load foods. modified Atkins strategy). I have been doing this for some time. But weight falls and energy levels, always low for cancer patients, decrease.

I wish cancer researchers and clinicians would provide real guidance about this specific area of nutrition rather than just advising that patients eat lots of antioxidant vegetables, fruits, and carefully chosen proteins.
KimberlyM (Los Angeles)
Fascinating. Has anyone thought to research why there was an epidemic of cancer in pre-war Germany? One wonders if the diet of people in a depressed economy with 30% unemployment was involved, and how it might compare to diet in other times and places.
John Smith (Cherry Hill NJ)
WARBURG Made some great scientific contributions, irrespective of his overweaning sense of self-importance. His theories now contribute to cancer research shifting focus from genetics to epigenetics, meaning that often environmental factors and how they cause activation and inactivation of genes is essential. Also, it seems that in the field of nutrition and health, there is considerable focus on free radicals and their negative effect on the body. It has been found that insulin lowers the levels of free radicals. I think it logical to study the effects of elevated levels of refined carbohydrates in the system and upon overall health and the decreased likelihood of developing cancer. In the US, though, people are going to the trenches because they're being warned about the dangers of over-indulging in large quantities of sugary soft drinks. US experts may still be among world leaders in scientific research. I'm starting to believe that there must be a genetic component to the denial of scientific facts, which produced the anti-vaccination movement in kids, who have snatched defeat from the jaws of victory by proclaiming that unlimited access to refined carbohydrates of all forms, and especially in soft drinks that are sold in quantities that would fill wading pools. We've seen how access to junk foods has caused an epidemic of childhood obesity and diabetes. Now we'll have to watch for elevated cancer levels among those who poison themelves with refined sugar.
Suhail Shah (Roslyn, NY)
Incredible article. Hopefully more research along the lines suggested by Warburg will make treating all cancer as easy as taking a pill. Also, very revealing article about the deadly effects of constantly elevated insulin blood levels. Keep your pancreatic islet cells (those responsible for secreting insulin in response to elevated sugar levels in the blood) as quiet as possible, I tell my patients. Not only is the dizzying array of high sugar sodas and snacks mainly responsible for the epidemic of obesity, heart disease and diabetes throughout the world, but more and more research these days is focusing on the direct correlation between these foods and cancer, the ultimate enemy.

Thank you NYT for publishing this article!
seattle expat (Seattle, WA)
"Cancer" refers to many different disease of different tissues. It has many causes (carcinogenic chemicals, including smoke, viruses, radiation), epidemiologic factors have been identified (meat consumption, legume consumption (protective effect)). Metabolic shifts are another important factor, and may help to treat a significant fraction of cancers, but it is unlikely to result in the "cure". We can learn much from Warburg's ego-driven mistakes, as well as his discoveries.
steve (Paia)
Dr. Edward Dewey in his "No Breakfast Plan" should get some credit here. He was a Civil War physician who helped discover the benefits of fasting in fighting illness.
Sui (NY)
Thank you for this article, which highlights one of the many negative aspects of excess sugar in one's diet. NYT, can we please have more frequent, accessible articles that educate people about the detriments of excess sugar consumption? These are so intimately tied to preventable diseases that are on the rise. Many articles on this topic are still wishy-washy, yet the science already exists.
Nancy (Boston)
HOw can you write a comment about tumor nutrition without noting folks like Judah Folkman, promoter of the angiogenesis theory, or even Dean Ornish, promoted of a form of "starve the beast" approach. There are serious studies ongoing about both theories (albeit Folkman, now deceased?, is probably taken more seriously in the scientific community."
Albert (MD)
Why does NYT not tell readers what Warburg got his Nobel Prize for? (discovered Vitamin C)
job r. (toronto)
There are lots of people experimenting with their diet in the combat of chronic diseases. E.g. the Wahls Protocol uses c combination between palio and ketogenic diet as a key strategy. The main point is to shift your energy burning from glucose based to ketone, or in other words, from carbs to (high quality) fat.

But good to hear that the medical sciences are now firmly recognizing this too!
JAY LAGEMANN (Martha's Vineyard, MA)
I have metastatic prostate cancer. Ever since my prostate was removed in 2008 I have regularly had PSA tests to check on the growth of my cancer. For the first 4 years the cancer doubling rate was every 19.25 months. After watching Micheal Morley's PBS show about the effects of diel and fasting on longevity and health I started the 5-2 diet where two days a week I only eat 500-600 calories. For the last three years on the 5-2 diet the doubling rate of my cancer has been 23.84 months. That means that the 5-2 diet, which is known to lower IGF levels, has slowed my cancer's growth by over 25%.

If a drug was shown in a limited trial to slow down prostate cancer growth by 25% I am sure that it would be extensively studied and funded. But since there isn't any serious money to be made by telling people to go on the 5-2 diet.

By the way there are side effects to going on the 5-2 diet. Both my wife and I have lost a little weight so that we weigh about what we weighed in high school. On the "starve days" we tend to be more alert and also more interested in sex. On the "feast days" we get to eat whatever we feel like without guilt.

I really think a study should be done with a large group of people with prostate cancer. It could prolong and improve the lives of many people with prostate cancer.
Bossystarr (Nyc)
I have a strange hunch this is true. Recently diagnosed with breast cancer, I also discovered I was borderline pre-diabetic. Body Chemistry and glucose levels, good to be aware of and make any lifestyle adjustments to lower insulin levels.
Fenella (UK)
When I was being treated for cancer in Germany (less than five years ago), a number of patients around me were being put on Warburg diets - all sugar removed. There are special foods formulated for cancer patients that are sugar free.

I don't know if they worked or not, but I do know that as I was getting sicker and as my tumour grew at a phenomenal rate, I was perpetually angry, moody and aggressive. After the Warburg principle was explained to me, I came to believe my mood was because the tumour was so big it was consuming sugar at a ferocious rate and I was probably hypoglycaemic. I don't know that for a fact, of course, but I have since met other cancer patients who also had these dramatic bad moods prior to diagnosis.
Logix (Serbia)
Great article! А lot of novel information on cancer. However, would the leading researchers on cancer agree that this is the right direction? Would it be the right decision to, e.g. significantly raise the funding for cancer research that is focused on glucose starving and the effects of insulin?

What % of researchers should focus their attention on this and do expensive experiments in order to find solutions?

All important issues...
Dave (Auckland)
Although many will violently disagree, fasting may be the simple answer to many cancers. After ten rounds of chemo, with more scheduled, as a last resort a friend agreed to fast. She fasted five days and then went on a whole, mostly raw food diet. There was no trace of cancer markers in her blood one week after the fast. She is better. 'Incredible' does not begin to describe this turn around. Fasting would seem to make sense in light of the thrust of this article.
LenK (New York)
I knew a man who overcame cancer by extreme fasting- this was many years ago. He was a medical student when he was diagnosed- he dropped out of med school- - fasted almost to death, recovered and became a naturopath, skilled in nutrition and kinesiology- knew him when he was in his late seventies and he was incredibly healthy and still working full time. He swore by daily enemas.
Sandro Amashukeli (Tbilisi, Georgia)
such a great article, such a great language, such a great explanation for wide audience, Bravo! yes, we are focused on psychology only and can confirm that curing cancer or any other illness by medical manipulation only is exactly the same as keep saving suicide committer on and on every and each time he/she attempts it another time, meaning that we ourselves daily destroy our health by all means available and then looking vigorously for relief. We know it sounds terrible, however we keep moving in wrong direction without hesitation. That should end one day - either we destroy humanity or just rationally keep it from stupidity!
Zenster (Manhattan)
IGF-1 and Sugar = the fuel for cancer. Milk is basically Cancer Juice.
More important:
It is not about TREATING cancer it is about NOT GETTING cancer.
Eat Real Food, Not too much, Mostly Plants.
Don't give cancer the fertile soil it needs to take root = keep your body ALKALINE.
Drink a Green Smoothie every morning that has Turmeric added to it.

We already have all of the information we need to not get cancer but it is more fun for the media to encourage and cover hot dog eating contests than it is to show boring fruits and vegetables and give people the excuses they need to continue their cancer causing diets.
Mahtrow (Punta Gorda fl)
Time to revisit Lynn Margulis and the role of (bacteria/mitochondria) in the evolution of cells and energy. It's their DNA, not nuclear DNA that needs to be unraveled.
DA (Los Angeles)
Why take metformin when berberine is just as effective, and is a natural plant substance that you don't need a prescription for and that doesn't enrich the awful drug industry?
Nytimes writers: please use PubMed. There are many studies on the effectiveness of berberine there (a PubMed search will pull up 3362 articles). Here is just one:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2410097/
Kirk A. Janowiak (West Lafayette, IN)
Biguanids diabetes chemicals like metformin, buformin, and the past-used phenformin; while currently synthesized because of demand and the ability to guarantee potency/dosage and purity are plant-derived chemicals as well.
Entropic (Hopkinton, MA)
Recommend "Good Calories, Bad Calories", which anticipated this, and is a great survey on insulin and diabetes. By Gary Taubes.
Clyde (<br/>)
An absolutely fascinating read! Thank you!
b conley (portland, me)
lew cantley is a genius, and as i understand is more afraid of sugar than martinis. In the end he will be proven right
isaac abrams (saugerties ny)
Agreed. Fascinating in so many ways. Also, thank you.
Wiser Words (NJ)
I couldn't agree more. We may be on the verge of a break through for treating, if not curing, cancer.