Wednesday, 13 May 2015

'Tripping Over the Truth' - a discussion on the origins of cancer

Today's post, from our chairman Robin Daly, is a review of the recently published 'Tripping Over the Truth: the Metabolic Theory of Cancer' by Travis Christofferson.

In 2012 Thomas Seyfried’s game-changing book ‘Cancer as a Metabolic Disease: On the Origin, Management, and Prevention of Cancer’ hit the bookstore shelves with a thud. At £90 or so, this heavy duty science book was clearly not aimed at the ‘man in the street’, however strong his interest in cancer.

Seyfried wanted to make the scientific community aware that a fundamental feature of cancer, known about for almost a century, has been systematically ignored to the detriment of the growing number of people with cancer. He wanted to put forward the radical suggestion that simply targeting an ever increasing number of cancer causing genes was not going provide the long sought for solutions. He went on to put forward a plausible and novel strategy of targeting cancer’s energy supply, its metabolism, through a specialised dietary regime - the ketogenic diet.

The task of communicating Seyfried’s crucial messages to a wider audience was picked up by Travis Christofferson, who published ‘Tripping Over the Truth: the Metabolic Theory of Cancer’ late last year. Written, in the most part, in very accessible English, and priced at around £10 this new offering hits the spot for readers like me.

It’s a compelling read that charts a century or more of cancer research - the blind alleys, the few startling successes, and the overarching failure of an astronomical investment of human effort, resources and skills.

What is in question is the single most basic aspect of cancer: its cause.

Two observations have been made over the years:

There is a crucial difference between the way a cancer cell and a healthy cell make energy. Healthy cells use a very efficient system turning glucose and oxygen into energy in mini power plants called mitochondria. In cancer cells the mitochondria are damaged, so instead the cells use large quantities of glucose in a process of fermentation.

Cancer displays mutations in its DNA

The crucial question is a ‘chicken and egg’ one. Which of these is a symptom of cancer and which is its cause? Did DNA changes damage the cancer cell's mitochondria, or did damage to the mitochondria in a cell that became cancerous cause changes in the DNA?

90 years ago a scientist named Otto Warburg pronounced that "the prime cause of cancer is the replacement of the respiration of oxygen in normal body cells by a fermentation of sugar.” So he was claiming that cancer is a disease of the metabolism, a result of damaged mitochondria. Despite being awarded a Nobel Prize for his efforts, his theory never really took root and was progressively sidelined by a developing theory - the Somatic Mutation Theory (SMT) - that was to lead to the present day doctrine that ‘it’s all about defective genes’. In a world where genes are unquestionably the culprits, damaged mitochondria and a reliance on fermentation to create energy, are merely symptoms of the underlying gene problem.

Why is this ‘chicken and egg’ question important?

In terms of how to treat or avoid cancer, the two competing theories are like night and day. Warburg’s theory points to a simple way to target cancer - find a way to disrupt its unique energy supply; in contrast, SMT has led to a major programme to find more and more genes that are linked to cancer (oncogenes), and then to target them with drugs. There is now large number of identified genes and targeting just one with drugs is phenomenally expensive. These drugs so far produce, at best, a very modest increase in survival time. Adding more and more eye wateringly expensive drugs, with a promise of a bit more life, whilst feeling progressively worse, is not an appealing or viable plan.

Warburg points to measures that affect the metabolism of all cancers, which include diet and lifestyle, and recently, the revisiting of some old, out of patent (ie cheap) drugs that happen to interact with the metabolism. To the SMT proponents, diet and lifestyle interventions are at best ‘nice to haves’, something for the patients to busy themselves with, and at worst, totally irrelevant. This outlook tragically provides the basis for the appalling food and dietary advice so often given in our hospitals.

So which of these two theories is right, or at least closer to the truth?

SMT enthusiasts plunged forward certain that gene sequencing was eventually going to provide them with the ‘telephone number’ - a unique code made up of changes in certain oncogenes - of each of the increasing numbers of identified cancer types, and that, armed with that information they were going to develop a targeted drug that was going to hit it right where it hurt. The original expectation was that each oncogene would be responsible for a particular cancerous change, so there should be a standard pattern of genes for each cancer. But the picture coming out of the latest research is showing nothing like that - one persons' breast cancer might have genes a, b and c while another's might have just "a" and a third might have none at all. It’s complete chaos.

What does this tell us? Logically, a single causatory factor, damaged mitochondria, applied to a million different people, with differing genetics, lifestyles, health histories, etc, would be expected give a million different results. And these results might include getting completely different types of cancer or not getting cancer at all. There’s no reason to think they would all be the same, any more than on the macro level where all human beings, despite generally having two arms, two legs and a head, are, in fact completely unique. In reflection of this, superficially similar prostate cancers turn out, on close inspection to be unique to the person who has them.

This begins to make sense of the bewildering complexities of the developing SMT world we have been led into. Could it be that the reason the gene picture is unique to each patient is that it is their unique symptom, not the cause at all, and, as we all know, treating symptoms rarely leads to a resolution - exactly the result we have seen and continue to see for approaches based on SMT. There is now open acknowledgement of the uniqueness of a patient’s condition in the developing science of Personalised Medicine, which sadly doesn’t refer to treating people respectfully and compassionately as individuals - as we hight have hoped - but means that their genes are studied as candidates for a raft of expensive targeted drugs. Largely speaking, the only clear winners over the last decades, particularly since the ‘War on Cancer’ began in earnest, have been those on the receiving end of the untold billions spent on research and treatment.

World class experts are now taking a step back from the ‘cutting edge’ of SMT science and gaining an appreciation of the possibility that science may just have made a 90 year detour due to dis interest in Warburg’s theory. Fortunately not all scientists, or indeed doctors, have made the same detour and some have continued looking at cancer as a disease of the metabolism. This has lead to some progress, and many people have managed to find ways to get help with their condition from maverick doctors who have refused to toe the SMT line. Vindication of this is now coming from the likes of top theoretical physicist Paul Davies who exhorts people with cancer to oxygenate and alkalyse their body, and avoid sugar (1)- pretty much core advice from ‘alternative’ cancer specialists for decades. And respected researcher Prof Mina Bissell has now done the science to show that cancer cells will revert to being healthy if they are put in a healthy environment (2), as well as to show that excess sugar doesn’t just promote cancer, it actually causes it(3).

Furthermore, the recent science of epigenetics has fundamentally changed the way we look at genes. Early gene theory led people to believe that bad genes = bad health. This understanding has since been superceded by the realisation that lifestyle and environment has everything to do with how
genes ‘express’ themselves. You may have genes with the potential for a particular outcome - the BRCA genes for breast cancer being probably the best known examples - but whether they do or not has everything to do with your general health and your environment.

If, as Christofferson’s book maintains, Warburg was right all along, how on earth are we going to get research and treatment back on track again? A glaring feature of Paul Davies’ advice is that, in contrast to the economics of SMT, there are no big bucks to be made there. In fact, contained in this understanding of the cause of cancer, is the information needed on which to build public health policies to start to actually reduce the incidence of cancer at last, and therefore to reverse the seemingly unstoppable growth of the ‘cancer industry’ - a startlingly parallel situation to cancer itself!

It follows that the impetus for this desperately needed change of direction is never likely to come from corporations or from any body of decision makers that is in any way funded or influenced by them. That pretty much leaves us - ordinary people whose families are being laid waste by cancer - to take up the baton and force a change for the better by informing one another and making our own choices. At this point, we simply can’t afford to allow cancer science and treatment to ‘follow the money’.

Read more blogs from Robin here.


Cancer as a Metabolic Disease: On the Origin, Management, and Prevention of Cancer: Thomas Seyfried

Tripping Over the Truth - The Metabolic Theory of Cancer: Travis Christofferson


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