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I want to devote this column to a difficult subject — Cancer. Yes, the "c" word
that so many don't want to talk about. Someone actually said to me once that they
didn't like to discuss it... they said talking about it made them feel like cancer
was a more real threat to them and they didn't want to "jinx" themselves.
It's just a word, people. And I, (as both a survivor, and as one who's lost too many people precious to me to this plague), think it's time we discussed it here. I received a letter a couple of weeks ago from a Vegetarian group asking me if I was aware that my "promoting of a lifestyle in which saturated fats and cholesterol are eaten regularly" was endangering people to cancer. They went on to tell me that "studies show" that vegetarians are less likely to get cancer. And that a low-fat, high carbohydrate diet was the only way to ensure health and avoid cancer. If you ask "what studies", they'll always point you to the "Framingham Heart Study" which we've discussed time and again... If you want a quick refresher, visit the following previous newsletter articles: Volume II, Issues #14, and #15: (Diet & Heart Disease Misconception: Part I and Part II) "Studies using rabbits done by Kritchevsky are offered as proof that saturated fats and cholesterol cause the formation of arterial plaques. Unfortunately, the basis of the experiment is flawed - rabbits are herbivorous creatures and lack the physiological traits required to assimilate and metabolize cholesterol, which is only found in animal products. It is no wonder that Kritchevsky's rabbits developed problems. One cannot apply the results of an experiment done on herbivores to an omnivorous species like humans." But for now, let's put cholesterol and heart disease aside. Let's look at the effect a high carb/high sugar diet has on cancer. Cancer cells require the same amino acids, carbohydrates, fats, vitamins, and minerals for their growth and reproduction as do normal cells — but in vastly different quantities and ratios. This fact alone raises the question about whether or not a traditionally "nutritious" diet can actually help fight cancer. Or does such a diet help fuel the growth of cancer? 
The Research
Numerous studies published over the past several years, including this year, support the concept that so-called "good nutrition" can fuel growth in most cancers. Also emerging evidence shows that diets deprived of certain amino acids can enhance the benefits of chemotherapy or radiation therapy and that diets deprived of glucose can kill cancer cells. For example, Dr. Chi Van Dang, of Johns Hopkins University School of Medicine, found that most cancer cells, when deprived of glucose, will self-destruct. [Dang, C.-V. Unique glucose dependent apoptotic pathway induced by CMYC. Proceedings of the National Academy of Sciences l998; 95: l511-l5l6.] And Dr. Craig Albright of the University of North Carolina has taken the anti-oxidants C and E from the diets of animals bred to develop breast cancer. He reports that when compared to control animals on a regular diet, the animals on the deprivation diet developed fewer cancers and the least number of metastases. He concluded that excess apoptosis (cell death) contributed to fewer tumors in the anti-oxidant-deprived animals. [Albright, Craig. Science News 2000; l59: 248.] In addition, five teams of scientists, including Drs. Yong and Hunt of George Washington University, Dr. Spitz of the University of Iowa, Dr. Lee of the University of Southern California, and Dr. Blackburn of William Beaumont Hospital, have all published studies showing that carbohydrate deprivation kills cancer cells, both in vitro and in vivo, Furthermore, such carbohydrate deprivation has no adverse effects on normal cells. Cancer scientist Angelo P. John published some results in the October 2001 issue of Medical Hypotheses (57:4, 429-431). Here he explains the biochemical reasons that most cancer cells must rely almost exclusively upon the glucose derived from carbohydrate foods as their major supply of nutrients. John�s discovery that cancer cells have defective mitochondria and must therefore depend largely upon glycolysis and glucose for nutrition will dramatically impact the future treatment of cancer. 
How and Why This Is...
In order to understand why the fight against cancer benefits from carbohydrate deprivation, we need look no further than normal human metabolism... and its many paths. Metabolism is primarily accomplished through two main methods: Glycolysis, and The Krebs Cycle (also called the Citric Acid Cycle.) [Clicking these links will display a graphic showing each, and how they work.] What follows is a brief explanation of each: Glycolysis — The Metabolic Path of Carbohydrate: In glycolysis, the six-carbon sugar glucose is oxidized and split in two halves, to create two molecules of pyruvate (3 carbons each) from each molecule of glucose. Along the way, the cell extracts a relatively small amount of energy from glucose in the form of ATP, 2 ATP molecules collected for each glucose molecule that starts down the glycolytic path. The pyruvate produced has one of three metabolic fates, to either become acetyl-CoA, ethanol, or lactate. When oxygen is available, the pyruvate can be converted to acetyl-CoA and enter the Krebs Cycle, where the acetyl-CoA will be completely oxidized and generate ATP through oxidative phosphorylation. Cancer cells generate their energy through glycolytic fermentation, a state involving anaerobic function. Bottom Line: Glycolysis does not utilize oxygen to release energy from glucose, but does require a process known as fermentation in order to recycle a required intermediate. When oxygen is limited (or in the case of cancer cells, cannot be used) cells can derive energy from glycolysis and fermentation. This is the ONLY method cancer can use to derive sustenance. The Krebs Cycle — The Metabolic Path of Everything Else: The Krebs Cycle is a fundamental metabolic pathway involving eight enzymes essential for energy production through aerobic respiration and arose early in evolution. This pathway is also an important source of biosynthetic building blocks used in gluconeogenesis, amino acid biosynthesis, and fatty acid biosynthesis. The Krebs cycle takes place in mitochondria where it oxidizes acetyl-CoA, releasing carbon dioxide and extracting energy primarily as the reduced high-energy electron carriers NADH and FADH2. NADH and FADH2 transfer chemical energy from metabolic intermediates to the electron transport chain to create a different form of energy, a gradient of protons across the inner mitochondrial membrane. The energy of the proton gradient in turn drives synthesis of the high-energy phosphate bonds in ATP, the common energy currency of the cell used to drive a huge variety of reactions and processes. Cancer cells are unable to thrive from energy derived through the (oxygen-rich) aerobic process of the Krebs cycle. Bottom Line: In the presence of oxygen, most cells (healthy cells) have the ability to further metabolize the products of glycolysis producing carbon dioxide and water as the end products. This is a process of aerobic respiration. Metabolic Conclusion: A normal healthy cell can burn oxygen and glucose for energy and releases carbon dioxide and water. This healthy cell is functioning aerobically - in the presence of sufficient oxygen. No anaerobic diseases (such as cancer) can flourish, replicate or even survive in this oxygen rich environment. A cancerous cell is lacking sufficient oxygen but will still produce energy by burning glucose. This is very inefficient and a severe drain on the body. This energy burning process (sugar fermentation) releases mainly lactic acid and carbon monoxide instead of carbon dioxide. This cell is functioning anaerobically - with no oxygen present. Cancer flourishes in this environment with little or no oxygen and low PH. Anaerobic cells must work harder than aerobic cells to produce energy from the glucose they metabolize. Therefore, anaerobic cells burn much more glucose to produce the same amount of energy as aerobic cells. Cancer cells exhibit this anaerobic mode of metabolism - lack of oxygen, high glucose consumption, carbon monoxide and high lactic acid production. Cancer cells thrive in this high sugar/low oxygen environment but cannot exist in the opposite condition of the high oxygen/low sugar mode of healthy cells. And what about Ketone bodies? 
The acetyl-CoA produced by mitochondrial beta-oxidation of fatty acids enters the
Kreb's cycle to produce energy, but that is not the only fate of acetyl-CoA. Some
acetyl-CoA is converted to acetoacetate, beta-hydroxybutyrate,
and acetone, collectively called ketone bodies. Ketone bodies are transported to other
tissues such as brain, muscle or heart where they are converted back to acetyl-CoA to
serve as an energy source. In the metabolic condition called ketosis, ketone bodies
are produced faster than they are consumed by tissues and the smell of acetone can
be detected on a person's breath. This form of metabolic pathway enters the equation
when the body burns its fat stores for additional fuel while deprived of sufficient
carbohydrate to allow glycolysis. Ketone bodies are actually a preferred fuel source
for the heart and a number of other organs, but are only a secondary source for the
brain. In the absence of glucose from dietary sources, glucose in the form of blood
sugar is manufactured by the body (through gluconeogenesis) in sufficient quantity for
brain sustenance.
When the body burns its own fat, as it must do on a diet with insufficient carbohydrates for glycolysis, ketones are produced by the liver and circulated in the blood. It is known that ketones can shut down an enzyme called phosphofructokinase. This enzyme plays a critical role in glycolysis, a process that is the only source of energy for cancer cells. Without sufficient energy, cells cannot produce sufficient ATP. This creates a build-up of free radicals that can lead to apoptosis. Normal cells are not affected in the same manner because they derive most of their daily energy needs from the Krebs cycle. ( See Diagram of ketogenic metabolism here. ) So... Is All This News? 
In a word — no. German-born Otto Heinrich Warburg, Ph.D., first discovered that cancer cells have
a fundamentally different energy metabolism compared to healthy cells back in 1931. He
discovered that malignant tumors frequently exhibit an increase in anaerobic
glycolysis — a process whereby glucose is used as a fuel by cancer cells with
lactic acid as an anaerobic byproduct — compared to normal tissues. The large amount
of lactic acid produced by this fermentation of glucose from cancer cells is then
transported to the liver.
According to Patrick Quillin, PHD, this inefficient pathway for energy metabolism yields little energy compared to the complete aerobic oxidation of glucose. By extracting only about 5 percent 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. It is one reason why 40 percent of cancer patients die from malnutrition. In simple language, cancer metabolizes much differently than normal cells. Normal cells need oxygen. Cancer cells despise oxygen. Cancer needs sugar — it metabolizes through a process of fermentation. If you've ever made wine, you'll know that fermentation requires sugar. The metabolism of cancer is approximately 8 times greater than the metabolism of normal cells. 
Okay, so here is what we can put together knowing the above: The body is
constantly overworked trying to feed this cancer. The cancer is constantly
on the verge starvation and thus constantly asking the body to feed it. When
the food supply is cut off, the cancer begins to starve unless it can make
the body produce sugar to feed itself.
The wasting syndrome is the body producing sugar from proteins (you heard it right, not from carbohydrates or fats, but from proteins) in a process called gluconeogenesis. This sugar feeds the cancer. The body finally dies of starvation, trying to feed the cancer. Now, knowing that one's cancer needs sugar, does it make sense to feed it sugar? Does it make sense to consume or feed a loved one a high carbohydrate diet? There are now many, many hospitals and clinics using nutrition as a tool to fight cancer. There are many food therapies, but not a single one allows many foods high in carbohydrates and not a single one allows sugars, because sugar feeds cancer. Why doesn't the average physician tell you this? Why are many cancer patients told to eat to keep their strength up and then have a list filled with puddings, toast, (sugared) sodas, and ice cream from which to choose. Many physicians didn't study nutrition — at least not as any major part of their training. As late as 1978, the AMA's official position (stated in courts of law) was that nutrition had nothing to do with health or disease. Today, at the University of Minnesota, they are experimenting with a chemotherapy delivered in a "smartbomb." Here's how it works: the drug is wrapped in a coating that stays intact as it travels through the body, that is until it reaches a location of no oxygen. When it reaches this "no oxygen" location, the coating falls apart releasing the chemotherapy to destroy the cancer, because the only place in your body where there is no oxygen is the cancer site. And A Personal Note... 
On October 10, 1998, my Mother passed away from lung cancer. She'd been diagnosed
in June of that year... only two months after my father passed. I only wonder what
might have been different had I known then what I know now. As she became more
and more ill and more depleted from the chemotherapy and radiation, she was given
more and more sugary treats to "help her keep her strength up". She wasted
away to skin and bones before our very eyes and we watched helpless, believing we
were doing all we could.At the National Cancer Institute's Government Website, they offer "helpful suggestions" on what can help a cancer patient who is not eating well, not being nourished, or not interested in food. Here are just some of their suggestions: | |||
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One of their cooking suggestions is: "Honey, Jam, and Sugar: Add to bread, cereal,
milk drinks, and fruit and yogurt desserts. Use as a glaze for meats, such as
chicken." They go on to suggest you "Sandwich ice cream or frozen yogurt between
cake slices, cookies, or graham crackers."
We took these suggestions. My mother starved to death. I may have learned all of this too late to help my own mother, but perhaps new awareness can help someone else's...  |
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