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Metabolic theory of cancer

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A theory of cancer based on cellular metabolism

The metabolic theory of cancer is the hypothesis that the primary cause of cancer is changes in cellular metabolism. The theory is strongly linked to the idea that diet can be used to prevent or treat many or most types of cancer. It is widely accepted that changes in cellular metabolism—specifically, an increased reliance on glucose for energy, and up-regulation of anabolic processes—do occur in many types of cancer cells. However, the idea that cancer can be controlled mostly or entirely by diet does not have broad acceptance in the medical field.

Key principles of the metabolic theory of cancer

The metabolic theory of cancer is built upon several well-known biochemical differences between normal and rapidly-proliferating cells, including:

  • The Warburg effect: In the 1920s, Otto Warburg observed that cancer cells prefer to generate energy through anaerobic fermentation, even when oxygen is plentiful. This is different from normal cells, which use oxygen-dependent oxidative phosphorylation for more efficient energy production. As a result, cancer cells rely heavily on glucose (sugar) for energy, and produce significant amounts of lactate.
  • Mitochondrial dysfunction: Proponents of the metabolic theory argue that mitochondrial dysfunction plays a crucial role in cancer. Mitochondria are the cell’s energy factories and play a role in regulating cell death (apoptosis). Alterations in mitochondrial morphology are evident in several types of cancer cells.
  • Metabolic flexibility and glutamine dependence: Cancer cells often rely on glutamine as an alternative energy source and as a building block for growth, especially when glucose is limited. This metabolic flexibility allows cancer cells to adapt and thrive under varying conditions, making them more resistant to standard treatments like chemotherapy.

Therapeutic implications

Dietary approaches: Low-carbohydrate or ketogenic diets are suggested as potentially helpful because they limit glucose availability to cancer cells, thereby "starving" them. These diets force the body to produce ketones, which cancer cells cannot easily use.

Targeting metabolism in treatment: Drugs that disrupt cancer cells' metabolic processes, particularly those targeting glucose or glutamine metabolism, are being explored as cancer treatments.

Controversy and research

The metabolic theory is still under investigation and remains controversial. While there is evidence supporting the role of altered metabolism in cancer, the genetic mutation model also has significant support. Many researchers are now examining cancer as a complex interplay of genetic mutations and metabolic dysregulation, rather than a purely genetic or purely metabolic disease.

See also

References

  1. ^ Seyfried, Thomas N. (2012). Cancer as a metabolic disease: on the origin, management, and prevention of cancer. Hoboken, N.J: Wiley. ISBN 978-0-470-58492-7.
  2. Tufail, Muhammad; Jiang, Can-Hua; Li, Ning (Sep 2024). "Altered metabolism in cancer: Insights into energy pathways and therapeutic targets". Molecular Cancer. 23 (1): 203. doi:10.1186/s12943-024-02119-3. PMC 11409553. PMID 39294640.
  3. Warburg, O (24 Feb 1956). "On the origin of cancer cells". Science. 123 (3191): 309–314. Bibcode:1956Sci...123..309W. doi:10.1126/science.123.3191.309. PMID 13298683.
  4. Vander Heiden, MG; Cantley, LC; Thompson, CB (22 May 2009). "Understanding the Warburg effect: the metabolic requirements of cell proliferation". Science. 324 (5930): 1029–33. Bibcode:2009Sci...324.1029V. doi:10.1126/science.1160809. PMC 2849637. PMID 19460998.
  5. ^ Seyfried, TN; Flores, RE; Poff, AM; D'Agostino, DP (March 2014). "Cancer as a metabolic disease: implications for novel therapeutics". Carcinogenesis. 35 (3): 515–27. doi:10.1093/carcin/bgt480. PMC 3941741. PMID 24343361.
  6. DeBerardinis, RJ; Cheng, T (21 January 2010). "Q's next: the diverse functions of glutamine in metabolism, cell biology and cancer". Oncogene. 29 (3): 313–24. doi:10.1038/onc.2009.358. PMC 2809806. PMID 19881548.
  7. Altman, BJ; Stine, ZE; Dang, CV (October 2016). "From Krebs to clinic: glutamine metabolism to cancer therapy". Nature Reviews. Cancer. 16 (10): 619–34. doi:10.1038/nrc.2016.71. PMC 5484415. PMID 27492215.
  8. Weber, DD; Aminzadeh-Gohari, S; Tulipan, J; Catalano, L; Feichtinger, RG; Kofler, B (March 2020). "Ketogenic diet in the treatment of cancer - Where do we stand?". Molecular Metabolism. 33: 102–121. doi:10.1016/j.molmet.2019.06.026. PMC 7056920. PMID 31399389.
  9. Pavlova, NN; Thompson, CB (12 January 2016). "The Emerging Hallmarks of Cancer Metabolism". Cell Metabolism. 23 (1): 27–47. doi:10.1016/j.cmet.2015.12.006. PMC 4715268. PMID 26771115.
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