Starving Cancer: The Hidden Power of Food, Fasting, and the Body’s Inner Terrain

Summary

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Podcast Summary: Starving Cancer – The Hidden Power of Food, Fasting, and the Body’s Inner Terrain

The Dr. Hyman Show | Host: Dr. Mark Hyman
Date: November 10, 2025

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Episode Overview

In this illuminating episode, Dr. Mark Hyman explores the revolutionary shift in the understanding of cancer—from a disease driven primarily by genetics to one profoundly influenced by the body’s inner "soil" or terrain. Joined by experts in metabolic and functional medicine, the episode dives deep into how food, fasting, lifestyle, and environmental factors can either foster or suppress cancer. The discussion connects chronic inflammation, insulin resistance, gut health, and toxic exposures to cancer risk and investigates the promise of ketogenic diets and fasting as adjuncts to conventional therapies.

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Key Discussion Points & Insights

1. The Seed and Soil Analogy in Cancer (02:34–06:45)

• Traditional Vs. Modern Perspectives:
  Cancer was once considered mainly a genetic (“seed”) problem. Contemporary functional medicine sees the body's environment (“soil”)—including diet, lifestyle, and chemical exposures—as the primary focus for both prevention and treatment.
• Epidemiological Patterns:
  Populations following traditional diets and lifestyles exhibit dramatically lower rates of cancer until they adopt western diets and habits.
  • E.g., Inuit and rural Africans had almost no cancer until processed food and sugar infiltrated their diets.
  • Japanese and Polish women have lower cancer rates in their home countries than after emigrating and adopting western diets.

“The most important thing we need to focus on is not the genetics of the problem, it's the soil problem.” – Dr. Hyman [00:04]

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2. Diet, Insulin, and Cancer Cell Growth (08:25–14:20)

• Nutrient Sensors and Growth Factors:
  High insulin levels—stimulated by frequent eating and processed carbohydrates—promote cell growth, including the uncontrolled growth seen in cancers.
  • Insulin and IGF-1 (Insulin-like Growth Factor 1) are key hormones in this process.
  • Frequent snacking and constant eating, now normalized (snacks rose from 3 to 6 times daily since 1977), keep insulin elevated.
• Magnitude of Lifestyle Impact:
  Changes in diet and meal timing produce far greater reductions in cancer risk than focusing solely on genetics.

"You're not talking about 10% higher risk...these people never get cancer. The magnitude of improvement you can get is crazy." – Guest (B) [06:45]

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3. Fasting, Ketogenic Diets, and Autophagy (17:23–23:10)

• Fasting as Cancer Defense:
  Intermittent fasting and ketogenic diets lower insulin and activate autophagy (cellular “cleanup”), potentially starving cancer cells.
  • Fasting around chemotherapy may reduce its side effects and protect healthy cells by sending them into ‘repair mode.’
  • Ketogenic diets restrict glucose, depriving cancer cells (which can't use ketones for energy due to mitochondrial defects).
• Repair vs. Growth Mode:
  Modern eating habits maintain a perpetual ‘growth mode,’ favoring cancer development; fasting shifts the body to maintenance and repair.

“If you have a sports car and you rev that engine and you're running it fast all the time…it’s going to burn out much faster…You gotta sometimes bring it to the shop, let it rest.” – Guest (B) [20:05]

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4. Chronic Inflammation, Gut Health, and Cancer (23:10–43:42)

• Drivers of Chronic Inflammation:
  Environment, ultra-processed diets, sedentary lifestyle, chemical exposures, leaky gut, and gut dysbiosis (microbial imbalance) all fuel chronic inflammation, which is a prime cancer accelerator.
  • Poor gut health impairs the immune system (60% resides in the gut) and induces systemic inflammation.
  • Bacterial byproducts like LPS and low levels of “good” postbiotics (e.g., butyrate) heighten cancer risk.
• Western Diet’s Impact:
  Ultra-processed foods decimate beneficial bacteria, increase bad bacteria, and drastically worsen cancer-promoting inflammation.

"Good gut bacteria make something called postbiotics...butyrate is an anti-cancer compound made by your microbiome...When that balance is disrupted, it leads to an overgrowth of the bad bacteria." – Dr. Hyman [25:07]

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5. Insulin Resistance as a Central Theme (43:10–48:49)

• Insulin’s Role in Cancer:
  Insulin resistance (often fueled by modern diets) is tightly linked to increased risk and growth of several cancer types.
  • High blood sugar (even in the normal range) is present in a majority of cancer cases.
  • Many pancreatic cancer patients already have diabetes or prediabetes at diagnosis.
• Advanced Glycation End Products (AGEs):
  Cooking methods and processed foods heighten AGEs, which further promote inflammation, aging, and cancer.

“Insulin is a growth hormone…it also binds to and causes cancer cells to grow.” – Dr. Hyman [38:10]

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6. Food Additives, Toxins, and Cancer (43:10–43:42)

• Regulatory Loopholes:
  Over 10,000 chemicals are approved for U.S. foods, most rubber-stamped by industry via a "Generally Recognized as Safe" loophole, not rigorous FDA review.
• Endocrine Disruptors, Carcinogens, and Packaging:
  Chemicals like BHA, BHT, pesticides, PFAS, BPA, and phthalates are widespread in food and packaging, linked to hormonal disruption, cancer, and other chronic diseases.

"99% of food chemicals…were approved not by the government, but by the companies that made them. It's like the fox guarding the hen house." – Dr. Hyman [41:55]

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7. The Metabolic Theory of Cancer and the Warburg Effect (43:42–63:34)

• Metabolic Dysfunction vs. Genetics:
  Famous biochemist Otto Warburg observed that cancer cells generate energy primarily via fermentation (glycolysis) even in the presence of oxygen, unlike healthy cells.
  • Cancer cells rely on glucose and glutamine (“fermentation fuels”) because of dysfunctional mitochondria.
  • The genetic mutations widely observed in cancer cells, according to guests, are downstream effects—not the primary cause—of this metabolic shift.
• Therapeutic Implications:
  Targeting cancer’s metabolic weakness (fasting, ketogenic diets, nutrient deprivation) shows promise, particularly for drug-resistant or late-stage cancers.

“The beast is driven by fermentation. And the best way to manage cancer is pull the plug on their fermentation fuels…glucose and glutamine.” – Expert Guest (C) [66:29]

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Notable Quotes & Memorable Moments

• On Dietary Impact:
  “You could take a woman in San Francisco and cut her risk of breast cancer by a factor of two or three.” – Guest (B) [06:45]

• On the Growth Environment:
  "You want to create a hostile environment for cancer to grow. How do we build that hostile environment?" – Dr. Hyman [08:11]

• On Snacking and Obesity:
  “By 2004, [meals] were up to six times a day…It was never this deliberate, ‘Hey, there’s good scientific evidence.’ It just crept in.” – Guest (B) [14:20]

• On Cancer and Mitochondria:
  "Warburg said cancer cells don't need oxygen for growth…they replaced energy through respiration with energy through fermentation." – Expert Guest (C) [49:59]

• On the Difference Between Cancer and Normal Cells:
  "Cancer cells…can’t burn fats or ketone bodies because you need a good mitochondria…When you burn ketones, you increase the metabolic homeostasis of normal cells. The cancer cell is marginalized.” – Expert Guest (C) [66:30]

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Important Segment Timestamps

• 02:34 – Seed and Soil Metaphor & Cancer Disparities
• 08:25 – Role of Insulin, Meal Frequency, and Processed Foods
• 17:23 – Fasting, Ketogenic Diets, and Chemotherapy Tolerance
• 23:10 – Inflammation, Gut Health & Cancer
• 38:10 – Diabetes, Obesity & Cancer Incidence Links
• 41:55 – Food Chemicals, Regulations, & Industry Loopholes
• 43:42 – Cancer Cell Metabolism, Warburg Effect Explained
• 66:29 – Therapeutic Fasting, Ketogenesis, and “Starving” Cancer

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Summary & Takeaways

• Functional medicine’s paradigm shift: Future cancer prevention and care will focus less on genes and more on cultivating an anti-cancer terrain—through food, fasting, lifestyle change, and toxin avoidance.
• Practical preventative strategies:
  • Avoid ultra-processed foods and sugars
  • Favor whole foods, fiber, and plant diversity
  • Embrace fasting or time-restricted eating
  • Minimize chemical exposures from food additives and packaging
• Therapeutic optimism: Integrative approaches like ketogenic diets and intermittent fasting are gaining foothold as real adjuncts in cancer treatment—backed by emerging science and clinical promise.

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If you want to reclaim your health and build a body that’s inhospitable to chronic disease, this episode gives both the why and the how.

Transcript

[A]

Coming up on this episode of the Dr. Hyman show, the most important thing.

[B]

We need to focus on is not the genetics of the problem, it's the soil problem.

[A]

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[B]

So.

[C]

Okay, got it.

[A]

So I think, you know, this whole idea that you're bringing forth is so important. So talk about this analogy of the seed and the soil and cancer and why we're ignoring soil conditions in the body and the environmental issues and diet and also lifestyle and stress and environmental chemicals, all those factors.

[B]

So the idea of the seed in the soil actually goes way back. I mean, it was written about sort of like 60, 70 years ago. But then, of course, everybody forgot about it because the point is that, you know, genetics, this whole focus we had on finding mutations in genetics, really talks about the seed. Right. It doesn't talk about the environment that you're in. And if you have a seed, of course it has the ability to grow, but it needs the right conditions, the proper soil to grow. And what we always seem to not talk about is how certain populations that live a sort of traditional lifestyle almost never get cancer, like, other than the ones that we know that are, say, virally caused. But if you go back. So Dennis Burkitt was this sort of legendary Irish surgeon, and he went to Africa and he discovered burkish lymphoma and stuff. And it's very interesting story, but he looked at these Africans who were eating a traditional diet, living a traditional lifestyle, and he said, boy, these people just don't get cancer. And the whites, of course, were getting colorectal cancer at the same rate as they were in the uk, for example.

[A]

Yeah.

[B]

And so they called these things diseases of civilization. So obesity, type 2 diabetes, and cancer would come as people change their lifestyle. You see this actually all over the world. So the Inuit in the far north, some people used to call them Eskimos. So again, eating a traditional diet, very high in, say, you know, animals, you know, whale meat and seal blubber and stuff. That's their traditional diet. They never get those cancers that we get. I mean, they get some viral cancers, but they don't get like colorectal cancer, breast cancer. In fact, the university in Ontario, Canada, used to send an expedition to the Arctic Circle sort of every year to find out why these people were immune. But of course, they weren't actually immune because as soon as in the 60s, 70s and 80s, they changed their lifestyle to western sort of lifestyles with the sort of bread and sugar and all that sort of processed foods that we ate Then you started to see all the cancers. So clearly it wasn't a genetic problem because the gene pool of these Africans or these Inuit were not changing, but it was the soil that. And it comes back, of course, to diet and lifestyle, which is the most important thing, because that's the main thing that's changing. And these people come over. That is what is the biggest determinant of cannabis cancer. These aliens go from being considered immune to cancer to high rates of cancer. Of course, they're eating sugar all the time. There's tons of smoking and all this other stuff. And you see this everywhere. So you see this, say in Japan, where you can look at a Japanese woman in Japan compared to a Japanese woman in San Francisco. And of course, the person in San Francisco has about double or triple the rate of breast cancer compared to the Japanese women in Japan. So it's like. So this is clear evidence that the most important thing we need to focus on is not the genetics of the problem, it's the soil problem. Right?

[A]

Yeah. And I love, my favorite story is the Polish women who are From Poland eat 30 pounds of sauerkraut a year, and they have almost no breast cancer. And it affects their microbiome because it's a pre. Pre probiotic food. Plus cabbage has all sorts of phytochemicals that fight cancer. And though when they move to the United States, they get cancer at the same rates as American women because they stop eating all the sauerkraut.

[B]

Yeah, absolutely. And these are the things that are really important, because if you can figure it out, of course, then you have the ability to do the opposite. You could take a woman in San Francisco and, you know, cut her risk of breast cancer by a factor of two or three. Imagine how amazing that would be. I mean, with genetics and all this stuff, we're talking about, like, you know, you're making progress in inches compared to diet and lifestyle, where you're talking about huge leaps and jumps. Like, you're not Talking about, like, 10% higher risk, you know, in medicine, how. Oh, it's statistically significant. There's a 10% lower risk. It's like, oh, these people never get cancer. Right. It's like, it's crazy, the magnitude of improvement you can get. Well, on the other hand, it's like.

[A]

10% is 200 or 300%. Right.

[C]

It's like a totally different.

[B]

Yeah, it's a totally different order of scale. And yet we focus all of our sort of resources on saying, oh, let's figure out, you know, this genetic condition. Which might affect like 1% of these cancer patients. And science, it's like, okay, let's, let's not do that. Let's try and figure out the other stuff. Like what is it? Is it sugar? Is it, is it, you know, fermented foods? Is it processed foods? Like, what is that? Because that's so important. But unfortunately it gets so little sort of research money and you know, we start talking, people, people want the other stuff, right?

[A]

So people are listening, wondering, okay, this whole soil thing makes sense, right? You want to create a hostile environment for cancer to grow. How do we build that hostile environment instead of a fertile one that most.

[C]

Of us have for kids?

[B]

Yeah, that's a great question. And so I talk about, in the book about like, what is it that makes cells grow? And what's really important is sort of growth factors, or our body contains natural growth factors that increase the rate of growth. And one of the big things of the Last sort of 15, 20 years has been the realization that our body entails nutrient sensors, which are hormones that go up when you eat. But they also are precisely the same hormones that our body uses as growth factors. So the most important one is insulin. So insulin, of course is a well known metabolic hormone. So you eat and insulin goes up. Assuming you're eating carbohydrates and protein, sort of a mixed meal you eat, insulin goes up. But more importantly, what it is, it's a nutrient sensor. It tells your body that food is available. And the reason that's important is because your body only wants to grow when nutrients are available, right? So you don't want to, you're saying you don't want more cells to continue to grow if there's no food available. That's not a good survival strategy. So the body links them. In fact, if you look back in evolutionary times, insulin was not a metabolic hormone. It was actually a growth factor. So as we evolved, we actually used the same molecule that we used as a growth factor for nutrient signaling as well. So we know that insulin is a very common growth factor. There's this thing called insulin, like growth factor or IGF1. And Valter Longo actually described this group of Ecuadorian dwarfs, the Laron dwarves, who actually have almost no IGF one. So they're very short. Turns out they're also immune to cancer because if you don't have that growth signaling, then the cells can't grow. And the cells that are going to be the most affected are those cancer cells. So what you have to do, of course, is say that, okay, if we have too much insulin, then that's going to be a signal to our body that we need to grow. So what can you do to sort of reduce that insulin signaling in the body by reducing nutrient availability? Which is two things. One is getting rid of the hyper processed foods, which tends to really amplify the insulin response of sugar, for example, is especially bad because it causes all this insulin resistance, which causes hyperinsulinemia. A lot of the refined foods are very bad because they sort of take away all the other natural components and you're left with this big spike of insulin. Like if you eat cookies, for example, well, you know, it's just going to, your insulin is just going to spike up. And the other thing, of course, is if you eat very, very frequently, you're going to keep insulin high all the time. So intermittent fasting is another strategy that you could use to produce insulin. And that's.

[A]

So it's when you eat and when you eat.

[B]

Yeah, exactly. So it's what you eat and when you eat. Because if you eat a high carbohydrate diet, which people did like people in China, for example, used to eat a ton of white rice, but almost zero sugar. And they were okay. So it's not necessarily just the carbohydrates.

[A]

Well, they, they, I, I lived in China for a while. You're Chinese. I mean, I traveled around, remember 1984? I mean, they, they, they had no accoutrements of modern living. I mean, they, they had to cut a board. They would use a saw to create boards. They, they would, to grind the flour. They would like literally walk in circles for hours with the grain in between two giant stones. They would work in the fields for 14 hours a day with hard labor. And yeah, you can eat a lot of rice if you do that.

[B]

Yeah, that's true. And it's also like, it was very, it was like rice and vegetables. Like every day it was just rice and vegetables. Rice and vegetables.

[A]

And then, well, the land of milk and honey. The Chinese phrase for it is the land of fish and rice. So it's really what they think of. Yeah, so you're talking about what is the problem, which is the incredibly high amount of starch and sugar we consume. And you've talked about this in the diabetes code, the obesity code. This is a central driver of almost all chronic western diseases. Heart disease, cancer, diabetes, Alzheimer's, high blood pressure are caused by this phenomena of insulin resistance or too much insulin, which is driven from our diet. Basically a highly refined, processed carbohydrate diet and also this constant eating pattern, this thing called snacking, which I think is a modern invention. We have a snack food industry, but I mean, I don't snack. If you eat properly, you're never hungry. I mean, you don't have these spikes in insulin going up makes you hungry. But what's fascinating is that what you're saying is that insulin actually fuels the cancer growth and sugar fuels the cancer growth. You might be eating clean, working out, even meditating, but still feel anxious, wired or totally exhausted. The truth is it's easy to become magnesium deficient in today's fast paced world. Stress screens, sugar, caffeine, and even workouts, they all deplete your magnesium stores. And magnesium is involved in over 300 processes in your body, from sleep to stress regulation, muscle recovery, heart health and hormone balance. That's why I take Magnesium Breakthrough every night. It's the only supplement I've found with all seven essential forms of magnesium your body needs in one formula. Most magnesium supplements only give you one or two forms. That's not enough to make a difference. If you feel burnout or constantly on edge, your body's likely needing more magnesium. Try Magnesium Breakthrough and feel the difference in your sleep, your mood and your energy. Bioptimizers has increased their discount for my audience. Just go to bioptimizers.com hyman and use code HYMAN for 15% off your order.

[B]

So all of these diseases are actually diseases of too much insulin. So if you look at obesity, for example, if you were to measure the levels of insulin, people who are more overweight tend to have higher insulin. Same with type 2 diabetes. Hyperinsulinemia and insulin resistance are really sort of two sides of the same coin. So one causes the other sort of hyperinsulinemia can cause insulin resistance, insulin resistance can cause hyperinsulinemia. So they're really the same thing. And again, the same thing applies to sort of cancer. And this is the pattern that was noticed so many years ago that there are these diseases of sort of too much insulin, which is that, that sort of, they all go together, the heart disease. And you don't see that in people eating traditional diets because they're not eating all the time. So I remember there was a study, this NHANES study, which is a big sort of American survey of lots of things, but they included dietary habits. So in 1977 they found that most people ate three times a day, so breakfast, lunch and dinner. And by 2004 it was onions up to six times a day. Right. So it's like, wow, that's crazy. And it was never this sort of deliberate, hey, there's good scientific evidence that we should eat six times a day. It just sort of crept in there. And I think part of it was, of course, the stack companies wanted to promote it and, you know, people thought it was a good idea. So then it was this sort of. It became almost gospel. Oh, you have to eat things a day. Right. And I remember thinking about it a while ago and thinking, where did that suddenly sneak? Did we have a big randomized, controlled child that I missed somehow? Because I don't think so. It was just this gradual change in attitudes. And you saw it because I start to think back to my upbringing in the 70s, right? So I grew up in the 70s. And you know, if you wanted a sort of after school snack, your mom said, no, you're going to ruin your dinner, right? If you want a bedtime snack, your mom would say, no, you should have ate more at dinner. And it's like, that's just the way it was. And of course people would have this sort of natural fasting period from after dinner, which was say 6 o' clock, because people ate a bit earlier back then to like say 8 o'. Clock. So 14 hours of fasting every single day without even.

[A]

We call that breakfast.

[B]

Yeah, exactly.

[A]

Breaking the fast.

[B]

Breaking the fast. That is a word that we use. And it's like somehow we went from that where people didn't have the obesity problems, type 2 diabetes problems, because they have this natural fasting period built in that has always been there. It's even built into the English language. And, and then it's like, oh, you got to eat all the time. And it's like, oh, you can't ever skip your breakfast. You got to snap all the time. Right? You see it in schools, for example. Oh, they go to school, they get a mid morning snack, then they have lunch, and then they have their afternoon and then they have their dinner. Then, you know, you're playing soccer and they think that they need to have a snack in between the halves of soccer. You know, I played.

[A]

Well, Jason, you've written a lot about, you've written a lot about fasting and the effects of either time restricted eating, which is, you know, 12, 14, 16 hour fasts every day, or, or taking a 24, 36 hour fast a week or even longer fast for diabetes. And I'd love you to sort of share why around cancer. This is so important. And on my podcast soon we're going to have Dr. Patrick Hanaway, who Is my colleague and friend, was the medical director at Cleveland Clinic, who had cancer and used fasting as an approach to his cancer treatment. He still got radiation, but he. He also did it in a way that actually reduced all the side effects to almost none. Has kept him healthy now for well over a year. And this cancer was not a great one. And let him go through the process with really no issues, which was really staggering. And really went on a ketogenic diet in order to do that, which is both using fasting and ketogenic diets to drop insulin levels to almost undetectable. So can you talk about this whole idea of fasting cancer, ketogenic diets, why it's so important and how it connects to this whole idea of insulin resistance and insulin high insulin levels?

[B]

Yeah. So both fasting and ketogenic diets have the same sort of goal at the end, which is trying to lower insulin. Because the difference between a ketogenic diet, say, and a low carb diet is that, you know, you're sort of low carb, ultra low carb for the keto, but sort of moderate protein, because protein can also stimulate insulin. Whereas some of the older low carb diets were like, very high in protein. You take protein, protein shapes or whatever it is, Right? Yeah. Like Atkins. And so not a good idea is not always the best idea, because you can get high insulin, but you also get this high mtor, which is sometimes not so good for cancer as well. But the idea is to really drop your insulin levels. And if these are diseases of too much insulin, then that's going to be a very useful adjumping treatment. So fasting is actually fascinating because there's all these different things we're discovering. So one of the things is sort of autophagy. So as you fast, of course, your nutrient sensors go down, so mtor insulin go down, and then you activate this process called autophagy, where you actually start to break down some of your subcellular organelles and stuff. So basically your body's just trying to clean house.

[A]

Pac man coming around and cleaning up all the garbage.

[B]

Yeah, exactly. People think it's a bad thing.

[A]

Maybe don't people know who Pac man was? But that was the original video game that Bell played back in the sevent. Using this pretty simple signing, though.

[B]

Yeah.

[A]

I don't know what Pacman is anymore.

[B]

People still find them sometimes. But yeah, the idea is that people think that this sort of breakdown process is very bad for you, but it's actually really good for you. And in fact, it's sort of one of the keys to rejuvenating the body. That is, you want to break down all your old stuff and then sort of rebuild the stuff that you need. So the, the whole idea of fasting is you're trying to put the body into this sort of regenerative maintenance mode. Because what we recognized over the last eight bit is that your body sort of has sort of, you know, you can go into growth mode or you can go into sort of the cell maintenance repair mode. And it really depends on your nutrients availability. When nutrients are available, you want to grow. When nutrients are not available, you don't want to grow. And you want to go into this sort of maintenance repair mode. And everybody thinks growth is good, but growth is not always good, especially as an adult. So I always say, think about a car. It's like if you have a sports car and you rev that engine and you're running it fast all the time, you're going to go fast, which is great, but it's going to burn out much faster. So you can't just keep revving that engine, keep redlining it. You got to sometimes bring it to the shop, put it in the garage, let it rest and all this stuff.

[A]

A pit stop.

[B]

Yeah, exactly. A little pit stop. So that's the point of the human body too. You can either go for growth or you can go for longevity or cellular maintenance repair. But you gotta have a bit of both. It's a balance there. It's not all growth. And this is where you say, oh, eat, eat, eat, eat. Well, you're gonna put your body, your nutrient sets are gonna go up, your growth factors are gonna go up, you're gonna put yourself in growth mode. But you don't wanna do that, especially for a disease such as cancer, which is a disease where cells are growing too much. You're basically feeding into that growth, and that's going to be very, very bad for you. So what you do instead is you do the fasting and you put your cells into this sort of maintenance repair mode. And it actually allows you to undergo both the chemotherapy and probably the radiation therapy better. Because chemotherapy, we have a couple studies on fasting and chemotherapy where what you do is you fast sort of just before and during and just after your chemotherapy. And what they've noticed is that those people tend to get a lot less side effects from treatment. Because what you've done, of course, is taken the cells of your normal body and you sort of put them into a more quiescent state. They're not Trying to grow, they're actually trying to slow down. And chemotherapy, the general way it works is it kills the fastest growing cells, which are usually the cancer cells, but it also kills like the hair follicles, because they're fast growing cells. It kills the lining of the GI tract, so you get nausea and your hair falls out. So if you can put those cells into sort of a quiescent sort of repair mode, it's not going to sustain as much damage from the chemotherapy. And instead the cancer cells, which can't stop their growth, they're always trying to grow, they can't do that. So therefore they're going to sustain full damage from the chemotherapy while your body is relatively protected.

[A]

Now, there are many root causes of cancer. Depends on the person, genetics, and everything they're exposed to throughout their lifetime. Something called we call the exposome. But chronic inflammation is one of the most common drivers of cancer. Now, this is chronic sterile inflammation, not infection. And it could be why cancer is on the rise. In younger people, the development and the progression of cancer, it happens downstream of chronic low grade inflammation. So how does that work? How does chronic inflammation drive cancer? Well, it creates a microenvironment that supports tumor development, tumor growth and tumor progression. In other words, metastasis. Inflammatory mediators, things like cytokines, they promote DNA damage. They inhibit something called apoptosis, which is basically programmed cell death, getting rid of damaged cells. So it stops the process of actually getting rid of all the cells that are going to turn into cancer. It also enhances angiogenesis, which is the formation of new blood vessels that supply tumors with blood nutrients for growth, which they need. Otherwise they die if they have no blood supply. Inflammation processes can also cause changes to your DNA through something called epigenetic modifications. If you eat bad food and junk food and ultra processed food, you are going to be silencing something called the tumor suppressor genes, genes that suppress cancer. Or even worse, you're going to be activating genes that cause cancer called oncogenes. Oncology is cancer. Oncogenes are cancer causing genes. These are genetic mutations that turn on tumors and it's caused by what we're eating and that further promotes cancer development. All right, so let's back up a little bit and go into what causes chronic inflammation. So many things. First, living in our modern world, just being alive today is an inflammatory state. We have a constant exposure to environmental toxins, things that we never had before, like pfas chemicals, bisphenol A or bpa, microplastics, and the list goes on and on. We're going to get into some more of those poor diet, ultra processed diet or sedentary lifestyle. The over prescribing of drugs, just aging itself causes higher risk, leaky gut, food sensitivities, food allergies, hormone imbalances and more. All these potentially drive inflammation. Now Hippocrates once said that all disease begins in the gut. And for the purpose of this conversation, we're going to follow his advice and start in the gut. So how do imbalances in your gut microbiome lead to cancer? Now this is really fascinating stuff. It's cutting edge stuff, so you're not hearing about this everywhere, but we're going to get into it. Today, healthy gut contains a whole diverse population of bugs of microorganisms that play key roles in your digestion, in a nutrient absorption and your immune function. Why? Because 60% of your immune system lives in your gut. It's right underneath the lining of your gut. Why? Because you're exposed to the outside world and it's trying to protect you from all the bad stuff inside your gut, which is poop and food. Now, good gut bacteria make something called postbiotics. You've heard of prebiotics like fiber or probiotics like Lactobacillus, but there's something called postbiotics. These are molecules, metabolites of bacteria in your gut and they can be good or bad. So they're called postbiotics and they're made by what you're eating and feeding the bacteria in your gut. Now there's a lot of them, but some of them are really important in regulating cancer. For example, butyrate is a anti cancer compound made by your microbiome. When you have good bugs in there, you also make other compounds like acetate and propionate. These are metabolized that are produced by bacterial fermentation of fiber and all the polyphenols, all those colorful compounds in veggies and fruits, that supports the integrity of the gut lining. And the gut lining is so important because without healthy gut lining, basically all that poop and food is leaking into your bloodstream and causing your immune system to go crazy. Now these metabolites, they're called short chain fatty acids, they have anti cancer properties, they regulate our immune system, they help fight inflammation. And when there's a good balance of these microorganisms, that's great. But when that balance is disrupted, it leads to an over growth of the bad bacteria and a reduction in the beneficial bacteria. So it's like Getting weeds in your garden, the good plants, they get crowded out by the bad weeds, right? And bad bacteria are bad because they release poisons, toxins. We call them endotoxins. That just means an internal toxin. And those endotoxins get into your system through a leaky gut, and they also cause a leaky gut and they cause inflammation. And the imbalances in your gut microbiome that cause this problem is called dysbiosis. Now, dysbiosis can compromise the integrity of the gut lining. It makes you have a leaky gut and leads to something called increased intestinal permeability. And the basic lay term is leaky gut. Now, basically think about your gut as one cell lining that protects you from the outside world. And the cells are stuck together like Legos. They have something called tight junctions. When those are damaged, which happens because of bad gut bacteria. And all our processed food and emulsifiers and additives and all this crap, you separate these cells and then the food and bacteria can leak in between the cells and get into your bloodstream. And then right underneath your gut lining is your immune system. So that's why this is such a big deal. And when you have this leaky gut, it allows toxins and undigested food particles and pathogens, bacteria to enter the bloodstream. And your body is like, wow, this is not me. That leads to an overactive immune system and chronic inflammation throughout the body and affects everything, not just cancer, but everything. Heart disease, cancer, diabetes, dementia, literally everything. Autoimmune disease, asthma, allergies, autism, add, depression, list goes on and on and on. And we're talking about cancer here. Now, the immune system responds to these foreign substances by what? By doing what it's supposed to do. It's like, this ain't me. It triggers an inflammatory response. So it's bad when you have bad bugs. And most of us have bad bugs in our gut. So how does this standard American diet, the SAD diet, disrupt our gut microbiome? Well, it's because it's so rich in bad stuff, like ultra processed foods, which are energy dense, but they contain a lot of other stuff like added sugars, sweeteners, refined grains, bad fats, toxins, actual literal toxins, chemical additives, preservatives, pfas, phthalates, things that are just poisons that damage the gut. Now, this feeds and grows the bad bacteria and it reduces something called bacterial diversity. You want an ecosystem like a rainforest, complex, diverse, resilient. You don't want a monocrop cornfield that can go out just like that with some adversity. And we are having a low bacterial diversity in our modern world. Now beneficial bacteria, the good ones like Bifidobacteria lactobacilli, Akkermansia, Fyla bacterium and Roseberia, they're lower. And you have to remember all those names by the way. I'm just telling you because it's all the bugs that are the good ones. You can get to know them if you want. They're nice actually, but they're lower in abundance when you have a western diet. So when you have all these bad foods, you all the good bugs go down and you get less of these good short chain fatty acids, less of these good anti cancer compounds that your gut naturally produces. Now on the other hand, when you eat this to processed diet, it increases the abundance of something called pro inflammatory bacteria. These like Ruminococcus proteobacteria, which produce pro inflammatory compounds called lps. LPS stands for lipopolysaccharides. Doesn't really matter. Basically these are like poisons. And these bacteria produce these poisons and they get into the system, they leak in and they start creating an inflammatory response. Now we can look at the gut in many ways and I've seen so many stool tests. They used to call me Dr. C every poop in my old job at Canyon Ranch because I looked at every soil test and we look a lot of different factors. We can look at levels of bacteria, we can look at levels of short chain fatty acids, we can look at ratios of good and bad bacteria. But there's a ratio of something called firmicutes to bacteroides. When you have a high ratio of firmicutes to bacteroides in the. These are basically categories of bacteria. It is is linked to obesity and diabetes and metabolic disease. But a high ratio has also been seen with breast cancer, colorectal cancer. And it's really important to consider as a broader picture of the overall microbial diversity and your individual health and genetics. Now in a study that was titled intake of sugar and food source of sugar and colorectal cancer risk in the multi ethnic cohort study, Blah, blah, blah, whatever. They're like these long names. The researchers noted that total sugar, total fructose, glucose and fructose and maltose, all different kinds of sugar, were associated with an increased risk for colorectal cancer, especially younger people. Now this is interesting because colorectal cancer is the number one cause of cancer death among men under 50 and the number two leading cause of cancer death in young women. Now, this isn't static. It's increasing by about 1 to 2% a year in adults under 55. There's also a strong link between type 2 diabetes and metabolic syndrome, obesity and risk for colorectal, hepatic, pancreatic, breast, endometrial, and lots of other cancers. Now, there's something else that's really important here, which is we're all metabolically unhealthy. There's an enormously strong link between type 2 diabetes, prediabetes, obesity, and the risk for so many cancers that are most common. Cancers like colorectal cancer, liver, hepatic cancer, pancreatic cancer, breast cancer, endometrial, uterine cancer, and many other cancers. In fact, 48% of all cancers are attributed to obesity, but I think the number is probably a lot higher. And obesity, if you're overweight, is associated with a 40% greater risk of early onset colorectal cancer. That's from the Journal of Gastroenterology. 45% of adults 59 and younger are obese. So a lot of people are at risk. And studies show that diabetes significantly increases the risk of cancer and that lots of people who have cancer have a high incidence of diabetes. Now get this. Up to 80% of pancreatic cancer patients actually have type 2 diabetes or pre diabetes or impaired glucose tolerance when they're diagnosed. This is a deadly cancer. It's caused by our diet. So what else do chronic diseases have in common? Well, insulin resistance, that's what we've just been talking about. And you've heard me talk about it forever. I'm going to keep talking about it because it's the cause of everything. Cancer, heart disease, diabetes, dementia. So how does insulin resistance relate to cancer? Well, insulin is responsible for keeping our blood sugar balanced and stable. Now, insulin is a growth hormone. It causes your fat cells to grow, it causes your belly to grow, but it also binds to and causes cancer cells to grow. So eating a high sugar, high starch, high glycemic diet causes our cells to become resistant to the effects of insulin. And what does that do? Well, that leads your body to produce more and more insulin to keep your blood sugar normal. These high levels of insulin, or what we call hyperinsulinemia, increases the production of another molecule called IGF1 that stands for insulin, like growth factor one. Now, it's a hormone that increases cell division, cell growth, and inhibits autophagy or cellular cleanup. Now, sometimes it's good. It's like Goldilocks. But when you have high levels of IGF1, from all the sugar. It basically causes cells to continue to grow and divide and prevents them from being killed. Okay. Now, high blood sugar is present in 39 to 99% of cancer cases. And that leads to insulin resistance, oxidative stress, chronic inflammation in the body. It also creates something called advanced glycation end products, or AGEs. Now, glycation is a chemical reaction. You're familiar with it when your chicken skin is crispy or your bread has a crust on it, or when you get that creme brulee thing, it's got that crispy thing on top that's called glycation. It's when sugar and proteins or other fats bind together and form this basically compound called AGEs or advanced glycation end products. When these glycated products bind to DNA, they bind to proteins and lipids. It causes something called the mallard reaction, the browning reaction. You've seen this. But the problem is these accumulate in our tissue and they, when they bind to something called rageous receptors for advanced glycation end products, when they bind to those receptors, it activates a whole inflammatory cascade, and that accelerates not only cancer, but also aging itself. And there's lots of sources of AGEs in our diet. We actually eat them on a regular basis, right? Ultra processed food is a big source. Dry heat processing is one way. Baked goods, cooking at high temperatures, brown charred, fried, burnt foods. These ages create damage to your blood vessels. They cause oxidative stress, they reduce blood flow, they cause damage to your DNA, to your tissue, to your mitochondria. They're just bad. Now, you can kind of measure this in the blood by something called hemoglobin A1C, which is essentially glycated hemoglobin. It's your hemoglobin, which you can measure easily in your blood and see how much sugar is bound to it. And that kind of gives you a rough idea. There's also an amazing new test called the insulin resistance score from Quest, which allows you to get a really good read on your degree of insulin resistance and how bad it is. Because hemoglobin A1c is a late stage phenomena. And it's great that you can do this test now and through Function Health, the company I co founded, to allow you access to your own lab data through, you know, just going directly to a quest lab and getting your data. Very simple process. You can go to functionhealth.com mark to learn and sign up. But the insulin resistance scores are really important because it really tells you what your risk is. Now, the test we Commonly use in medicine. Now, to look at glycation is called hemoglobin A1C. And if it's 6% or higher, it's associated with a high cancer risk in both diabetics and non diabetics. And even a lower level may be a problem. We find that even levels down to five are probably optimal. But anything over five, you're starting to increase your risk for heart disease and other things. So the cutoffs we have in medicine are arbitrary. We say six, it's six and a half. Used to be 5.7, it's prediabetes, 5.5. I mean, it's all a moving target because, you know, we're finding that at lower and lower levels, there's a problem. So basically, you want your hemoglobin AC as low as possible. Let's look at another big factor that causes cancer. Fructose. Now, fructose is something found in fruit, which is good, but it's not fruit we're talking about here. Epidemiologic or population studies which don't prove cause and effect, but they found strong associations between high fructose intake from sources like high fructose corn syrup and increased risk of pancreatic and colon cancers. Now, to realize we never had this stuff in our food supply until the 70s. There was no high fructose corn syrup. Now it's about 15% of our calories. It's in everything. And it's got not 50, 50 fructose and glucose like sugar. It might have 55 to 75% fructose, which has all these adverse effects. And it's free fructose. Now there's something called the fructose transporter, and this is called glute 5. And thought about your glutes, it's called glut 5. And it's overexpressed in cancers like pancreatic, colorectal, breast, lung cancer. Now, when you have high glut 5 expression, it basically allows for increased in intake or uptake of fructose by cancer cells. And what does that do? That makes them grow because they, they love the sugar. It cause them to move, migrate and move around, meaning starting to spread and invasion, meaning metastases. So where are we getting high fructose levels in our diet? It's not from fruit. It's from added sugars and sweeteners like high fructose corn syrup, sucrose, and fructose as sweeteners that are in all the ultra processed food we eat. I mean, it's 60% of our diet is ultra processed food. So fructose in high fructose corn syrup and all the food ads is bad. So what else could be causing cancer that's in our SAD diet? Well, food additives. Over 10,000 chemicals are allowed in the food we eat in the United States. 10,000. And here's what's shocking. 99% of the food chemicals that have been introduced to our food supply since 2000 were approved not by the government, not by the FDA, but approved by the food and chemical companies that made them. It's like the fox guarding the hen house, right? Since 2000, 756 new food chemicals have been added to our food supply through a loophole in the law called grass. G R A S it stands for generally recognizes safe. So it seems like, oh, it seems like it's safe. Well, it doesn't seem to be killing anybody right now. So let's just put in the food supply. Now, this grass loophole is a big deal. Food chemical companies exploit this loophole, allowing them to make their own safety determinations for substances that they say are generally recognized as safe. Now, the 1958 Food Addams Amendment intended for rigorous FDA review, meaning if you want to add some new chemicals to the food, the FDA has to review the science on this. But this grass loophole basically has become the main approval route. You basically take the company's word for it that it's safe. How crazy is that? Right? When a company determines a substance is grass, it means they think it's safe among, quote, qualified experts. So they get a gadget experts, they pay and they say it's safe. And then they submit a notice to the fda. But the process is entirely voluntary. And the FDA can review these notices and issue a quote, no questions letter. But it doesn't actually approve these substances or even affirm the company's safety data. So there's all this crap in our food that got in there without any real oversight. Now, due to this loophole, harmful ingredients have been added and continue to be added to our food supply. Let me give an example. 7 Carcinogenic flavor ingredients were approved as grass by female. This is the Flavor and Extract Manufacturers Association. Not a government group, an industry trade group. This is a group reviews and approves nearly all flavor ingredients. But these ingredients were later banned in 2018 after a petition by the Environmental Working Group for being linked to cancer in animals. Now, I'm on the board of the Environmental Working Group, so I've been part of this. I get it. It's really bad. Now, food additives are commonly used to enhance the flavor of baked goods. Ice cream, candy, chewing gum, beverages, all kinds of stuff. And they got weird chemical names. Benzophenone, ethyl, acrylate, pyridine, styrene. Do you have these in your cupboard at home that you cook with? I doubt it. Right. The term flavor is this vague label that food manufacturers use to hide chemical names from consumers. It's deliberate. They say it's got natural flavorings, artificial flavings, blah, blah, blah. You don't even know what it is. Right. A lot of other grass substances which are not approved in other countries include bha, which is classified as reasonably anticipated to be a human carcinogen by the National Toxicology Program. Right. Bht or butylated hydroxytoluene. When you put that in your salad, it's in everything. And that has been determined to disrupt endocrine function by causing change to thyroid and also affects animal development and fetal development. Now BHT is in everything. It's in cereal, chewing gum, potato chips, vegetable oil, baked goods, cakes, biscuits, crackers, pastries, everywhere. And it's banned in Europe. We're going to get to that in a minute. There's another thing we have to think about with food, which are the toxins in food, pesticides. So. And all other toxins. So how do you avoid those? Well, avoid processed and packaged foods. All that BPA is in the plastics and the cans and the packaging. Phthalates, the forever chemicals, pfas, microplastics that leach into our food from packaging, from the manufacturing processes. It's in our water, in our soil. Make sure you filter water. In fact, Consumer Reports tested food products for phthalates, which is one of these toxic chemicals, from 67 grocery stores and 18 fast food chains and found that levels vary dramatically. Some of the worst offenders for having these chemicals were Coca Cola, Fairlife, Core Power, High Protein Milkshakes, Slim Fast, Yoplait, Wendy's Crispy Chicken Nuggets, Chipotle and Moe's Southwest Chicken, Grilled Chicken Burrito, Burger King, Whopper, Cheerios, and the list goes on.

[C]

In cancer, there is some defect in the ability of the mitochondrion in the cell to produce energy, which is the way most of our cells get energy. I mean, we breathe oxygen and oxygen is a form of serves as the final combination, common acceptor of electrons in our mitochondria to generate energy through oxidative phosphorylation. And he said that's broken in cancer.

[A]

And in order for cancer, what you basically said was in order for us to produce energy in our cells, most of us combine oxygen with sugar in this kind of chemical reaction down assembly line called oxidative phosphorylation. It's kind of the normal way you produce energy from food and it's through glucose primarily and oxygen. So that's what, that's what you're talking about?

[C]

Yeah, yeah. So, so we, we, we bring, we bring glucose into the cell or, or other foods that would be broken down into either into glucose or acetyl CoA, which is the end product of the glycolytic pathway pyru. So the cell brings in glucose. There's a ten step pathway called glycolysis, the old Emden Meyerhoff porns pathway. And then the pyruvate, which is a three carbon derivative of glucose, is then enters into the mitochondria and is fully oxidized to produce significant amounts of energy. With the key waste products being water and CO2. So every time we exhale, we're exhaling the waste products of food metabolism, which are, which is CO2 and the moisture water. We can develop urine from combining with amino acid breakdown products. So it's a very highly efficient, highly, highly energy efficient system. But Warburg was saying that cancer cells have a defect in their mitochondria. And that defect is compensated for by a upregulation of these ancient glycolytic fermentation. So glycolysis is present in all of our cells. The problem is when the mitochondria become defective, the end product of glycolysis, pyruvic acid, is no longer entering the mitochondria but is being diverted to lactic acid, a waste product of the glycolytic pathway. And that acidifies the cancer microenvironment. So cancer then becomes a disease of cells that proliferate with, instead of producing oxygen, CO2 and water, they're producing lactic acid as a waste product. So. And Warburg noticed that all the major cancers that he studied were all blowing out large amounts of this lactic acid.

[A]

And he said what accumulates in your muscles when you over exercise it causes.

[C]

Exactly, exactly. But then that deficit is made up. As soon as the oxygen can be, the muscles can be reoxygenated, they go back to respiring. So the muscles have a capacity that when oxygen becomes deficient from overuse of muscles, the muscle will then use the local glucose to produce massive amounts of quick energy with the waste product of lactic acid, which goes back into the bloodstream in exercised folks. And the Lactic acid goes to the liver and is created back to glucose, and that's the chloricycle. And Saul and Gertie Corey received the Nobel Prize for their. For their recognition of how lactic acid from muscles can be reconverted back into glucose for the body. So hold on one second.

[A]

I think that what you just said was so important. I want to make sure everybody gets it and then we can kind of continue it on how it's related to cancer. So everybody, basically, from my understanding, is that when we eat our food is primarily turn into glucose. Glucose then has to go through this process of breakdown into byproducts we call pyruvate. And then there's a whole bunch of steps that then turns that into energy in the body with cancer cells that basically processes is kind of defective. And so it turns, instead of turning into easy form energy from glucose, it creates lactic acid, which changes the whole environment itself. And basically the other sort of point I think it's important people realize is that your body is like a hybrid car. It can run on gas or electric, your cancer cells, and the gas is sugar and the electric is fat. In cancer cells, they don't run well on fat, and it basically starves them. They only can run on sugar, which is gas. It's kind of a dirty burning fuel. And that ends up with all this linkage of cancer to things like diabetes and insulin resistance and it's. And all these various factors. So that's all how it ties together. Now then, take a stand. This process of the secondary pathway, which is fermentation, instead of what we call the primary pathway, burning energy, which is oxygen phosphorylation, essentially the Krebs cycle. It's how we break down sugar and energy. So I think that I just sort of want to like, reinforce that because there was a lot in there.

[C]

No, no, you're 100% correct, Mark. This sometimes can be a little overwhelming.

[A]

I mean, even most doctors, by the way, like, you know, we remember biochemistry for just enough for our exams. Then we forget it all, including the Krebs cycle, which is what you're talking about, which is how we turn food and oxygen into energy. But it's one of the most important things we do in our.

[C]

You know, it's. It's really an interesting thing because, you know, most of us, when we had to study the Krebs cycle as. As a requirement only because it was tortuous to try to memorize all the stuff, you know, and there was no pleasure in doing that. Other than the fact that you say, oh, you, to memorize it, you regurgitate it on a test and then you wouldn't have to worry about it again. So, but, but when, when, when, when, when we are in a different, in a different sphere now where we really need to understand that in order to manage a very devastating disease. So you have it, you, I take, I took a completely different view of these tortuous biochemical pathways when I said I needed to know this in order to manage the cancer, not in order to have an effective non toxic management of the tumor. So now it becomes a process. It becomes part of your soul to understand these processes because, because, because you're going to be able to wield the power of your knowledge to manage a disease. Because you finally understand what all this, all this crap meant. And, and so now we realize that as Warburg said, cancer cells don't need oxygen for their growth. And he showed data that he can take all the oxygen out of the system. And these tumor cells were still growing fine. And his argument was they replaced their oxidative phosphorylation, or energy through respiration with energy through fermentation. Fermentation is energy without oxygen. And he was, he said that they.

[A]

Were getting their wine or beer. Right?

[C]

Yeah, yeah, yeah. Well the, the byproduct that's an alcohol, that's alcoholic fermentation resin, poly lactic acid fermentation. There's an extra step by that the yeast use to, to, to convert the lactate into ethanol. So, but that's a, that's another step. Our muscles and our cancer cells are producing lactic acid as a waste product of the fermentation process. So, so as a result. But Warburg was saying that the, you have to replace energy. So without energy, nothing will grow, period. That's the key basis of all of our life existence. Without energy, we die real quick. And you want to know how fast we can die? If people drink cyanide, you die real, real fast.

[A]

As I said that mitochondria, yeah, it.

[C]

Poisons complex 4 of the mitochondria, shuts down electron transport, prevents oxygen from binding to electrons and your whole body just shuts down instantly.

[A]

So you can't make any cyanide, you just can't make energy. And then you die.

[C]

Can't make energy. Your brain dies, your heart dies. Everything dies. Anything that's linked to oxidative phosphorylation dies real quick. Except a cancer cell. So that's the. So Warburg said cancer cells are resistant to cyanide I said, whoa, this is. So they don't need. They don't need oxygen, and they don't. And they can live in cyanide. And I said, whoa, what the hell is this? But he said, a long time ago, in the 1920s, they. They were showing this kind of thing. They would take a rat that had a tumor and they would inject the rat with cyanide, and the rat would die instantly, but not the tumor. You could take the tumor out and grow the cells, and culture was fine. The tumor was resistant to the cyanide. And he said, that's because they're oxidative phosphorylation. They have replaced oxidative phosphorylation with fermentation, which is energy without oxygen. So what, what? That became very clear from his hundreds and hundreds of scientific papers and analyses. And so I went back and I looked at all that stuff really, really carefully and confirmed in no uncertain terms that otto Warburg was 100% correct in his knowledge of the origin of cancer. He was not correct in the readouts, and I'll explain that in a minute because we've cleared. We've cleared that all up, the misinformation regarding the readouts of, of dysfunctional respiration. But he claimed that cancer starts with a chronic disruption of oxidative phosphor energy through oxidative respiration. Then the cell will gradually, over time, transition to this ancient process of fermentation. And he also clearly said that if you damage respiration too acutely, the cell will die. And you will not get a cancer cell from a dead cell. And that's exactly what happens with the cyanide. You can never get. If you're. The whole body is dead, there's no way you're going to get a cancer cell. But if you have a cancer cell in there, it's not going to die from cyanide. So as I said, so people with cancer take. Drink cyanide to kill themselves. Well, they'll kill their body, but the tumor cells in their body will still remain alive. So as long as they have the fermentable fuels in the microenvironment. And at that time, Warburg figured that the major fermentable fuel was the sugar glucose. So glucose can either be completely respired in the mitochondria of the cell, or it can be fermented if the mitochondria are not functional, or the individual would be in a low oxygen environment. So. So it became clear to Warburg that the release of large amounts of lactic acid from tumor cells was the result of a defect in oxidative phosphorylation. And this then could explain the origin of cancer. Problem is, in the 1950s, Sidney Winehouse and others, who was the head of the national cancer institute and rightly so, reported that there were some cancer cells that took in as much oxygen as some normal cells. So he said warburg must be wrong because the oxygen consumption. We're seeing cancer cells that are taking in oxygen as. As avidly as normal cells, and yet the cancer cell is still blowing out lactic acid. What's going on with this? So they said then, oh, the cancer cell needs so much energy, it both respires and produces lactic acid at the same time. So this major controversy and battle went on for years and is still going on for many people today in the papers that they publish, showing that cancer cells consume oxygen just as readily as normal cells in culture. And therefore cancer cells are using oxidative phosphorylation.

[A]

Wrong.

[C]

We've shown that's not the case. It turns out that the tumor cells do, in fact, consume oxygen, but they're not using it for ATP synthesis. They're not using the consumed oxygen for generating energy through oxidative phosphorylation. They are using it to produce reactive oxygen species. R o s r o s are carcinogenic and mutagenic. These radicals, oxygen radicals, damage DNA, RNA, and proteins. They cause the mutations that you see in the nucleus of the tumor cells. So the oxygen consumed by cancer cells is producing DNA damage as a downstream epiphenomenon of the damage to oxidative phosphorylation. So the cancer field today is focusing on mutations and targeting mutations. These are all effects. They're not the cause of cancer. And this goes back to the argument with Sidney Winehouse and warburg in the 1950s. Except the folks today absolutely do not understand, do not appreciate, or cannot accept the fact that the oxygen consumption in cancer cell is not used for oxidative phosphorylation. It's used for reactive oxygen species and other reactions not involving ATP. So you have to put the story together. So when you mentioned car t immunotherapy, all these immunotherapies, they're based on the somatic mutation theory. So now Warburg. Warburg was the initiator of the mitochondrial metabolic theory of cancer. I will explain more because he did not know about glutamine fermentation, which we now know about. He did not. He also assumed that the oxygen consumed by cancer cells, Even though It was low, was still linked to oxfos. Okay, that's a misunderstanding on Warburg's part.

[A]

They're giving him credit. He was that with over 100 years ago.

[C]

Oh, yeah, it was 100 years ago. And I. And because the pathway for glutamine fermentation was not yet developed, so he did not know about the second major fermentable fuel. So we got. He was absolutely right on the origin of cancer. He was incorrect on assuming that lactic acid production equaled a certain amount of ATP. We now know that that calculation is, is somewhat in error. We also know that oxygen consumption is in error. So we can put it all together. Warburg was 100% correct in the knowledge of how cancer started. His readouts were, were, were, were incorrect. And we're, we're polishing it all up. So this is the mitochondrial metabolic.

[A]

Let me take a pause here for a second. So basically what you're saying is that most oncology today is focused on the idea that cancer results from genetic mutations in the cancer. However, what we're now learning at the same time is that you can take 100 cases of breast cancer, and they may be all genetically very different, or colon cancer, or prostate cancer, or pancreatic cancer. And so even they have the same name, the same pathology. On a microscope, the underlying genetics are quite different. And so we're playing a little bit of whack.

[B]

A mole.

[A]

Now, there may be some ways of improving cancer response to chemotherapy by identifying which genetic mutations there are and which drugs work better for which ones. And it's sort of an incremental improvement, but it's not a, it's not a kind of cataclysmic shift in our thinking around cancer, which is moving from a genetic theory to a metabolic theory. And I think the metabolic theory is quite interesting. I think it clearly needs to be fleshed out more. But it looks like it's holding promise to deal with things like stage 4 melanoma, stage 4 pancreatic cancer, stage 4 breast cancer. Cancers that are really death sentences are responding. Even glioblastoma, which is brain cancer, very well, the ketogenic diets. So you kind of have to be able to sort of navigate this new landscape where certain cancers are really responding to a metabolic approach. And so we can't just sort of relegate it to some crazy whack job theory. This is actually now becoming more mainstream thinking.

[C]

Well, going back to what you said about the breast cancer, you know, when you look at individual breast tumors, you know, they have different stage ones for, you know, all the different kinds of HER2.

[A]

And yeah, the staging and the typing, you know, which actually may be less important.

[C]

Yeah, yeah, yeah. So, so. But you're 100% correct when you look at the genetic profiles of all these different tumors, they're all essentially different from each other. I mean, there's some commonalities and mutations, of course, but many of them. Many studies have. Have shown if we take all the individual cell. Many individual cells out of a tumor and do a full genomic sequence. No, no two cells in the. In the tumor exact. Have the exact same kinds of mutations. Yet. Yet every cell in that breast tumor has dependency on fermentation as a source of energy. So the common metabolic problem, all the cells have one major common problem or phenotype or observation. They're all fermenting, regardless of what their mutations are. So the common pathological phenotype is fermentation. Okay, so then the simple question is, where do. How do they get their energy from fermentation? And the two fuels that drive fermentation are glucose, the sugar. And what we have shown is the amino acid glutamine. Now, glutamine for the cancer field people will say, oh, we all knew glutamine was a big, big role in cancer. You guys in the field thought it was being respired. No, because the oxygen. No, it's not respired. It's fermented, just like the glucose. So. But it's also fermented in the mitochondria. So the mitochondria, they call the pathway is called glutaminolysis, and it's a fermentation pathway in the mitochondria. So you have a fermentation pathway in the cytoplasm, and you have a fermentation pathway in the mitochondria, which makes it look like the mitochondria are respiring, especially when they're taken in oxygen. So we had to parse out all this stuff and clearly define what the actual biomedical biochemical mechanisms are that are driving the beast. And the beast. The beast is driven by fermentation. And you're. You're right, Mark. The cells in a glioblastoma, the cells in colon, lung, they're all fermenters. So they all have different. That's why when you take car t immunotherapy, if you're not hitting the fermentation pathway, you're essentially missing the target. So nothing could be like when you say, oh, we have a targeted therapies precision medicine These guys, these targets, I mean, they're missing the target. And you pay a lot of money for a missed target. And then you say. And then you say, oh, you know, I have. We're going to use precision medicine. Yeah. Well, if it's so precise, how come you blew out my liver when you were trying to cure my lung cancer?

[A]

Exactly. You know, problem. You know, most of the treatments we have now are really toxic. Radiation, chemotherapy, surgeries have been screwed. And what's amazing about metabolic oncology is the therapy is diet and maybe some other compounds would block some of these fermentation pathways that really have not only no side effects, but they have a ton of beneficial effects in terms of overall metabolic health, in terms of reducing inflammation, improving stem cell function, causing DNA repair, and helping you deal with oxidative stress.

[B]

I mean, just.

[A]

It's just the list goes on about how this works. Quite amazing.

[C]

No, it is, it is, it's remarkable. And because you're all. You're going. We're going back to the origin of, of many of the diseases that we have. And, you know, a lot of this is systemic inflammation, you know, chronic exposure to different chemicals. You put all that together and you end up with diabetes, cardiovascular disease, cancer, dementia. You end up with all these kinds of chronic diseases. And a lot of it has to do with disturbed energy. Bio metabolic homeostasis is disturbed in many of these chronic diseases. The issue for us, though, is, you know, ferreting out the mechanisms of how cells grow. Cancer cells grow in a. In a dysregulated. Dysregulated way. And, and I think, you know, we're. I don't want to become too diffuse and say, okay, let me jump now into Alzheimer's and show you how this works. Let me jump into type 2 diabetes and show me. And show you how that works. That the major focus we have right now is correcting massive misinformation on how cancer cells express this dysregulated growth. Because ultimately that's what the disease is. It's cell division out of control. And these cells are dividing out of control because they have lost their ability to use energy through respiration, have fallen back on. On ancient fermentation pathways. And, and the organelle, the organelle inside the cell that controls the cell cycle and regulated growth is the mitochondrion. And Warburg clearly showed many years ago, and I have, in my own work, Doc, Validated everything that Warburg said with respect to mitochondrial dysfunction, that the organelle controlling the differentiated state and regulated growth is dysfunctional. And therefore, the cells are falling back on ancient fermentation pathways and are dysregulated in their cell growth. So, you know, so what's the best way to manage cancer is pull the plug, Pull the plug on their fermentation fuels. And there's only two fuels that can drive this beast, and it's glucose and glutamine. So, and then they can't, as you mentioned earlier, they can't burn fats or ketone bodies because you need a good mitochondria oxidative phosphorylation system to generate energy from fats and ketone bodies. So the fats and ketone bodies, though, help the heart, help the brain, especially for ketone bodies. So you mentioned, as you said, you can. All of these different chronic diseases can be improved significantly by this metabolic approach, because when you burn ketones, you essentially increase the metabolic homeostasis of normal cells. So, and the cancer cell is marginalized, it can't use the ketone body or the fat. So you really put them in a very compromised position and they will gradually be eliminated. And not only that, in our, in our paper, in my book and in the paper we just showed for managing cancer in a dog using purely metabolic therapy, when you cut the calories down, we have this process called autolytic cannibalism. It's very interesting. So all cells in the body must carry their weight when food restriction. So there has to be a coordinated interaction among all the cells in our body. And when you have a cancer, a group of cells that are using energy in a very inefficient way and not contributing to the society of the cells, the body will turn on those cancer cells and use them as fuel, eat them, and supply their metabolites for the rest, called autolytic cannibalism. And in order to get, in order to get into that stage, you have to lower blood sugars and you have to increase ketones, and then the body starts turning on these cancer cells and dissolving them.

[A]

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