In the featured podcast, Dr. Peter Attia interviews professor Thomas Seyfried, Ph.D., recipient of our Game Changer Award in 2016 for his work on cancer as a metabolic disease, which is also the title of Seyfried’s book1 on this topic. His work is also heavily featured in Travis Christofferson’s excellent book, “Tripping Over the Truth: The Metabolic Theory of Cancer.”

The actual podcast can be heard on Dr. Attia’s site

Seyfried, in my view, is simply the best cancer biologist in the world. The featured interview2 goes into great technical detail that can be challenging for some, but if you’re interested in understanding the mechanics of cancer, I highly recommend taking the time to listen to it in its entirety, especially toward the end.

Without a doubt, it is one of the finest detailed discussions about why cancer cells grow and how conventional medicine has it mostly wrong when it comes to treatment, especially radiation and chemo. Without a doubt, it is one of the best interviews Seyfried has ever done. Although Attia is a Harvard trained physician with oncology training, he frequently disagrees with Seyfried, who schools him in the basics.

I have listened to the entire interview twice and learned even more the second time. Now I have a fairly good background on this topic so if you are new to it and have a loved one who needs this information you may need to listen a few times. Toward the end of the interview Seyfried gets into some very important principles in cancer treatment, such as:

  • Being careful to avoid biopsies if at all possible as they are strongly related to allowing the cancer to metastasize.
  • Surgical therapy can be a useful intervention but it should be delayed as long as possible while the patient is on metabolic therapy so the tumor will shrink and allow the margins to be more well defined so it can be removed more easily.
  • Avoid radiation and chemotherapy at all costs as they typically impair the immune system that is ultimately responsible for resolving the tumor.
  • More than 1,600 people die from cancer every DAY in the U.S., but 8,100 die from cancer every day in China, where the problem is far worse. Remember these are deaths per day, not cancer diagnosis.
  • It is vital to understand that more people die from cancer treatment than the cancer itself.

 

Introduction to Cancer as a Metabolic Disease

The established dogma that cancer is a genetic disease currently rules everything, from the research that receives funding to the treatment you can expect from an oncologist. Indeed, this dogma is what fuels the entire cancer industry. Unfortunately, it’s not leading to any significant breakthroughs in treatment, let alone prevention.

Seyfried and others have been able to advance the theory that cancer is primarily the result of defective energy metabolism in and damage to the cells’ mitochondria. Simply put, genetic mutations are not the primary cause of cancer but are rather a downstream effect of the defective energy metabolism. As long as your mitochondria remain healthy and functional, your chances of developing cancer are actually slim.

According to Seyfried, while it’s still poorly understood how a ketogenic diet works to subdue epileptic seizures, the mechanism of action on cancer cells is really clear, and is based on the pioneering findings of Dr. Otto Warburg, a classically trained biochemist who in 1931 received the Nobel Prize in Physiology or Medicine for his discovery of the nature and mode of action of the respiratory enzyme cytochrome C oxidase.3

Warburg’s work shows how cells obtain energy from respiration, and how cancer cells have a fundamentally different energy metabolism compared to healthy cells (see section on Warburg Effect below).

Following in Warburg’s footsteps, research by Seyfried and others show that cancer is primarily a metabolic disease involving disturbances in energy production through respiration and fermentation in the cells. Studies have actually shown that cancer is suppressed when the nucleus from a tumor cell is transferred to cytoplasm of normal cells with normal mitochondria.

What this tells us is that normal mitochondria suppress cancer growth, and in order for cancer cells to proliferate, you must have dysfunctional mitochondria.

Seyfried’s research has shown that cancer growth and progression can be managed following a whole-body transition from fermentable metabolites, such as glucose and glutamine, to respiratory metabolites, primarily ketone bodies that are formed when you follow a ketogenic diet. This transition reduces tumor vascularity and inflammation while enhancing tumor cell death.

 

The Warburg Effect

Warburg discovered that even in the presence of oxygen, cancer cells derive energy from the ancient process of anaerobic fermentation (sometimes called glycolysis), which causes an overproduction of lactic acid. This is known as the Warburg Effect:

  • Aerobically, in the mitochondria
  • Anaerobically, in the cytoplasm, which generates lactic acid, a toxic byproduct in high concentrations

 

Aerobic respiration is far more efficient, capable of generating more than 30 times more adenosine triphosphate (ATP) than anaerobic energy generation. As explained in the featured interview, normal, healthy cells will produce very minimal amounts of lactic acid in the presence of oxygen. Cancer cells, on the other hand, behave very differently.

Cancer cells continue to produce massive amounts of lactic acid, even in a 100-percent oxygen environment, which caused Warburg to conclude that the primary cause of cancer is that the respiratory system of cancer cells is defective, causing the cells to revert from healthy aerobic energy generation to unhealthy anaerobic fermentation. You can read Warburg’s 1956 paper4 “On the Origin of Cancer Cells” here.

Please note that respiratory system in this context does not refer to the lungs but rather to the processing of oxygen from the lungs in the electron transport chain of the mitochondria that ultimately passes the electrons from your food to oxygen to create water and ATP.

So, in a nutshell, what Warburg discovered is that cancer cells have dysfunctional mitochondria — hence the claim that cancer is a metabolic disease rooted in mitochondrial dysfunction.