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

26:31For 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.

27:04They 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 overgrowth 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.

27:43And the imbalances in your gut microbiome that caused 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.

28:27And 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. It affects everything, not just cancer, but everything, heart disease, cancer, diabetes, dementia, literally everything, autoimmune disease, asthma, allergies, autism, ADD, depression, the list goes on and on and on. And we're talking about cancer here.

28:59Now, 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.

29:41Now 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, Acromantia, Facilobacterium, and Rosaburia. They're lower. And you don't 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.

30:14They're nice, actually. But they're lower in abundance when you have a Western diet. So when you have all these bad foods, 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 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. It doesn't really matter. Basically, these are like poisons.

30:48And 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. I used to call me Dr. C every poop at my old job at Canyon Ranch because I looked at every stool test. We look at 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, and these are basically categories of bacteria, it is linked to obesity and diabetes and metabolic disease.

31:24But 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 Coloart Study, blah, blah, blah, whatever, I 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 in younger people.

31:59Now, 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, 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 the most common cancers, like colorectal cancer, liver or hepatic cancer, pancreatic cancer, breast cancer, endometrial or uterine cancer, and many other cancers.

32:50In 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 prediabetes or impaired glucose tolerance when they're diagnosed.

33:31This 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.

34:06So eating a high sugar, high starch, triglycemic 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 IGF-1. That sounds for insulin-like growth factor one. And 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 IGF-1 from all the sugar, it basically causes cells to continue to grow and divide and prevents them from being killed.

34:51Okay. Now, high blood sugar is present in 39 to 99 % of cancer cases. Now that leads to insulin resistance, oxidative stress, carotid inflammation of 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.

35:31When 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 bind to something called RAGEs, 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.

36:08Baked goods, cooking at high temperatures, brown chard, 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 phenomenon.

36:46And 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 forward slash 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.

37:15And 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. It used to be 5.7. It's prediabetes, 5.5. I mean, it's all a moving target because we're finding that at lower and lower levels, there's a problem. So basically you want your hemoglobin to see 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.

37:49Epidemiologic 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 you have 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 50 % of our calories. It's in everything. And it's got not 50-50 fructose and glucose like sugar. It might at 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 GLUT5.

38:23I thought about your GLUTs. It's called GLUT5. And it's overexpressed in cancers like pancreatic, colorectal, breast, lung cancer. Now, when you have high GLUT5 expression, it basically allows for increased intake or uptake of fructose by cancer cells. And what does that do? That makes them grow because they love the sugar. It caused them to 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.

39:01I think it's 60 % of our diet is ultra processed food. So fructose in high fructose corn syrup and all the food 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 2 ,756 new food chemicals have been added to our food supply to a loophole in the law called GRAS, G-R-A-S.

39:51It 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 GRAS 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.

40:30You basically take the company's word for it that it's safe. How crazy is that, right? When a company determines a substance is gross, it means they think it's safe among, quote, qualified experts. So they get a bunch of experts they pay, or 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 safety data. So there's all this crap on 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.

41:10Let me give an example. Seven carcinogenic flavor ingredients were approved as GRAS by FEMA. This is the Flavor and Extract Manufacturers Association, not a government group, an industry trade group. This is a group that 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'm in 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.

41:51And they got weird chemical names, benzophenone, ethylacrylate, pyridine, styrene. Do you have these in your cupboard at home that you cook with? I doubt it. 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 fraplings, blah, blah, blah. You don't even know what it is. 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.

42:27When you put that on your salad, it's in everything. And that has been determined to disrupt endocrine function by causing change to the 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, and all other toxins. So how do you avoid those? Well, avoid processed and packaged foods.

42:56All 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 and our soil. Make sure you filter your 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.

43:42In 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. We breathe oxygen, and oxygen serves as the final common acceptor of electrons in our mitochondria to generate energy through oxidative phosphorylation. And he said that's broken in cancer. and in order for me just not for a sec 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 an assembly line called oxidative phosphorylation it's kind of the normal way you produce energy from food and it's through glucose uh primarily and and oxygen so that's what that's what you're talking about yeah yeah yeah yeah so so we we bring we bring glucose into the cell or or other foods that would be broken down either into glucose or acetyl-CoA, which is the end product of the glycolytic pathway.

44:43So the cell brings in glucose. There's a 10-step pathway called glycolysis, the old Emden-Meierhoff-Parnes pathway. And then the pyruvate, which is this three-carbon derivative of glucose, 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 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 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.

45:42So 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 blowing out large amounts of this lactic acid. And he says that - Which is kind of what accumulates in your muscles when you overexercise, it causes - Exactly.

46:35Exactly. But then that deficit is made up as soon as the muscles can be re-oxygenated, 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 Corey cycle. And Saul and Gertie Corey received the Nobel Prize for their recognition of how lactic acid from muscles can be reconverted back into glucose for the body.

47:21Hold on one second. 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 with how it's related to cancer. So everybody, basically, from my understanding is that when we eat, our food is primarily turning to glucose. Glucose then has to go from this process of breakdown into byproducts we call pyruvate. And then there's a whole bunch of steps that then turn that into energy in the body. With cancer cells, that basically process is kind of defective. And so it turns, instead of turning into an easy form of energy from glucose, it creates lactic acid, which changes the whole environment itself.

47:57And basically, the other sort of point I think is 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 stars 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 all these various factors. So that's all how it ties together. Now, I'll take this down to this process of the secondary pathway, which is fermentation, instead of what we call the primary pathway of burning energy, which is oxygen to phosphorylation.

48:42It's like the Krebs cycle. It's how we break down sugar and energy. So I think that I just sort of want to reinforce that because there was a lot in there. No, no, you're 100 % correct, Mark. Okay. This sometimes can be a little overwhelming. I mean, even most doctors, by the way, like, you know, we remember biochemistry for just enough for our exams that 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. It's one of the most important things we do. You know, it's really an interesting thing because, you know, most of us, when we had to study the Krebs cycle as a requirement, only because it was tortuous to try to memorize all this stuff.

49:20And it was no pleasure in doing that other than the fact that you say, oh, you have to memorize it, you regurgitate it on a test, and then you wouldn't have to worry about it again. But when we are in a different sphere now where we really need to understand that in order to manage a very devastating disease. So 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, 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 you're going to be able to wield the power of your knowledge to manage a disease because you finally understand what all this crap meant.

50:15That's right. 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 said that they were getting their - Wine or beer, right? Yeah. Well, the byproduct, that's alcoholic fermentation, lactic acid fermentation. There's an extra step that the yeast use to convert the lactate into ethanol.

51:08But that's another step. Our muscles and our cancer cells are producing lactic acid as a waste product of the fermentation process. So as a result, but what Warburg was saying that 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. As I said, that is a mitochondria. Yeah. It poises complex four of the mitochondria, shuts down electron transport, prevents oxygen from binding to electrons, and your whole body just shuts down instantly.

51:55So you can't make energy if you drink cyanide. You just can't make energy and then you die. 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 Warburg said, yeah, cancer cells are resistant to cyanide. I said, whoa, this is, so they don't need, they don't need oxygen 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 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.

52:33It 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 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 that all up, the misinformation regarding the readouts of dysfunctional respiration.

53:28But 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 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 drink cyanide to kill themselves.

54:12Well, 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 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.

54:55Problem is, in the 1950s, Sidney Whitehouse 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 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.

55:57Wrong. 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, ROS. ROS 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.

56:45So 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.

57:29So now 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 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. He gave him credit. He was over 100 years ago. Oh, yeah. It was 100 years ago. And because the pathway for glutamine fermentation was not yet developed. So he did not know about the second major fermentable fuel. So he was absolutely right on the origin of cancer.

58:09He was incorrect on assuming that lactic acid production equaled a certain amount of ATP. We now know that that calculation 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 incorrect. And we're polishing it all up. So this is the mitochondrial metabolic... Let me take a pause there 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 allowed 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.

58:54And 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-a-mole. 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 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 four melanoma, stage four pancreatic cancer, stage four breast cancer.

59:36Cancers that are really death sentences are responding, even glioblastoma, which is brain cancer, very well to 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. 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 one's for, you know, all the different kinds of HER2 and...

1:00:11Yeah, the staging and the typing, you know, which actually may be less important. Yeah, yeah, yeah. 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 in mutations, of course, but many of them, many studies have shown if we take all the individual cell, many individual cells out of a tumor and do a full genomic sequence, No two cells in the tumor have the exact same kinds of mutations. Yet, every cell in that breast tumor has dependency on fermentation as a source of energy.

1:00:50So 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, 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.

1:01:35It's fermented just like the glucose. So, but it's also fermented in the mitochondria. So the mitochondria, 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 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 is driven by fermentation. And you're right, Mark, the cells in the glioblastoma, the cells in colon, lung, they're all fermenters.

1:02:22So 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 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? Exactly. You know, most of the treatments we have now are really toxic.

1:03:01Radiation, chemotherapy, surgeries have been crude. And what's amazing about metabolic oncology is that therapy is diet and maybe some other compounds would block them, 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 the oxidative stress. I mean, it's just the list goes on about how this works. You're already amazing. No, it is. It's remarkable. And because we're going back to the origin of many of the diseases that we have.

1:03:42And, 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. 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 dysregulated way. And I think, you know, I don't want to become too diffuse and say, OK, let me jump now into Alzheimer's and show you how this works.

1:04:29Let me jump into type 2 diabetes and show you how that works. 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 ancient fermentation pathways. and 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 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.

1:05:33So, 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, 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.

1:06:19And 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 paper, in my book and in the paper we just showed for managing cancer in the 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 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.

1:07:13And 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. If you love this podcast, please share it with someone else you think would also enjoy it. You can find me on all social media channels at Dr. Mark Hyman. Please reach out. I'd love to hear your comments and questions. Don't forget to rate, review, and subscribe to The Dr. Hyman Show wherever you get your podcasts. And don't forget to check out my YouTube channel at Dr. Mark Hyman for video versions of this podcast and more.

1:07:43Thank you so much again for tuning in. We'll see you next time on The Dr. Hyman Show. This podcast is separate from my clinical practice at the Ultra Wellness Center, my work at Cleveland Clinic, and Function Health, where I am Chief Medical Officer. This podcast represents my opinions and my guests' opinions. Neither myself nor the podcast endorses the views or statements of my guests. This podcast is for educational purposes only and is not a substitute for professional care by a doctor or other qualified medical professional. This podcast is provided with the understanding that it does not constitute medical or other professional advice or services.

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1:08:44Thanks so much again for listening.