The Dr. Hyman Show

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

70 min
Nov 10, 20255 months ago
Listen to Episode
Summary

This episode explores the metabolic theory of cancer, arguing that diet, fasting, and insulin levels are more critical than genetics in cancer development and prevention. The discussion covers how processed foods, sugar, and constant eating patterns fuel cancer growth, while ketogenic diets and intermittent fasting can starve cancer cells by cutting off their primary fuel sources: glucose and glutamine.

Insights
  • Cancer is fundamentally a metabolic disease driven by mitochondrial dysfunction and fermentation pathways, not primarily a genetic disease—genetics load the gun but environment pulls the trigger
  • Insulin and IGF-1 act as growth factors that directly fuel cancer cell proliferation; controlling insulin through diet and fasting is more impactful than genetic interventions
  • The gut microbiome plays a critical role in cancer prevention through production of short-chain fatty acids and postbiotics; dysbiosis from processed foods creates a pro-inflammatory environment that enables cancer
  • Cancer cells cannot efficiently metabolize ketones or fats due to mitochondrial defects, making ketogenic diets and caloric restriction powerful non-toxic therapeutic strategies
  • Modern food additives, pesticides, and chemicals approved through industry self-regulation (GRAS loophole) are significant unaddressed carcinogenic exposures in the food supply
Trends
Shift from genetic/mutation-focused oncology to metabolic theory of cancer as primary driver of diseaseGrowing clinical validation of ketogenic diets and fasting as adjunct cancer therapies with minimal side effectsIncreasing recognition that chronic diseases (cancer, diabetes, heart disease, dementia) share common root cause: insulin resistance and metabolic dysfunctionRising awareness of food industry regulatory capture and GRAS loophole allowing unapproved chemicals into food supplyEmerging focus on gut microbiome composition and postbiotics as preventive and therapeutic cancer interventionsLifestyle medicine and functional medicine gaining traction as evidence-based alternatives to conventional oncology approachesConsumer demand for transparency in food labeling and removal of chemicals banned in other developed nationsIntegration of metabolic testing (insulin resistance scores, hemoglobin A1C) into cancer risk stratificationPersonalized nutrition and metabolic profiling becoming standard in functional medicine cancer management
Topics
Metabolic Theory of CancerInsulin Resistance and Cancer RiskKetogenic Diet and Cancer TreatmentIntermittent Fasting and AutophagyGut Microbiome and Cancer PreventionShort-Chain Fatty Acids (Butyrate, Acetate, Propionate)Dysbiosis and Leaky GutSugar and Fructose as Cancer FuelFood Additives and CarcinogensGRAS Loophole in Food RegulationWarburg Effect and Cellular FermentationOxidative Phosphorylation vs. FermentationIGF-1 and Growth Factor SignalingEnvironmental Toxins (PFAS, BPA, Phthalates)Functional Medicine Approach to Cancer
Companies
BioOptimizers
Supplement company offering magnesium breakthrough formula with seven forms of magnesium; primary sponsor with promot...
Function Health
Lab testing and personalized health insights platform co-founded by Dr. Hyman; offers insulin resistance scoring and ...
Cleveland Clinic
Major healthcare institution where Dr. Hyman works; mentioned in context of colleague Dr. Patrick Hannaway's cancer t...
Environmental Working Group
Non-profit organization that petitioned FDA to ban carcinogenic flavor ingredients; Dr. Hyman serves on board
Quest Diagnostics
Laboratory testing company offering insulin resistance score test for assessing degree of insulin resistance
Canyon Ranch
Wellness resort where Dr. Hyman previously worked reviewing stool tests and patient microbiome data
Ultra Wellness Center
Dr. Hyman's clinical practice offering functional medicine services and patient care
People
Dr. Mark Hyman
Host and primary discussant exploring metabolic theory of cancer and functional medicine approaches
Dr. Patrick Hannaway
Colleague who used fasting and ketogenic diet as adjunct cancer treatment with minimal side effects
Otto Warburg
Pioneering researcher who discovered cancer cells rely on fermentation rather than oxidative phosphorylation
Dennis Burkitt
Irish surgeon who discovered Burkitt's lymphoma and observed traditional populations had near-zero cancer rates
Sydney Winehouse
Challenged Warburg's theory in 1950s by showing cancer cells consume oxygen; controversy resolved by modern research
Baltazar Longo
Described Ecuadorian dwarves (Laron dwarves) with low IGF-1 who are immune to cancer
Quotes
"The most important thing we need to focus on is not the genetics of the problem. It's the soil problem."
Dr. Mark HymanEarly in episode
"Genetics, you know, 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."
Guest speakerMid-episode discussion
"If you have a seed, of course, it has the ability to grow, but it needs the right conditions, the proper soil to grow."
Guest speakerSeed and soil analogy
"Cancer cells don't need oxygen for their growth... they replace their oxidative phosphorylation or energy through respiration with energy through fermentation."
Guest speakerWarburg effect discussion
"The common pathological phenotype is fermentation... all the cells have one major common problem or phenotype or observation. They're all fermenting, regardless of what their mutations are."
Guest speakerMetabolic theory explanation
Full Transcript
Coming up on this episode of the Dr. Heimann show. The most important thing we need to focus on is not the genetics of the problem. It's the soil problem. Modern life makes it surprisingly easy to run low on magnesium. Stress, screens, sugar, they all deplete this essential mineral. Magnesium supports over 300 functions in your body, from stress and sleep to recovery and energy. That's why I take magnesium breakthrough. The only supplement with all seven forms your body needs. Most formulas, just one or two. Bioptimizers has increased their discount for my audience. Go to bioptimizers.com slash hymen and use code hymen to get 15% off your order today. Before we jump into today's episode, I want to share a few ways you can go deeper on your health journey. While I wish I could work with everyone one-on-one, there just isn't enough time in the day, so I built several tools to help you take control of your health. If you're looking for guidance, education and community, check out my private membership, the Hyman Hive, for live Q&As, exclusive content and direct connection. For real-time lab testing and personalized insights into your biology, visit Function Health. You can also explore my curated Dr. Trusted Supplements and Health Products at drhyman.com. And if you prefer to listen without any breaks, don't forget you can enjoy every episode of this podcast, Add Free with Hyman Plus. Just open Apple Podcasts and tap Try Free to start your 7-day free trial. When you think about functional medicine and the approach you're taking, it's a very different model of thinking about cancer. So yes, if you have a tumor or something, you might need to get it cut out, you might need radiation or you might need some chemo at some point. But the question that never really gets asked is one, why did the cancer develop in the first place and how do I change those conditions? And two, how do I actually create a healthy immune system and a healthy soil and actually make sure that the cancer can't grow? And as a functional medicine doctor, I often say we're very much like regenerative farmers where we focus on soil health, as opposed to industrial farmers which use a lot of chemicals, pesticides, basically antibiotics and glyphosate and herbicides to make the plant healthy. And I remember being at this conference on nutrition, I don't know why they invited me. It was all the big food companies, the big ag companies, and I was invited to give a talk, which I did and I didn't hold back anything. I'm sitting next to this guy at dinner, I'm like, so what do you do? He says, well, I'm in plant medicine. Like plant medicine? I said, what is that? He said, well, we make pesticides. So I said, okay, got it. So I think 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 the soil conditions in the body and the environmental issues and diet and also lifestyle and stress and environmental chemicals, all those factors. So the idea of the seed and the soil actually goes way back. I mean, it was written about sort of like 16, 17 years ago, but then of course, I'm pretty forgotten about it because the point is that, you know, genetics, you know, 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 Birkitt was this sort of legendary Irish surgeon. And he went to Africa and, you know, he discovered Birkitt's lymphoma and stuff. And it's a very interesting story. But, you know, he looked at these Africans 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. And so they called these things diseases of civilization. So obesity took two diabetes and cancer would come as people change their lifestyle. And 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 sea of blood burn stuff. That's a 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 were not were 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 NME 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 cancer. You know, these these these A go from the infant's certain immune to cancer to high rates of cancer. Of course, they're eating sugar all the time, right? There's tons of smoking, 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 Japanese women in Japan. So it's like, mm hmm. So this is near accidents that the most important thing we need to focus on is not the genetics of the problem. It's the soil problem, right? The seed. 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. 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, they're not talking about, like, 10 percent higher risk, you know, in medicine, how go, oh, it's statistically significant. There's a 10 percent lower risk. It's like, oh, it's never good cancer, right? It's like, it's crazy. The magnitude of one person you can get. Well, on the other hand, it's like 10 percent is 200 or 300 percent, right? It's like a totally different, 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 percent of these cancer patients and science. It's like, okay, let's let's let's try to figure out the other stuff. Like, what is it? Is it sugar? 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, you start talking to people who want the other stuff, right? So people are listening and 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 of us got for kids? Yeah, that's a great question. And so I talk about in the book about like, what is it that makes cells grow? It was really important is sort of growth factors or a 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, you know, metabolic hormone. So you eat and insulin goes up. You know, 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 any metabolic hormone. It was actually a growth factor. So when, as we evolved, we actually used the same molecule that we use 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 IGF-1. And, um, uh, Baltralongo actually described this group of Ecuadorian dwarves. The Lauron dwarves who actually have almost no IGF-1. So they're very short. It 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 hyperprocessed foods, which tends to really amplify the insulin response. So sugar, for example, is especially, you know, 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 at 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, 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 reduce insulin. And that's so- So it's when you eat and when you eat. 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, you see a ton of white rice, but almost zero sugar and they were okay. So it's not necessarily just the carbohydrates. Well, they, I lived in China for a while. You're Chinese. I mean, I traveled around, remember, 1984. I mean, they had no accoutrements of modern living. I mean, they had to cut up board. They would use a saw to create boards. 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 could eat a lot of rice if you do the cuts. 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. And then- Well, the land of milk and honey, the Chinese phrase for it is the land of fish and rice. 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 an essential 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 process carbohydrate diet. And also this constant eating pattern, this thing called snacking, which I think is a modern invention. So we have a snack food industry, but I mean, I don't snack. If you eat properly, you're never hungry. I mean, if you don't have these spikes and insulin going up, it 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 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 slash hymen and use code hymen for 15% off your order. All of these diseases are actually diseases of too much insulin. If you look at obesity, for example, and if you were to measure the levels of insulin, people who are more overweight tend to have higher insulin, same with diabetes. Hyperinsulin, you can add insulin resistance. So really, two sides of the same coin. One causes the other, hyperinsulin, they can cause insulin resistance, insulin resistance, and cause hyperinsulin. They're really the same thing. The same thing applies to cancer. This is the pattern that was noticed so many years ago, that there are these diseases of too much insulin, that they all go together, the heart disease. You don't see that in people eating traditional diets because they're not eating all the time. I remember there was a study, this Enhane study, which is a big American survey of lots of things, that they included dietary habits. So in 1977, they found that most people ate three times a day, so breakfast, lunch, and dinner. By 2004, it was on and up to six times a day. Right? So it's like, wow, that's crazy. And it was never this 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 stacking companies wanted to promote it. And people thought it was a good idea. So then it became almost gospel. Oh, you have to eat six times a day. And I remember thinking about it a while ago, I'm thinking, where did that sun-beast music get out? Did we have a big randomized controlled child that I miss so much? 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. So I grew up in the 70s. And if you wanted a sort of after school snack, your mom said, no, you're going to ruin your dinner. Right? So if you wanted a bedtime snack, your mom would say, no, you should have ate more at the shift. 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 six o'clock. Because people ate a bit earlier back then to like say eight o'clock. So 14 hours of fasting every single day without even- We call that breakfast. Oh, yeah, exactly. Breaking the fast. Breaking the fast. That is the word that we use. And it's like somehow we quit 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 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, they go to school, they get a mid-morning snack, then they have lunch, and then they have their after-year-olds. And then they have the dinner. Then you're playing soccer, and they think that they need to have a snack in between the halves of soccer. You know, I played soccer. Jason, you've written a lot about fasting and the effects of either time-restricted eating, which is 12, 14, 16-hour fast every day, or taking a 24 or 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 Hannaway, who is my colleague and friend, who 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 also did it in a way that actually reduced all the side effects to almost none, has kept him healthy now for a well-over-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 annexes this whole idea of insulin resistance and high insulin levels? 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'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 very high in protein, you take protein shapes or whatever, and that's kind of what we know. Yeah, like atkins, and so half of the protein 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 adjunct treatment. So fasting is actually fascinating, because there's all these different things we're discovering, so one of the things is sort of autosagy, so as you fast, of course, your nutrient sensors go down, so mTOR, insulin go down, and then you activate this process called autosagy, where you actually start to break down some of your subcellular organelles and stuff, so basically your body's just trying to clean house. Pac-Man coming around and cleaning up all the garbage. Yeah, exactly. People think it's a bad thing. Maybe people know who Pac-Man was, but that was the original video game that Bill played back in the 70s, and it's pretty exciting now. Yeah, I don't know what Pac-Man is anymore. People still find them so excited, but the idea is that people think that this sort of breakdown process is really bad for you, but it's actually really good for you. 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 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 day and a 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 this 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. You got pit stop. 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 got to have a bit of both. It's a balance there. It's not all growth. And this is where you say, oh, ed, ed, ed, well, you're going to put your body, your nutrient sensor going to go up, your growth factors are going to go up. You're going to put yourself in growth mode, but you don't want to do that, especially for a disease such as cancer, which is a disease where cells are drawn 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 fast thing and you put your cells into this sort of maintenance repair mode. And that actually allows you to undergo both the chemotherapy and probably the radiation therapy better because chemotherapy, we have a couple of 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 taking 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 flowing cells, which are usually the cancer cells, but it also kills like the hair follicles because they're a fast growing cell that kills the lining of the GI tract. So you get nausea in your hair fall zone. 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. Now, there are many root causes of cancer. It 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 an 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 micro environment that supports tumor development, tumor growth, and tumor progression. In other words, metastasis inflammatory mediators, things like cytokines, they promote DNA damage, 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 to cancer. It also enhances angiogenesis, which is the formation of new blood vessels that supply tumors with blood and nutrients for growth, which they need. Otherwise, they die if they have no blood supply. Inflammation that 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 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 list goes on and on. We're going to get some more of those. Poor diet or ultra processed diet or sedentary lifestyle, the over and 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 metabolites that are produced by bacterial fermentation of fiber and all the polyphenols, all those colorful compounds and veggies and fruits that supports the integrity of the gut lighting. And the gut lighting is so important because without healthy gut lighting, basically all that poop and food is leaking into your bloodstream and causing your immune system to go crazy. Now, these are 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 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 lighting. It makes you have a leaky gut and leads to something called increased intestinal permeability in the basic leitermis leaky gut. Now basically think about your gut as one cell lining that protects you from the outside world. And the cell is 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 undidested 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. Out of immune disease, asthma, allergies, autism, ADD, depression, and 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. And they, 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, the damage they got. 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, acrimacia, bacillabacterium, and rosaburia, they're lower. 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, in 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 lipopoly saccharides, 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, I used to call me Dr. C, every poop in 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 fermicides to bachoroides. When you have a high ratio of fermicides to bachoroides in your visor-basic categories of bacteria, it 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-Ethic Co-Art Study, blah, blah, blah, whatever, they're like 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, 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, free diabetes, 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 Gastronology. 45% of adults, 59 and younger, are obese. So then 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 free 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 leaves your body to produce more and more insulin to keep your blood sugar normal. At least high levels of insulin or what we call hyperinsulinemia increases the production of another molecule called IGF1. That sounds for insulin like growth factor one. It's a hormone that increases cell division, cell growth and inhibits autophagy or cellular cleanups. 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. Now that leads to insulin resistance, oxygen stress, chronic 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. When these glycated products bind to DNA, they bind to proteins and lipids, it causes something called the maled reaction, the browning reaction. You've seen this. But the problem is these accumulated in our tissue and they, when 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. Make goods, cooking at high temperatures, brown charred fried bird 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's, because hemoglobin A1C is a late stage phenomenon. 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 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, Fort slash mark to learn and sign up. But the insulin resistance score is 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 in the 5.7 is pre-diabetes, 5.5. I mean, it's all moving target because, you know, we're finding out at lower and lower levels, there's a problem. So basically you want your hemoglobin A1C 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. And after 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. 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 glute, it's called glute 5 and it's overexpressed in cancers like pancreatic colorectal breast lung cancer. Now when you have high glute 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 love the sugar. It causes them to move migrate and move around, meaning starting to spread an 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 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 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 it 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 additives 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 bunch of 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 on our food that got in there without any real oversight. Now do this loophole, harmful ingredients have been added and continue to be added to our food supply. Let me give you an example. Seven carcinogenic flavor ingredients were approved as grass by FEMA. This is the flavor and extract manufacturers association, not a government group, an industry trade group. This is a group reviews and approved 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. 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. And they got weird chemical names, benzo phenone, ethyl acrylate, pyridine, styrene, do you have these in your company 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 a liver and say it's got natural flavorings, artificial flavorings, 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 recently anticipated to be a human carcinogen by the National Toxicology Program, right? BHT or butylated hydroxy toluene. Would 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 and 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 Procine, milkshakes, Slim Fast, YoPlate, Wendy's Crispy Chicken Nuggets, Chipotle and Moe's Southwest, Chicken Grilled, Chicken Burrito, Burger King Whopper, Cheerios and the list goes on. 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. We breathe oxygen and oxygen is a form of, serves as the final common acceptor of electrons in our mitochondria to generate energy through oxidative phosphorylation. He said that's broken in cancer. Not per se. What he basically said was, in order for us to produce energy in our cells, most of us combine oxygen with sugar in this chemical reaction down in the assembly line called oxidative phosphorylation, it's the normal way you produce energy from food. It's through glucose primarily and oxygen. That's what you're talking about. We bring glucose into the cell or other foods that would be broken down into either glucose or acetyl-CoA, which is the end product of the glycolytic pathway. The cell brings in glucose. There's a 10-step pathway called glycolysis, the old Emden-Meierhoff-Parnes pathway. Then the pyruvate, which is a three-carbon derivative of glucose, is then enters into the mitochondrion, is fully oxidized to produce significant amounts of energy with the key waste products being water and CO2. 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. It's a very highly energy-efficient system. Warburg was saying that cancer cells have a defect in their mitochondria. That defect is compensated for by a up-regulation of these ancient glycolytic fermentation. 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. That is, it satisfies the cancer environment. 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. Warburg noticed that all the major cancers that he studied were blowing out large amounts of this lactic acid. He said that accumulates in your muscles when you over exercise it causes. Exactly. Exactly. But then that deficit is made up as soon as the oxygen can be, the muscles can be re-oxygenated. They go back to respiring. 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. The lactic acid goes to the liver and is created back to glucose. That's the chloracycle. Sol 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. Hold on. Hold on. 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 without how it's going to cancer. Everybody basically, from my understanding, is that when we eat our food is primarily turning to glucose. Glucose then has to go through this process and break down into byproduct we call pyruvate and then the whole bunch of steps then then turns that into energy in the body. With cancer cells, that basically processes and 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. 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 stars them. They only can run on sugar, which is gas. So it's kind of the dirty burning fuel. And that ends up with all this slated cancer to things like diabetes and some resistance and all these various factors. So that's all how it ties together. Now then take this down as a process of the secondary pathway which is fermentation instead of what we call the primary pathway burning energy which is oxygen phosphorylation, such as the Krebs cycle. It's how we break down sugar and energy. So I think that I just sort of reinforced that. There was a lot in there. No, no, you're 100% correct, Mark. 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 and oxygen and energy. That's one of the most important things we do to enter our energy. 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 torturous to try to memorize all this stuff. You know, it was no pleasure in doing that other than the fact that you say, oh, you remember, you'd regurgitate it on a test and then you wouldn't have to worry about it again. So, 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, you have it, I take, I took a completely different view of these torturous 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. And so, now we realize that, as Warburg said, cancer cells don't need oxygen for their growth. And he showed data that, you know, he can take all the oxygen out of the system and these tumor cells were still growing fine. And his argument was they replace their oxidative phosphorylation or energy through respiration with energy through fermentation. Fermentation is energy without oxygen. And he said that they were getting their... That's very quiet or beer, right? Yeah. Well, the byproduct, that's alcoholic fermentation, lactic acid fermentation. There's an extra step by that the yeast use to convert the lactate into ethanol. So, but 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 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. As I said, that is the mitochondria. Yeah, it poises complex for the mitochondria, shuts down electron transport, prevents oxygen from binding to electrons, and your whole body just shuts down instantly. So, you can't make energy. 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 the cancer cell. So, that's that. So, Warburg said, cancer cells are resistant to cyanide. I said, whoa, this is... So, 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. He 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 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 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 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 micro environment, 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. Problem is, in the 1950s, Sydney 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 can, 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 in 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. Wrong, 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 epiphenominent 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 Sydney 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 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 oxfoss. Okay, that's a misunderstanding on Warburg's part. Legally in credit. He was over 100 years ago. Yeah, well, 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. He 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, the mitochondrial metabolic theory. We take up policy 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, 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. 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-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 sliced 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. 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 ones for, you know, all the different kinds of HER2 and... Yeah, the staging and the type, you know, it's actually maybe less important. 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 and mutations, of course, but many of them, many studies have shown if we take all the individual cells, 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, 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 do glutamine, it 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 pathways, 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 biochemical mechanisms are that are driving the beast. And the beast is driven by fermentation and your right mark, the cells in the 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 therapy, 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, oh, you know, I have, we're going to use precision medicine. You know, 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, you have a problem, you know, most of the treatments we have now are really toxic, radiation, chemotherapy, surgeries have been crude. And what's amazing about metabolic oncology is that therapy is diet. And maybe some other compounds have blocked 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 oloxidative stress. I mean, it's just the list goes on about how this works. You're already imaging. No, it is made, it's remarkable. And because you're all, you're going, we're going back to the origin 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. 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, okay, let me jump now into Alzheimer's and show you how this works. Let 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, 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. 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, 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. 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. Thank 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 guest's 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. If you're looking for help in your journey, please seek out a qualified medical practitioner. 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