The War on Cancer was intended as an effort to research the biology of cancer with the aim of developing ‘effective’ cancer treatments. President Nixon declared War on Cancer when he signed the National Cancer Act of 1971, yet it is a war which ultimately has no end insight with no real progress by the allies in attacking the so called enemy. Forget about ISIS, the War on Cancer has cost the public dear, both in terms of lost life and wasted financial investment. Just like War’s in far away lands, the only benefits seem currently to be those who can profit from an enduring battle. Yesterday was the Anniversary of the Great War (December 23, 1971), is it time we declared peace, stopped fighting and directed our efforts at a scientific evidence based understanding of cancer metabolism?
How much has this war cost us? And what, if anything, has it achieved?
161,823 died of cancer in the UK during 2012 http://www.cancerresearchuk.org/content/cancer-mortality-statistics#heading-Zero and the financial costs were no less startling, estimated at ‘over £15 billion’ per year. http://www.bbc.co.uk/news/health-20222759
Year upon year we spend more and more on cancer treatment, we raised £522 million for Cancer Research here in the UK between 2014 and 2015 http://www.cancerresearchuk.org/sites/default/files/annual_report_and_accounts_2014-15.pdf
Sadly, despite their claims that we’re beating cancer sooner, we aren’t. As Kolata (2009) discussed, the cancer death rate, adjusted for the size and age of the population, has only decreased by 5 percent since the 50’s, and even that is debatable. (Read this article about how industry plays with the figures to both keep us donating and impress upon us that progress is being made in the war http://raypeat.com/articles/articles/cancer-disorder-energy.shtml). Cancer remains a major cause of death, and an unknown attacker despite 40+ years of ‘research’. Currently the war efforts are directed towards the Human Genome Project, which is intended to expose the genetic factors that cause cancer. As ever this is currently unable to progress the frontline battle and our frontline troops face an uncertain future as they raise money for research and keep their fingers crossed that aren’t one of the unlucky ones that gets dragged into a dirty war. For more on the gene mutation theory, have a look at this fantastic article by Ray http://raypeat.com/articles/articles/the-cancer-matrix.shtml
I have a confession, to my knowledge I have never donated to a Cancer Charity, other than ones set up directly by families in which I know they money is helping them directly at a very difficult time (either to seek treatment not paid for via the National Health Service or just to maintain their ability to survive during tough times). I have donated many hours to assist those in need (if they wish my advice) and will continue to do so. However, I will not put a penny in the pot if it goes towards junk research, as I stated earlier I totally respect anyone who has engaged in actively trying to help but for me the effort is unjustified from two major points.
- The majority of Cancer research is so poor that it is never going to establish a cure or even prevention. Look at how many years this has been ongoing without any progress. We can fire a bomb that goes directly to an address, we can fire a man into space but when it comes to disease (especially cancer) it is down to luck of the draw. You either get it or you don’t. If you do then it needs killing…burn it, cut it out, chop of the effected area and basically maim the person to eradicate the disease. How long you then survive is down to how serious your treatment was, but a tick goes in the ‘Cancer Survivor” box.
- Running a race, or indeed anything that causes the inability to work aerobically puts you at risk of developing a Cancer Metabolism.
So, should you run the race for life, or is it in fact putting you in the firing line? Lactate is produced during aerobic glycolysis when glucose is broken down and oxidized. During intense exercise (anaerobic glycolysis) when oxygen levels are lower, there is increased production of lactate.
‘High rate of glycolysis is a metabolic hallmark of cancer, and anaerobic glycolysis promotes energy production under hypoxia (inadequate oxygen in the tissue). Indeed, lactate is associated with poor clinical outcome in several cancers, and whilst initially considered an indicator of the glycolytic flux, we now know that lactic acid directly contributes to tumor growth and progression.’ (Dhup, Dadhich, Porporato, & Sonveaux. (2012). Cellular respiration refers to the metabolic processes occurring within the cells that convert food into adenosine triphosphate (ATP) and waste products. Large molecules are broken down into smaller molecules that releases the energy that we need. Sugar, fatty acids and amino acids are all utilised and oxidised with oxygen (O2).
Aerobic respiration requires that we have O2 available in order that we can generate ATP. Pyruvate enters the mitochondria to be fully oxidized by the Krebs cycle resulting in the ‘so called’ waste product ‘carbon dioxide’ as well as water (H2O). The energy produced then breaks the bonds in Adenosine diphosphate (ADP) adding a third phosphate to form the ATP via the metabolic reaction known as substrate-level phosphorylation. NADH is also oxidized to NAD+, yielding 2.5 ATPs and FADH2 (flavin adenine dinucleotide) yields 1.5 ATPs during oxidative phosphorylation (OXPHOS), which provides most of the ATP produced via cellular respiration.
The potential of NADH and FADH2 is converted to more ATP via the electron transport chain in which oxygen is the terminal electron acceptor. In theory 38 ATP molecules can be produced via cellular respiration (2 via glycolysis, 2 via Krebs cycle, and about 34 via the electron transport system). However, the yield can be lower due to various factors and may be anywhere between 29 to 30 ATP per glucose. Aerobic metabolism is much more efficient than anaerobic metabolism (which yields 2 molecules ATP per 1 molecule glucose).
Glycolysis is a pathway that can function both with and without oxygen. As discussed above, aerobic conditions produce pyruvate and anaerobic conditions produces lactate.
However, without oxygen pyruvate is not metabolised via cellular respiration and instead undergoes fermentation. Pyruvate is no longer transported into the mitochondria, instead it remains in the cytoplasm and is converted to waste products so that it can be removed from the cell. This works to oxidize the electron carriers allowing them to perform glycolysis and remove the excess pyruvate. Fermentation oxidizes the NADH to NAD+ so it can be re-used in glycolysis, which prevents a build up of NADH in the cytoplasm. This waste product is called lactic acid that occurs due to lactic acid fermentation. When your energy needs exceed your supply (such as when running a charity race), the respiratory chain is no longer able to process the hydrogen atoms that are joined by NADH. NAD+ regenerates when the pairs of hydrogen combine with the pyruvate and form the lactate. When oxygen becomes available again NAD+ attaches to hydrogen from the lactate and forms ATP. The fermentation process is far less efficient and produces only 2 ATP compared to the 29-38 ATP produced during aerobic respiration.
Otto Warburg's early work on Cancer Metabolism is often misrepresented (you’ll often see Warburg credited as finding that sugar causes Cancer) yet his main observation was that lactic acid was produced by cancer cells even when adequate oxygen was seemingly present. Over exertion (such as when running) depletes our reserves of glucose and we shift to producing lactic acid, which in turn increases cortisol (stress hormone) and causes you to shift to fat and protein as fuel rather than glucose (hurrah you here the fat burning gym junkies cry). How long you have the ability to run for without shifting to using fat or protein for fuel is an unknown factor, basically you could either run out of glucose stores (unless you have a very large rucksack to carry enough fuel for your required distance) or you may fail to consume enough oxygen. Either way its safe to assume that running any sort of distance puts you at an enhanced risk of fat/protein usage as opposed to the preferred source.
Forming lactic acid as a by-product of adapted energy metabolism is normal if one is running. For example, if you’re being chased by an attacker then it is far safer to produce fuel via an emergency mechanism if your either low on glucose or oxygen (such as when you’re losing the ability to breath properly mid chase). Long term its not a biomarker you wish to exhibit. Both Warburg and Albert Szent-Gyorgyi pioneered the understanding of respiratory defects being present in Cancer cases. Indeed Koch showed that the ability to efficiently use oxygen corrected a cancer metabolism.
Kolata. (2009). In long drive to cure cancer, advances have been elusive. The New York Times, April 24.
Dhup., S, Dadhich., R, K, Porporato., P, E, & Sonveaux,. P. (2012). Multiple biological activities of lactic acid in cancer: influences on tumor growth, angiogenesis and metastasis. Curr Pharm Des;18(10):1319-30.)
Koch, W.F. (1921). The Survival Factor in Neoplastic and Viral Diseases. The Inter. Oxid. Instit., Priest River, Idaho, 83856.