Metabolism-Based Treatments for Managing Cancer

Abstract

AbstractMounting evidence indicates that cancer is primarily a mitochondrial metabolic disease rather than a genetic disease. Abnormalities in cancer cell mitochondria impair oxidative phosphorylation, thus causing a gradual shift in cellular energy production from respiration to fermentation. Glucose and glutamine are the two major fermentable fuels for cancer cells. Glucose drives tumor growth through glycolysis in the cytoplasm, while glutamine drives tumor growth through glutaminolysis in the mitochondria. Restriction of fermentable fuels is therefore an effective therapeutic strategy for cancer management. Ketogenic metabolic therapy (KMT) lowers blood glucose while elevating blood ketone bodies, a “super fuel” for normal cells, but a nonfermentable fuel for cancer cells. The efficacy of KMT for cancer management can be enhanced when used together with glutamine-targeting drugs and procedures that further inhibit fermentation. Hence, KMT represents an alternative, nontoxic strategy for managing and preventing a broad range of cancers and could also be important in reducing healthcare costs in the emerging era of global budgeting.