← The Peter Attia Drive

#30 - Thomas Seyfried, Ph.D.: Controversial discussion—cancer as a mitochondrial metabolic disease?

Nov 26, 2018 2h 48m 18 insights
<p>In this episode, Thomas Seyfried, a cancer researcher and professor of biology at Boston College, discusses a controversial view of cancer as a mitochondrial metabolic disease. Many topics related to the causes, treatments, and prevention of cancer are covered in this in-depth conversation.</p> <p>We discuss:</p> <ul> <li>How Tom got interested in cancer research [<a href="">9:00</a>];</li> <li>Calorie-restricted ketogenic diets, fasting, and epileptic seizures [<a href="">18:30</a>];</li> <li>Otto Warburg and the Warburg effect [30:45];</li> <li>Germline mutations, somatic mutations, and no mutations [42:00];</li> <li>Mitochondrial substrate level phosphorylation: Warburg's missing link [51:30];</li> <li>What is the structural defect in the mitochondria in cancer? [<a href="">1:02:00</a>];</li> <li>Peter's near-death experience with the insulin suppression test while in ketosis [1:06:30];</li> <li>Insulin potentiation therapy and glutamine inhibition [1:13:15];</li> <li>The macrophage fusion-hybrid theory of metastasis [1:39:30];</li> <li>How are cancer cells growth dysregulated without a mutation? [<a href="">1:47:00</a>];</li> <li>What is the dream clinical trial to test the hypothesis that we can reduce the death rates of cancer by 50%? [2:03:15];</li> <li>How can the hypothesis be tested rigorously that structural abnormalities in the mitochondria impair respiration and lead to compensatory fermentation? [2:26:30];</li> <li>Case studies of GBM survivors [2:32:45]; and</li> <li>More.</li> </ul> <p> <span> Learn more at <a href="http://www.peterattiamd.com/"><span><u>www.PeterAttiaMD.com</u></span></a></span></p> <p> <span>Connect with Peter on <a href=""> <span> <u>Facebook</u></span></a> | <a href=""> <span> <u>Twitter</u></span></a> | <a href=""> <span> <u>Instagram</u></span></a>.</span></p>
Actionable Insights

1. Implement Press Pulse Cancer Therapy

Adopt a ‘press pulse’ strategy for cancer by constantly reducing glucose (via diet/drugs) and periodically reducing glutamine (via drugs). This aims to starve tumor cells of their fermentable fuels while protecting normal cells.

2. Achieve Therapeutic Ketosis for Cancer

Maintain a glucose-ketone index (GKI) of 1.0 or below by significantly lowering blood sugar and elevating ketones through diet and supplementation. This creates a selective metabolic disadvantage for tumor cells and enables other targeted therapies.

3. Avoid Brain Radiation Therapy

Refrain from using radiation therapy for glioblastoma (GBM) patients, as it can cause radiation necrosis, elevate blood sugar, and release glutamine. These effects may worsen patient outcomes and quality of life.

4. Consider Hyperbaric Oxygen in Ketosis

Utilize hyperbaric oxygen as a pulse therapy (e.g., 2.5 atmospheres for 90 minutes daily) to create oxidative stress specifically in tumor cells. This should only be done when the patient is in therapeutic ketosis.

5. Strategically Target Glutamine for Cancer

Use glutamine-blocking drugs (e.g., Don, 6-norleucine) in a pulsed manner to deprive tumor cells of this essential fuel. This strategy must be carefully managed to avoid compromising the normal immune system and gut health.

6. Optimize Surgery Timing for Cancer

Delay surgical debulking until metabolic therapy has shrunk the tumor, reduced inflammation, and made its margins more defined. This approach aims for a more complete and potentially curative resection.

7. Integrate Stress Management in Cancer

Implement stress-reducing practices like music therapy and yoga to lower corticosteroids, which can otherwise hinder blood sugar control and the effectiveness of metabolic therapies. Inform patients that stress reduction helps the treatment work.

8. Use Insulin Therapy with Ketosis

Administer insulin therapy to further lower blood sugar, but only when the patient is already in a state of therapeutic ketosis. This ensures glucose reduction without stimulating tumor growth, which insulin can do with high glucose.

9. Prevent Cancer via Mitochondria Health

Maintain mitochondrial health by avoiding known risk factors such as viral infections, intermittent hypoxia, radiation exposure, and exposure to carcinogens. Healthy mitochondria are crucial for preventing cancer.

10. Exercise Caution with Biopsies

Be aware that needle biopsies, while diagnostic, may potentially create an aggressive inflammatory environment that could facilitate tumor spread or metastasis. Consider the risks versus the diagnostic benefits.

11. Avoid Avastin for Cancer

Do not use Avastin (bevacizumab) for cancer treatment, particularly for breast and brain cancers. This anti-angiogenic drug has been shown to harm more patients than it helps and can promote invasive tumor behavior.

12. Maintain Low Blood Sugar for Seizures

For epilepsy management, keep blood sugar levels consistently low (e.g., 65-70 mg/dL) and avoid spikes (e.g., to 120 mg/dL). Even slight elevations can trigger breakthrough seizures.

13. Practice Healthy Calorie Restriction

Engage in calorie restriction for health benefits, but ensure it does not lead to muscle breakdown. Breaking down muscle indicates entering a pathological starvation mode that should be avoided.

14. Avoid Yo-Yo Dieting

Refrain from chronic yo-yo dieting, as it can have long-term detrimental effects on physiological systems. The body’s ’thrifty physiology’ can be negatively impacted.

15. Support Metabolic Cancer Research

Contribute financially to foundations (e.g., Single Cause Single Cure Foundation, Travis Foundation, Metabolic Therapy Foundation) or directly to university labs (with specific funding statements) to advance research in metabolic cancer therapies.

16. Advocate for Metabolic Clinical Trials

Support and advocate for clinical trials that rigorously test metabolic therapies for cancer, especially as a primary treatment or in combination with minimal conventional treatments, to challenge existing standards of care.

17. Utilize Podcast Learning Strategies

If struggling with technical concepts in a podcast, pause, review show notes, use external resources like Wikipedia, or reach out via social media for clarification. Do not continue listening without understanding key concepts.

18. Sign Up for Weekly Health Updates

Subscribe to Peter Attia’s weekly email at peteratiamd.com for updates on longevity science, performance, sleep, and interesting research papers. This provides a consistent source of high-value information.