
An Old Idea, Revived: Starve Cancer to Death - joshrotenberg
http://www.nytimes.com/2016/05/15/magazine/warburg-effect-an-old-idea-revived-starve-cancer-to-death.html
======
stellar678
This is one of the best newspaper science articles I've ever read. It's a
survey of the landscape, talks to a wide variety of experts, and modulates
expectations for some miracle cure while still laying out the possibilities
that could come from this approach.

Very good read!

------
WalterBright
A family member of mine was diagnosed with metastatic cancer and told to get
her affairs in order. She went on a strict no sugar diet. 5 years later, she
has no sign of cancer.

Of course, she also had standard surgery and chemo. But I wouldn't be in the
least surprised if the no sugar diet slowed the cancer down enough for the
chemo/surgery to be more effective.

~~~
ryanwaggoner
My car broke down the other day and I immediately started doing my prayers and
sacrifices to the car healing gods. 2 weeks later, my car is running smoothly
with no signs of issues!

Of course, my mechanic also replaced the engine, but I wouldn't be surprised
if my process helped.

~~~
tluyben2
That's why 'smart people' advise to do both; try something you believe in (it
helps if you believe) but do it next to regular treatments. Replace the engine
and pray at the same time. Praying doesn't hurt although it won't help because
of the praying (if there would be a god, it is well accepted that he doesn't
listen to individual requests; you get your chance in heaven) but because of
the faith/believe you have which somehow makes you stronger.

BTW: Is that sugar as in all sugars or refined sugars? Not eating 'sweets' is
not a bad idea anyway no matter if it helps against cancer or not. Just like
not eating massive amounts of meat and exercising. It might not help you
achieve immortality but it can't hurt. And no it does not 'remove all fun from
life'.

~~~
ryanwaggoner
I don't disagree, but I think _other people_ looking at the situation should
be able to distinguish the two.

~~~
tluyben2
Yes, and it should be told to them correctly. Saw a lot of people die by
picking the alternative way only...

~~~
WalterBright
I was careful to point out that she did not eschew the standard treatment, and
followed all of her oncologist's advice.

------
dnautics
This is probably why cannabinoids are likely to have a synergistic effect in
treating some (but not all) cancers when used in concert with immunotherapies
and chemotherapies... The cannabinoid receptors connect into the akt system
and modulate cell energy use. In vitro, some cancer cell lines are eradicated
by cannabinoids, probably in vivo it's more complicated but weakening the
cells probably helps.

~~~
Alex3917
Interestingly, cannabinoid antagonists also show some preclinical success.

~~~
dnautics
that also makes sense. If you tweak finely tuned energy use in either
direction, then things will break.

------
numair
I was recently shocked and practically offended to read guidelines on what to
eat while undergoing chemo[1]. It was a high-sugar diet, basically (milkshakes
were _encouraged_!). I couldn't imagine anything worse than shocking your body
with radiation, and then providing cancer cells with all the sugar they need
for growth. Hopefully the ideas in this article start to affect public health
policy and guidelines.

1: [http://www.guysandstthomas.nhs.uk/resources/patient-
informat...](http://www.guysandstthomas.nhs.uk/resources/patient-
information/cancer/diet-and-chemotherapy.pdf)

~~~
pygy_
Depending on the tumor, feeding it well may increase its sensitivity to
chemotherapy.

On the other hand, I've read recently that fasting improved chemo tolerance
because it puts healthy cells at rest while the cancerous ones are oblivious
to the reduced calories intake... Not sure if it is universal. Such an early
study was likely targeted a specific kind of cancer.

~~~
digi_owl
Well the article tried to stress that what they wrote about didn't apply to
all cancers.

Also, seem to me the basic complication of dealing with cancers is that
anything that will kill a cancer cell is likely to also kill healthy cells. So
inversely, whatever you do to keep the patient alive is likely to also
exasperate the cancer problem.

------
berberich
Tim Ferriss had Dr. Dom D'Agostino on his podcast late last year[1], where
they talked about this subject in-depth. I thought it was a fascinating
conversation and a great introduction to the topic.

[1]: [http://fourhourworkweek.com/2015/11/03/dominic-
dagostino/](http://fourhourworkweek.com/2015/11/03/dominic-dagostino/)

------
sergioisidoro
I've read in multiple places that biohackers are using Intermittent fasting as
a way of preventing cancer.

By making sporadic (eg. once a month) fasting periods of 12h to 24h, they
expect to starve cancer cells in their very early stages (basically using the
underlying principle of the article).

I would be extremely interested in seeing a study of the incidence of cancer
in people doing Intermittent fasting vs general population.

~~~
tremon
_By making sporadic (eg. once a month) fasting periods of 12h to 24h_

Uh, any adverse effects if you increase that frequency? Because I reach a
fasting period of 12h almost every day...

~~~
nommm-nommm
Most people do I imagine. If you eat dinner at 6pm and breakfast at 8am that
is a 14 hour fast.

~~~
oliv__
Mmmh... lunch?

~~~
nommm-nommm
Lunch isn't usually eaten in the middle of the night.

~~~
oliv__
This was edited. It used to be in this order: breakfast at 8am and dinner at
6pm.

------
tiatia
Dichloroacetic_acid
[https://en.wikipedia.org/wiki/Dichloroacetic_acid#Cancer](https://en.wikipedia.org/wiki/Dichloroacetic_acid#Cancer)

Can't be patent protected, hence clinical trials are very difficult (to fund)
but are under way for limited applications:
[http://www.ncbi.nlm.nih.gov/pubmed/24297161](http://www.ncbi.nlm.nih.gov/pubmed/24297161)

The mechanism of action targets the unique cancer cells energy metabolism.

~~~
apo
And here's a review (although old) of the literature on the link between
dichloroacetate (DCA), glucose, and cancer:

[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2567082/](http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2567082/)

------
danieltillett
It is not only glucose that cancer cells can become addidicted to, but also
amino acids. Often the cancer cells can overcome a lack of glucose by using an
amino acid. An idea that was explored too soon (i.e. before we knew which
cancers this would work on) was starving the cancer cells with multiple
nutrient withdraws.

------
xchip
TL;DR: Cancer cell live on glucose... keep levels down

~~~
dualogy
Simple-minded. That may slow, delay or avoid run-away growth & metastasis (of
many not all cancers) but not any&all unwanted growths, because blood glucose
never can go to 0. Cancer cells once sufficiently isolated from the immune
system also love glutamine, other amino acids and vitamins. How long do you
want to restrict all those? Ever heard of cachexia? With no food coming in,
nutrients from the blood get scavenged by the baddies as bodily reserves are
depleted. What then?

------
dschiptsov
At least do not become a fat fertile ground for it.

BTW, in developing world with traditional simple, not processed foods and
setting in a tribal culture eating habits rates of cancers are way lower (and
no, it is not because lack of diagnostic tests).

------
ValleyOfTheMtns
Such a method may also force the cancer to evolve to survive under such
stress.

------
codeulike
So would a ketogenic diet be effective then?

~~~
ac2u
Needs more studies. Armchair analysts find it intuitive though, but we don't
know for sure yet.

~~~
retroafroman
This is the best way to describe just about any diet or exercise ideas floated
on HN.

~~~
commandar
People also tend to very much forget that cancer is not a disease, but a
_class_ of diseases. Not all cancers will respond equally to the same
treatments.

~~~
nonbel
Can you give an example of a disease that responds equally to the same
treatment in all people?

~~~
commandar
I'm not talking about across different people; I'm talking about different
types of cancer.

The causes and treatments for lymphatic cancers are different from lung
cancers are different from breast cancers are different from prostate cancers
are different from brain cancers are different from liver cancers, ad
infinitum.

~~~
dualogy
Well there must be _some_ things they all have in common. Anaerobic
environment I thought, is that still the case? No transport of oxygen via iron
possible, in my layman's memory?

~~~
Natanael_L
Like saying suffocating in vacuum and suffocating from oxygen substitution in
an enclosed space (like by inert gasses) is equal. The causes are different
enough that different solutions are necessary.

~~~
nonbel
I don't see how this analogy works at all? In either case a space suit works
doesn't it?

Anyway, this whole "cancer isn't one disease" meme is best depicted by the
bottom right panel of the second section of this comic:
[http://www.phdcomics.com/comics/archive.php?comicid=1162](http://www.phdcomics.com/comics/archive.php?comicid=1162)

It looks just like the "string theory landscape", next you will be told that
we need to stop worrying about comparing predictions to evidence when it comes
to cancer research. Just wait a few years/decades.

[https://www.quantamagazine.org/20151216-physicists-and-
philo...](https://www.quantamagazine.org/20151216-physicists-and-philosophers-
debate-the-boundaries-of-science/)

~~~
Natanael_L
Can you fit the space suit? (maybe I should have said something about small
spaces).

Just because there's a shared behavior there's no guarantee there's a shared
cause or mechanism. And even when there are, the environment can make any
given solution unusable.

~~~
nonbel
I can't think of any disease where we can't come up with such examples
(indicating that the same treatment can't be used in all cases).

~~~
Natanael_L
Yep. For example, there's people so strongly allergic to medicines that
normally would be the default choice for curing a variety of diseases, making
them unusable for these people.

Then there are even more "fun" special cases of simultaneously occurring
diseases where the cure for one makes the other disease more dangerous.

But the point regarding cancer is that it just really ISN'T a single disease.
That's like calling rockets, hot-air balloons, airplanes and helicopters the
same thing. Sure, they all fly, but the mechanisms for them all are
drastically different.

Cancers are the collection of diseases which causes cells to replicate
uncontrollably.

~~~
nonbel
>"But the point regarding cancer is that it just really ISN'T a single
disease."

No, this is just a recent meme people started repeating because it said in a
documentary or something. It is just as much "one disease" as many other
medical issues grouped together as "one disease".

It is an awful meme too, because it discourages looking at commonalities and
gives poorly performing researchers an excuse for not figuring anything out.
Both of which slow the process of understanding cancer.

~~~
commandar
I have no idea which documentary you're referring to, but the idea that
cancers are a class of different diseases with differing mechanisms isn't
exactly fringe.

I mean, here's Harold Varmus, former head of the NIH and a Nobel Prize winner
for his work on cancer research:

"What we've learned can be grouped into three categories. First, we've learned
that cancer is not simply a single disease that affects many parts of the
body. It is not, for example, a "war on cancer" as a single enemy. It is many
different diseases with common themes that can cause different kinds of
disorders in many of our organs. These include mutations in many different
genes, changes in essential cell functions, and unusual interactions with the
cellular environment in which tumors grow. We need to study each of these
areas separately."

[https://www.nlm.nih.gov/medlineplus/magazine/issues/winter13...](https://www.nlm.nih.gov/medlineplus/magazine/issues/winter13/articles/winter13pg2-3.html)

~~~
nonbel
Sorry, see here:
[https://news.ycombinator.com/item?id=11718642](https://news.ycombinator.com/item?id=11718642)

------
known
Cancer cells need to be isolated to starve them; That's the difficult part;

~~~
dualogy
I think for many/most of them the key thing is that they need some 20x the
amount of glucose than normally oxygenated cells. So they're actually
supremely inefficient in terms of energy. What's the problem then? They just
won't die off normally via programmed-cell-death (apoptosis) or autophagy or
immune system attack, but keep replicating. Blood sugar levels may modulate
rate of growth and metastasis, but since blood sugar can never go too low,
that's only part of the picture.

------
SherlockeHolmes
I am very sorry for your loss.

my (armchair) analysis on cancer treatment - i) chemotherapy, in vacuum, most
likely does considerably more harm than good, ii) sugar feeds cancer cells,
iii) essential to feed body nutrients from a variety of sources (all must be
plant based and non-processed), iv) it is likely a prudent investment to
engage in holistic treatments such as being immersed in positivity and
fulfilled environment and ingesting plant products with powerful healing
properties known to locals across the world.

Having said all this, it is difficult to say no to conventional treatment and
to MDs working at prestigious hospitals when the life of your loved one is at
stake.

I have multiple cancer patients in my extended family, and this is in a family
that lives on a south Asian diet (with all kinds of spices and turmeric, lots
of vegetables). the cancer epidemic is extremely scary, and makes me feel
vulnerable with my life - regardless of how knowledgeable I try to be on the
subject.

My belief is that we must approach cancer as we have approached infectious
diseases such as measles and whooping cough. We must identify carcinogens in
our environment (this may be physical and spiritual), and take serious steps
to remove them from our social construct.

~~~
NotSammyHagar
I am sure you mean well, but you need to be better informed about biology.
Table sugar is not the greatest thing in the world for our bodies, but your
body needs certain kinds of sugars to function. Glucose is how your brain is
powered. Sadly there is no evidence that restricting sugar would retard
cancerous growth. Yes, there are toxins in our environment. Going past that to
things that affect cancer is a huge step. Just like we don't worry anymore
about a black cat crossing our path, we should use science to inform our ideas
about medical treatment.

~~~
mrob
The brain does need some glucose to function, but the bulk of its energy need
can be met by ketones. After adapting to this energy source the need for
glucose is low enough that it can be met entirely by gluconeogenesis (making
glucose from proteins and fats). Humans can survive on a zero carbohydrate
diet with no cognitive impairment.

~~~
dualogy
> making glucose from proteins and fats

plus recycling of pyruvate/lactate/some-such

------
mookerific
Just a plug for /r/ketoscience.

------
andreygrehov
A friend of mine (she is a microbiologist, let's call her Lucy) was diagnosed
with Uterine cancer. Oncologist told her they have to remove her womb,
otherwise she'll die in a couple weeks. She decided to avoid "traditional
treatment". Instead, she shared her issue with various professors from the
university she is working at. One of the professors (another friend of mine)
advised her to go to the Republic of Peru. He gave her contacts of his friend
who's already been there and suggested to talk to him first. Lucy got in touch
with this guy, he convinced her to go and in a week or so she was already in
Peru.

In Peru, Lucy met some sort of a shaman. He wrote down her a list of things
she must eat and things to avoid. This list also contained some herb, that she
had to eat during the 2-3 months she was there.

After a few months, she got back home. 6 months after - no cancer. Year after
this all happened she was dancing at my sister's wedding, healthy and happy.

Now as for the Peru guy and the friend of my friend who been there :) He had a
brother. They both got cancer. One of the brothers decided to go with
traditional treatment (radiation and all that). The other one went to Peru.

Long story short: the one who picked traditional methods died many years ago.
The other one (who convinced Lucy to go) - completely recovered.

As far as I know, overall treatment was less than $5,000. If I'm not wrong,
this was including rent + air flight.

I must add, that Lucy lost 45 pounds within a year. During my sister's
wedding, she was only eating some oceanic fish and rice.

Edit:

This is just a short story from people I know in person. All of them are
scientists working at university, doing researches on molecular genetics &
microbiology.

I'm not even sure the guy in Peru was a shaman. That's just how I called him
here. I just don't believe he was a real doctor. The gist of the whole
treatment was fasting, not a herb.

~~~
galuggus
One of the worst things about cancer is hearing stories like this all the
time. It's really unhelpful and very draining to have your body undergo hell
and your mind besieged by well=intentioned idiots telling you to expel toxins/
pray the cancer away/ stop eating this.

~~~
andreygrehov
Agree. Maybe this is all a coincidence they both survived and the other guy
passed away. Have no idea. Shared what I know. Nothing less, nothing more.

~~~
ryanwaggoner
You don't really _know_ anything of value about this though. Are you an
oncologist? Did you see her scans and test results? Have you been to her
follow ups? Talked with her doctors? Do you even know the name of this magical
herb that cures cancer but has somehow eluded the attention of thousands of
researchers desperate to save hundreds of millions of suffering people,
including their own loved ones?

~~~
andreygrehov
Ryan, there is no magical herb. The gist of treatment was fasting. I have no
idea what kind of diet it was. Do you want to know more? I can ask her details
and the other guy who survived by sticking to the same diet.

~~~
ryanwaggoner
I want to know whether they're dedicating their lives to winning a Nobel prize
and saving billions of lives with this magical cure. If not, why not? They had
fatal cancers cured in just a few months with no treatment, and then just went
back to work and forgot about it?

Also, if the essence is fasting, why did they need to go see a shaman in Peru?

~~~
reddytowns
The problem is that medical science today isn't equipped to prove/disprove
this kind of medicine. All that would happen if they could convince anyone to
even believe the story, which I highly doubt, is one study would be conducted.

The scientists would ignore all the diagnosis and individual examination the
shaman did, and the study would probably have the participants take a specific
amount of a single specific herb on a single specific schedule. Basically,
they'd take all the complexities of the alternative medical system and tried
to distill it down to a one-size-fits-all regimen.

Then, after it undoubtedly showed no effect, they'd proclaim the shaman is a
fraud and that nothing he does really works.

I mean, really, are you going to sit there and tell me that its more logical
that _all_ the alternative medical systems developed over thousands of years
are bullshit, than the possibility that modern medicine has gaps covered by
these other medical systems, that can't/won't be filled using the scientific
method, wrapped and perverted as it is by the hubris and single-minded culture
of the doctors and scientists using it?

~~~
ryanwaggoner
So the only kind of "science" that could prove this works is to layer on so
many confounding effects and other variables that it'd be impossible to tell
what, if anything, is happening.

Gee, I wonder why rational people are skeptical of that.

And to answer your question, no, I do not believe that alternative health
systems "developed" over thousands of years work. If they work, then they're
medicine. We only use the term alternative health to define things that are
too magical to have their effects show up when studied using the scientific
method. And barring the ability to collect some reliable data on their
efficacy, then yes, they're bullshit by default. What other reliable framework
for evaluating them could I possibly have?

~~~
carapace
We have to come up with something rigorous to deal with these sorts of things.
Whether you call it "science" or not we still have to come to grips with
"weird shit".

I know a guy. He's a healer. He can do things that Western science has
absolutely no idea about. In point of fact several people who were diagnosed
with cancer have worked with him and afterwards were no longer diagnosed with
cancer.

This is factual.

Yet good luck getting people in general to take this seriously. No one wants
to hear it. My mom's neighbour had breast cancer, she beat it with
conventional medicine, more power to her. But she refused even to think about
anything outside of the established system. For her it worked.

Personally, I'm very frustrated. I come from a strongly scientific background,
so when I meet a person who can fucking cure fucking cancer I would really
like to see the scientific establishment take that seriously.

But whatever. I can take some consolation that at least my family and I don't
have to worry about cancer, even if I can do nothing to change the zeitgeist
of society.

For those of you wondering why this guy wouldn't try to spread the word, well,
first of all he does! He talks to anyone he meets and is not shy about it at
all. The limiting factor is the people who don't want to hear about crazy
shit.

(P.S. If _you_ have cancer and want to talk to my healer friend I can put you
in touch. He's in Europe now and kind of retired, and I haven't spoken to him
in a year or so, but if you truly need help and feel that this guy is "the
one" you can contact me and I'll see about putting you in touch.)

~~~
ryanwaggoner
_This is factual._

Well, no, it's not. From my perspective, this is yet another random anecdote
from the Internet. It's no different to me than someone saying they can turn
base metals into gold, hear the voice of God directly, or travel to alternate
dimensions.

And even from YOUR perspective, you have no idea what's fact and what's not.
Apparently this healer is so powerful that your family need not worry about
cancer. But I suspect you have little hard evidence of any actual healing, no
proposed mechanisms that make any sense, and no ability to reproduce any of
this.

The amazing thing about the scientific method is that it gives us a framework
to separate claims from reality. If you have a better framework then please
share it. But there seems to be little value to a framework built on "I know a
guy, trust me." We had that for thousands of years. Health care under such a
framework was pretty rough.

