March 23, 2015

Metabolic Theory of Cancer: Speculation on the Causes of Cancer (Pt.1)

Those of us who are steeped in the ancestral health paradigm sometimes get a little too big for our britches. Because we know a little more about the care and feeding of the human body than the average guy or gal on the street, we tend to think we have an explanation for just about every health-related issue there is. When someone we know is diagnosed with a chronic illness, it’s easy for us to say to ourselves, “If only he had done x, y, and z, this wouldn’t have happened.” Or, “If only she hadn’t done a, b, and c, she wouldn’t have ended up like this.”

And, sure, when it comes to things like type 2 diabetes, heart disease, obesity, difficulty conceiving, and the like, we do have plenty of answers. (Or think we do, anyway.) So we play the blame game. The afflicted individuals brought their conditions upon themselves by engaging in certain behaviors and/or not engaging in others. It’s not that we think they “deserve” whatever conditions they have; it’s just that we can readily identify things they did or did not do, that eventually brought those conditions about. (And in my opinion, in some cases, ignorant doctors hold just as much responsibility as the patients.)

But what about cancer? Anyone out there gutsy enough to say that someone with cancer had it comin’? I’m sure as heck not.

Can we honestly lay blame on anyone for actions (or inactions) that might have resulted in cancer, or is cancer the quintessential example of a situation that demands us getting off our high horses and saying that sometimes, life just throws you a rotten egg? Maybe, sometimes, despite all our best efforts, we’ll draw the short straw. Maybe, in some cases, it’s possible that something as vicious and awful as cancer can be attributed to plain ol’ “bad luck.”

A paper came out recently wherein the authors suggested something like that, and it created a bit of a firestorm in the oncology and larger medical worlds. The authors wrote:

“Only a third of the variation in cancer risk among tissues is attributable to environmental factors or inherited predispositions. The majority is due to ‘bad luck,’ that is, random mutations arising during DNA replication in normal, noncancerous stem cells.” (Tomasetti & Vogelstein, 2015)

Well, as you can imagine, this was received about as well as a rare roasted leg of lamb at a vegan picnic. (Even though it was pretty badly misinterpreted and reported in the news, as media outlets are wont to do. The authors were not saying we’re helpless in the face of cancer risk. This is what happens when journalists read the abstract and think this equips them to speak with authority about the whole paper.) People went nuts. They were quick to point out that many cancers really do have their origins in environmental and lifestyle factors that are perhaps not entirely under our control, but certainly are to some extent:

“The fact that age-adjusted cancer rates for different tissues vary substantially among countries where statistics are kept, and between workplaces or communities that differ in environmental exposures, demonstrates that a large fraction of cancers are influenced by environmental factors.” (Ashford et al. 2015) However, these same authors were slightly more forgiving in an additional comment: “Some mutations are initiated by chemical or viral exposures, and others occur without a known cause.” (Ibid)

“The role of chance underlying the onset of any individual cancer has long been recognized. However, although important for the individual, chance has little to say about the incidence rate in a population, or differences between populations. These are far better explained by exposure to environmental and lifestyle factors, allowing important opportunities for, and supporting implementation of, primary prevention.” (Wild, et al. 2015)

The authors of the paper in question responded to some of their critics with the following, which paves the way for the rest of this post:

“The idea that we cannot completely control our cancer destinies by living a perfect lifestyle in a perfect environment, even when we have no hereditary predisposition to cancer, has proved unsettling. To others, our paper had a completely different message. That a child has cancer is bad enough; that a parent may feel guilty for failing to avoid a certain life-style or environment, and thereby 'causing' that cancer, is agonizing. We chose to use the word ‘bad luck’ particularly because we were aware of the unjustified guilt felt by many patients and their families about cancers that were beyond their control.” (Tomasetti & Vogelstein, 2015)

Colin Champ, MD, a radiation oncologist, had this to say:
“This article really made me think about epigenetics. This controversial and hot topic is the mechanism that changes how genes are expressed without changing our DNA sequence. This pesky term basically means that our lifestyles can actually be incorporated into our genes, potentially in an indirect manner to put it simply. In other words, the “luck” of our genes may actually be directly from our lifestyle.” (Do click on those links from Dr. Champ if you want to see how the media’s field day with this story was unjustified. The authors did not say cancer is just a matter of chance.)

Let’s see what do our go-to experts have to say about the influence of diet, lifestyle, and environment on cancer:

“Although how the transformation of a normal cell to a tumor cell ultimately achieves this calculated uncoupling between glycolytic flux and mitochondrial respiration is not completely clear, it would seem that environmental and/or dietary factors that impact on the epigenetic regulation of HK-2 may be intimately involved.” (Mathupala, Ko, Pedersen, 2010)

“None of the hexokinases arise as a result of […] chromosomal rearrangements or deletions. This knowledge implicates epigenetic events (e.g., demethylation) and/or gene amplification as playing a significant role in the up-regulation of HK-2 gene expression during tumorigenesis.” (Ibid)

“The influence of environmental factors via epigenetic mechanisms that possibly promote or induce cancer is now coming to center stage.” (Pedersen, 2007)

With this in mind—that it really does seem like at least some cancers are driven by lifestyle and environment, but that others might arise from factors we have no control over—let’s take a look at who gets cancer:

Elderly people
Middle-aged folks
Toddlers & teenagers
Obese people
Lean people
Couch potatoes
Professional athletes
Vegetarians & vegans
Tall people
Short people
Wealthy people
Destitute people
People of every race, religion, color, creed, gender, and nationality

Cancer is an equal opportunity killer.
The great equalizer.
This is probably the only “nice” thing we can say about cancer: it doesn’t discriminate.

BUT: Just because cancer has every single one of us in its crosshairs, I don’t think this means we are powerless against it.

This post and the next few will be filled with speculation on my part. This speculation is based on the origins of cancer as outlined in this series. The mitochondrial dysfunction that is at the heart of the cellular changes associated with cancer might not be the only mechanism by which cells become cancerous, but it’s certainly the most well understood and scientifically solid. It has been our guiding principle from the very first post, and it will continue to guide us here.

If malfunctioning mitochondria underlie just about everything else about cancer cells—increased glycolysis, aerobic fermentation, DNA mutations, evasion of apoptosis, and more—then it stands to reason that anything that causes damage to mitochondria can be considered a potential cause of cancer. We will address prevention strategies in a few more posts, but I don’t think it’s unreasonable to suggest that if we identify some of the causes of mitochondrial damage, then doing the opposite can probably be one part of a multi-pronged approach to prevention. (Kind of like how a low-carbohydrate diet can be therapeutic for Alzheimer’s disease, one cause of which might be a lifetime of carbohydrate abuse. And a low-carb diet might not be required for prevention, but I would argue that as much of a lifetime as possible of good glucoregulation is.)

So here’s the big question: If mitochondrial dysfunction is the underlying cause of cancer (or, more accurately, cancerous changes are a cell’s way of protecting itself in the face of dysfunctional mitochondria), WHAT CAUSES MITOCHONDRIAL DYSFUNCTION?

It’s time to revisit a few things we touched upon in previous posts. Now that we have come such a long way in our understanding of all this, the pieces will come together pretty well.

Let’s go back to what I said earlier about assigning blame. When someone leads a lifestyle that is in direct opposition to cultivating healthy mitochondria, then yeah, maybe it’s not such a mystery when they get cancer. But look at the chart again: little kids get cancer. Toddlers. Can we point a holier-than-thou finger at these cherubs and say they should have exercised more? (Or less?!) Or eaten less sugar? Or slept more? Or gotten more sunlight? If you happened to still be up on the aforementioned high horse, I sincerely hope this has just made you humbly dismount.

So what’s the deal here? Are two, three, five, or seven years of being alive on planet Earth enough time to “break” one’s mitochondria so badly that one ends up with cancer? We can see the connection between certain lifestyle habits and the development of cancer, especially in older folks, who have been engaging in theoretically damaging lifestyle habits for six, seven, or eight decades. But what about when this tragic, awful thing strikes little kids?

We can’t accuse these kids of bringing cancer upon themselves. I suppose, if we were feeling particularly evil, we could look at the mother’s and father’s diet and lifestyle pre-conception and during gestation, or possible toxic exposures in utero, and see if we could identify any possible triggers. But come on. Let’s give people a little more credit, okay? I really do think that there are cases of cancer where there is no identifiable behavior that brought the cancer about. This probably accounts for some cases in adults, and I would guess it accounts for the vast majority of them in children. So where do these cancers come from?

Where do any cancers come from?

In my speculation/opinion, there are causes we can control, and causes we can’t. (And, to be honest, somewhere deep down, for the ones we think we can’t control, we probably can; we just haven’t identified the triggers yet. Kind of like that old saying, “There are no mysteries; only answers we haven’t found yet.”) Just because we don’t know what causes certain health issues doesn’t mean causes don’t exist. But even when we do know the causes, maybe sometimes there’s no way to control for them anyway, so all knowing about them accomplishes is giving people who already need melatonin, magnesium, and inositol to calm down and fall asleep more things to worry about all night.

We’ll take a look at some potential causes of cancer next time. For now, I just wanted to make sure we all understand that not everyone who gets cancer gorges on junkfood all day while they mainline soda and sit on their rear ends indoors playing video games into the wee hours. And maybe even using only “all-natural,” non-toxic cosmetics, eating only organic produce, drinking only reverse osmosis-filtered water, eating only grassfed/pastured meats, and getting plenty of daylight and good quality sleep isn’t enough to make anyone “cancer-proof.”

When it comes to cancer, maybe there really is a tiny bit of luck of the draw. I am absolutely willing to concede that. Even if this is true, however, there’s still an awful lot we don’t need to leave to chance. Just because we can’t control everything doesn’t mean we shouldn’t try to be proactive in the ways we can be.

With that in mind, we’ll explore some potential causes of cancer and how to be proactive about them in the next couple of posts.

Continue to the next post: Part 2 of potential causes of cancer.

Remember: Amy Berger, M.S., NTP, is not a physician and Tuit Nutrition, LLC, is not a medical practice. The information contained on this site is not intended to diagnose, treat, cure, or prevent any medical condition.


  1. Welcome back Cancer as a Metabolic Disease! We have been waiting for you. This series is an important and prophetic view into the future of cancer treatment. Keep the series together, Amy, and provide them as an e-book (or whatever). It is important for the general public to learn a new way of looking at this most feared disease so that people will be better able to cope if (or when) someday cancer touches their lives.

    We humans have a tendency to wonder about what we did wrong when some disaster befalls us. Such thoughts benefit no one, especially the victim, so it is best to get them out in the open and out of the way, as today’s episode is doing. Very important!

    One comfort about cancer is the human body’s amazing monitoring system that constantly searches for and find cells that in some way have become defective and forgotten who they are. The monitors are followed by repair mechanisms that set the renegades straight or, in event they cannot, kill them or make them commit suicide (apoptosis). A defective cell that evades all attempts by the body to protect against it has the potential to become a cancer.

    Readers: Go back to the last episode “Cancer as a Protective Mechanism.” It explains beautifully the fact that a cancer cell is not a host cell anymore but rather a single cell guy who wants only to keep himself alive and growing at any cost. His drive is to protect his own identity. This new look at cancer as a metabolic disease opens new opportunities for more productive research. (Readers: Save all episodes of Cancer as a Metabolic Disease until an e-book appears. You will not regret it.) A&F

    1. Thanks, Alice! This is one of the best comments I've had on the blog. Maybe someday I will put all these posts together as an e-book. If I do, you'll get credit for sparking the idea. ;-)

  2. Sounds like the causes of mitochondrial dysfuntion (i.e. cancer), as many other things in nature, fall under the 'statistical control laws' of a normal distribution. MOST of mitdys is caused by this variable, a bit less by that one, and so on.

    IMEHO (e = extremely), sheer (bad) luck as a cause of mitdys is certainly possible, but improbable; should reside at the tail end of the statistics.

    As Bill Clinton would say, in his Arkansas campaign office: it's the sugar in the blood, stupid.

    1. Ola, Paulo, my biggest )and maybe only) fan in Brazil! I agree -- we can control our mitochondrial destiny to a large degree. Not *entirely,* but to a large degree. (Don't forget the little kids that get cancer. A lot of that seems unexplained.) But the bell curve analogy is a good one -- "most" factors can be controlled for, and "most" of the mitochondrial factors will fall in the middle (largest part of the distribution), but there will be outliers. Maybe there are a couple of factors that only cause a very small number of cases of cancer. And there will always be outliers with cancer patients, too -- the old man who smoked all his life, drank heavily, partied hard, and died happily in his sleep at a ripe old age. Or the person who does "all the right things" and still somehow gets cancer. These are the things I'll be addressing in the next few posts.

  3. Sometimes it seems hereditary, sometimes not, and sometimes its just the luck of the lottery draw, but more people seem to be coming up "winners" in the lottery than before with cancer. More bad luck or more environmental and bad personal choices, or is it the genes? I had one grandfather who lived to near 90, smoking two packs of Rothmans a day, eating eggs for breakfast (of course that's okay now), drank his rum (not necessarily in moderation), and died from "old age" in his bed (fortunately not smoking). However, my mother developed breast cancer, at about the same age that her mother developed cancer (and survived), showing the link of it being in the genes/family history. So what is one to do just give up? I like Mark Sissons' writing on the aspect that just because we may have a disposition in our genes to an illness, we may stave off activating the diseases by making better choices on how to live. If I follow this advice, I feel good, and when I don't I do not feel well. That's on an easily observed scale of the effect of one's life-style choices on one's health, so what do these choices affect on the smaller non-observable scale?

    Keep on writing and contributing to the discussion and speculating.


    1. Thanks, J. I agree - no, we are absolutely NOT supposed to resign ourselves to what might or might not be our genetic heritage. That's the whole point of the next couple posts -- that sure, we all have "genetic baggage" and predispositions. But that doesn't mean we're completely helpless regarding our health. We might not be able to all-out prevent every type of cancer (I certainly don't think we can), but we can sort of prime our bodies as best we can to be healthy and robust. Mitochondrial health & flexibility is near the top of the list of steps that would include, and I plan to cover ways to maintain/improve those in the next few posts.

      You're right on another point, too: there sure do seem to be more people's numbers coming up for cancer than there used to be. And it can't strictly be a factor of increased life span, and how more people died from infectious disease in the past, because like I said, plenty of young people get cancer. It's not just because people are living longer. Something's going on in our diet, our lifestyle, and our physical environment, and the storm that's brewing is affecting *all* of us. :-/

  4. Hi there Amy

    I found your blog from the book by Ellen David and Keith Runyan on T2D and Ketogenic Diets. Just wanted to say what a wonderful blog you have, so full of interetsing and detailed science. Thanks so much.

    Ian A

    1. Thanks, Ian! Welcome aboard. Ellen is great. She's helping me with the layout for an e-book I'm working on now, in exchange for me having helped edit & proofread her 2 e-books. Her Ketogenic Diet Resource site is amazing.

  5. Hey, Amy! I think you have another big fan on Brazil!

    First I would like to thank you for the effort to put this series together and provide us this kind of mindblowing information! Very interesting series so far! I've already been in touch with some of Dominic D'Agostino and Thomas Seyfried work as well as some videos and posts from Peter Attia and Robb Wolf, but the way that you're putting all of this information together is fascinating and I can say that I'am learning a lot from your posts and the research papers that you provide in them. Can't wait for the next !

    Keep up the great work!
    ps: loved the idea of an e-book on this!

    1. Thanks/obrigado. :) It's good to know people are learning from the cancer posts. I am, too! (I didn't know most of this until I started reading all those papers.) It's fascinating, and I don't know why this information isn't trickling down to the offices of family doctors & oncologists. Most cancer treatment wards are still shoving Ensure shakes down people's throats. (Nothing but sugar, corn syrup, and n-6 loaded oils.)

  6. Hi, Amy! I stumbled across your blog and WOW!!! This cancer series is seriously knocking my socks off. So much great information.

    Thank you so so so much for taking the time to document all of this amazing information. As a person with quite a bit of family history of cancer, Alzheimer's, and Parkinson's, this information is absolutely fascinating to me. I'm also very much looking forward to the next couple of posts where you discuss some tactics that people can use as possible preventions.

    Great work!! :)


    1. :) Thanks! Glad you found me. I'm guessing you've already discovered that I wrote a book about Alzheimer's, but just in case:

      As for the cancer series, I have to be very careful and say that anything I write about *possible* and *potential* causes/prevention methods are just that: possibilities, based solely on my opinion, but an opinion that is rooted in biochemistry & physiology. It's so dodgy sometimes...never, ever want to imply that I know how to prevent cancer. Just my best guesses, unfortunately. (But then again, that's all *anyone* has at this point, including doctors, right?)

    2. I did see your book! It's on my list of things to buy. :)

      I know what you mean about being careful. But, IMO, I think you are on to something...


  7. Amy,

    This has been an amazing series, really incredible. You have made an extremely complex subject available to anyone, that really is something you should be proud of. It's so good, you should offer this complete series as an ebook complete with all your excellent illustrations. It really does have it's place out there. I'm nearly complete on Christofferson's book and to be honest I had to kind of skip over some technical jargon above my head. Looking for those explanations and answers was how I found your site, your articles. I for one would buy it, please consider it and please keep writing, I made a small donation a couple of days ago to encourage you to do so!! I hope others too will support your tremendous efforts.

    Keiron, UK.

    1. Thank you, Keiron! What a lovely comment. :) I've considered putting these posts together into an e-book, but I'll have to see about securing some of the permissions to use various graphics & images from different studies. I agree, though -- it would be nice to have it all together in once place. And I would have to emphasize that this is really just one theory, and, as usual, there is much more that remains unknown. But it certainly all seems compelling to *me.* (And thanks very much for the donation! Very much appreciated, as this blog is a labor of love and I do it in my spare time.) :)