To a friend with cancer: Support with Diet and Breathe Work published in AugustSeptember2014 issue of Townsend Letters
In my recent studies I found an intriguing thread of logic. Here are some ideas that might help you feel better in the short run and, dare we hope, help your body’s overenthusiastic cells to normalize.
This thread of thought comes from various sources. Here is an overview of where we are headed. Three authors from the early 20th century observed a significant increase in the incidence of cancer in populations transitioning from their ancestral diets to a modern diet. Also in the early 20th century, the Warberg Hypothesis, of 1929 describes the shift in metabolism on a cellular level as a fundamental cause of cancer. Our next authors draw a connection between diet and metabolic change. But, you might ask, how could I make a convincing case with such dated literature? Since the 1950s, with the discovery of the double helix there has been a shift in the world of research towards a molecular understanding of health, specifically towards an understanding of the genome and its relationship to illness. The powerful effects of dietary change are complex and difficult to isolate and quantify. They do not have the elegance of a molecular understanding which to our modern way of thinking equates with true science. However, as I continued to study, I discovered to my delight, that there is currently a renewal of interest in a biochemical understanding of cancer. This new focus is seen in the world of integrative medicine, but also in more mainstream corridors: a 2012 book from a professor at Yale and a review of recent work at Harvard’s teaching college both herald the return of popularity of the Warberg hypothesis with its focus on metabolism.
Anaerobic metabolism means metabolism without oxygen. Having studied briefly the work of Buteyko practitioners, who work with breathing as a tool for health, I wondered if low oxygen levels might further contribute to the shift towards anaerobic metabolism. Not many people are familiar with the work of Constantine Buteyko. The practitioners trained in his approach contend there has been, in the last century, increasing hypoxia (low oxygen in cells) due to changes in the way we breathe. A look at the literature reveals an interesting interplay between hypoxia, metabolism and cancer. In order to speak persuasively about this thread of connection, the writing becomes necessarily dense, but hang in there: in the end we return to the simple lifestyle solutions of breathing and diet.
The shift from ancestral to modern diets
Let’s start with a look at changes in diet. Dr. Joseph Romig was a physician who worked with both primitive and modernized Eskimos and Indians at the turn of the last century. In his 36 years of contact, he never saw a case of cancer among natives eating their traditional foods. Among those who had modernized their diet, he saw cancer frequently. Vilhalmur Stefansson, was both physician and anthropologist and also worked in Alaska. In his book Cancer, Disease of Civilization, he cites missionary records indicating that the Eskimos did not suffer from cancer prior to the changes in their diet upon contact with American civilization. As civilization reached them at the turn of the century, they began to experience greater incidences of many diseases, including cancer. A dentist and pioneer in the world of nutrition, Weston Price made similar observations among South Pacific Islanders and others that he visited during his extensive travels. Although there were many aspects which changed in these diets at that time of transition, the increasing consumption of refined carbohydrates was a significant factor and the one relevant to this train of thought.
Differentiated or dedifferentiated
Christian Allan PhD and Wolfgang Lutz MD’, authors of Life Without Bread (2000: we are getting considerably more modern here) take the position that the increase of carbohydrates in the diet might be an essential factor in the increase in cancer. They start at the very beginning with a description of the evolution of cells.
In the beginning of life on earth, simple cells had not evolved to have differing functions in a larger organism. They were undifferentiated. These cells are called prokaryotic cells. Prokaryotic cells are defined by not having internal organelles (nuclei or mitochondria among others) and by relying on anaerobic forms of metabolism. Not relying on oxygen for metabolism was a good plan in an early atmosphere low in oxygen. As life evolved into more complex organisms, cells became differentiated to perform specific functions. These more evolved cells had a new and much more efficient way of generating energy that worked in an atmosphere with more oxygen in it: their primary source of energy was an aerobic process in the mitochondria. Allan and Lutz contend that mitochondria evolved to digest fats, a more efficient fuel than sugar. These more evolved cells with mitochondria are called eukaryotic cells. Eukaryotic cells are defined as having internal organelles (including mitochondria and nuclei) depending on oxygen for their metabolism and performing specialized functions (i.e. they are differentiated).
Why do we care about this esoteric information? In the early 1950s, according to Allan and Lutz, the understanding of cancer could be summarized by the following statement: “Cancer cells are cells that have reverted to more primitive cells that behave less like eukaryotic cells and more like prokaryotic cells.”
This concept of differentiation is, in fact, currently used in the diagnosis of cancer. The level of cellular differentiation is used as a measure of cancer progression. The grade given to a cancer is a measure of how differentiated a cell in a tumor is. A lack of differentiation is considered a hallmark of an aggressive cancer.
Aerobic or Anaerobic
The relationship between aerobic and anaerobic as a key factor in cancer development was addressed in the 1956 by Nobel laureate Otto Warberg. In his “The Origin of Cancer” (Science Magazine) he observed that most cancer cells predominantly produce energy in an anaerobic process rather than the aerobic process used by most normal cells. Known as Warberg’s hypothesis, this understanding guided research about cancer at that time. It is currently recognized that tumor cells typically have glycolytic (the anaerobic or non oxidative process) rates that are up to 200 times higher than those of their normal tissues of origin. What could be the cause of this change of energy production in the mitochondria? Warberg speculates about an “insult to mitochondria”.
Anaerobic metabolism and genetic instability
In his 2012 book Cancer as a Metabolic Disease ,Thomas Sayfreid PhD from Yale, draws on and develops Warberg’s hypothesis with a new interpretation of the role of genetics. Although inherited genes do influence the growth of cancer, current theory looks more closely at the genetic change that happens during the course of a lifetime. The genes of cells can be injured by a series of mutations which make it possible for cancer to grow: they transform a quiescent cell into a proliferating cell. According to Seyfried, anaerobic metabolism is what causes genome instability. In his words “all hallmarks of cancer including the Warburg effect can be linked to impaired respiration and energy metabolism”. He adds: “the downstream effects of damaged mitochondrial function” is the inability of a cell to maintain its differentiated state. “Sayfried’s perspective differs from his colleagues in that he regards the normal cell to be basically proliferative, like the primitive bacteria that it evolved from, not naturally quiescent, as most other biologists believe”.[i] In his view, cancer involves a return to a former state and a loss of control rather than the acquisition of new mutations that cause the cell to replicate wildly.
Does cellular fuel influence cellular metabolism?
But, let’s get back to Warberg’s question of how the mitochondria might have been insulted. The use of PET scans to detect cancer draws attention to the role of fuel in cancer cells. PET scans involve radio labeling of tissues with the highest glucose uptake: such as the brain, the liver and most cancers. Some would argue that the cause for the high requirement of glucose in cancer cells is rapid growth, but could that characteristic requirement give us clues about both cause and treatment of cancer?
Researcher Sophia Y. Lunt from the Massachusetts Institute of Technology observes that: “increased glucose metabolism is selected for in proliferating cells throughout nature. .. ranging from microbes to lymphocytes.”[i]
The Carbohydrate Theory, proposed by Allan and Lutz, suggests that a diet too high in carbohydrates, leading to high levels of glucose in the blood, can cause cells to dedifferentiate. They suggest that the ratio of fat to glucose in a cell’s fuel is reflected in the number of mitochondria in the cell. (Remember: a defining attribute of a dedifferentiated cell is the loss of mitochondria.) As an example of this they mention the cells around the heart which have more mitochondria than other cells. Studies indicate that the heart’s preferred fuel is fat,[ii]
The effects of various energy sources on cell metabolism were studied by researchers who studied “cell lines” in France[iii]. A cell line is a group of human cells which have been conditioned to grow outside of the body in a medium. These are primarily cancer cells, as their level of dedifferentiation facilitates their ability to live outside the body. The researchers found that the more primitive cells used less oxygen and more anaerobic fermentation for their energy production. They also found that in these same, less differentiated cells, the respiration (the aerobic process) improved in the absence of glucose, suggesting the hopeful thought that a reduction of glucose may be a way to redifferentiate cells.
Thomas Seyfried’s work supports this hopeful theory noting numerous studies indicating that dietary changes lower circulating glucose and significantly reduce growth and progression of various different cancers: mammary, brain, colon, lung and prostate.[iv]
While writing this paper, I received an article about the thrust of research at Mass General Hospital, Harvard’s teaching hospital. Dr. Mostoslavsky, a researcher at Mass General states: “It took us 80 years to bring the revealing observations of Otto Warberg back from obscurity”. “Now that we widely acknowledge cancer metabolism as a main player in cancer, it will take much less time to exploit metabolism in tackling this devastating disease.” A promising beginning, but the article continues with a statement that shows a distrust of a dietary approach: “It is impossible to deprive a patient’s cancer cells of glucose, because the liver will synthesize additional sugar if the blood stream has an insufficient supply.” It is certainly true that there cannot be a complete removal of glucose from the blood stream, and nor would one wish to do so. However, the statement shows a lack of understanding of enormous impact of refined foods and sugar consumption in the modern diet. The consumption of sugar has risen in the US to a current average of 161 pounds per person per year, and other modern foods are quickly converted to sugars. The consumption of these foods often results in high and erratic blood sugar levels, as reflected in the dramatic increase in diabetes among other health problems.
Breathing, metabolism and cancer
We have been exploring the causal relationship between cellular fuel, anaerobic metabolism and cancer growth, now let’s take a side trip and look at how breathing might fit into the equation.
Might the shift to anaerobic metabolism also be triggered by low levels of oxygen in the cells, known as hypoxia? The literature offers an interesting answer to this question. A study from the University of Georgia states that oxygen levels can be a key trigger for growth of some kinds of cancer. “As oxygen decreases, the cells switch to glycolysis [anaerobic metabolism] to produce their energy. Glycolysis is drastically less efficient way to obtain energy, and so the cancer cell must work even harder to obtain even more food, specifically glucose, to survive. When oxygen levels dip dangerously low, angiogenesis, or the process of creating new blood vessels, begins.”[v] Angiogenesis is essential for cancer to grow.
Several studies indicate a relationship between hypoxia and the rate of growth of cancer. A study from Yale University School of Medicine found: “The physiological effects of hypoxia and the associated micro environmental inadequacies increase mutation rates, select for cells deficient in normal pathways of programmed cell death, and contribute to the development of an increasingly invasive, metastatic phenotype”.[vi] Another study states: “tissue hypoxia has been regarded as a central factor for tumor aggressiveness and metastasis”.[vii] Yet another study says: “Clinical evidence shows that tumor hypoxia is an independent prognostic indicator of poor patient outcome. Hypoxic tumors have altered physiologic processes, including increased regions of angiogenesis, increased local invasion, increased distant metastasis and altered apoptotic programs” [viii].
The DJ Chaplin, author of one of the studies cited above mused about the origins of hypoxia, “Surprisingly little is known, however, about the natural history of such hypoxic cells”.[ix]
Why the increase in Hypoxia?
The perspective of Buteyko practitioners offers one answer to the question of why there is an increase in hypoxia. In the 1930s Ukrainian doctor Konstantin Buteyko observed rapid breathing rates among severely ill patients. While working with these patients, he developed a method to slow their breathing which proved helpful in their recovery from various illnesses. Practitioners of his technique take the counterintuitive position that hypoxia is caused by rapid breathing rates. In their view, increased modern respiration rates of12-20 breaths per minute (in contrast to breath rates of 6-8 breaths per minute in the 1890s as noted in older text books) are the cause of increased levels of hypoxia. This understanding is affirmed by the research of L. Bernardi and co-researchers at the University of Pavia in Italy.[xi]
For an explanation of Buyeyko’s understanding of breathing and hypoxia here is an excerpt of an article that I wrote for the Nutritional Therapist:
"There is a surprising paradox at the core of Buteyko. When more air is breathed than is required, the cells are actually deprived of oxygen. With more rapid breathing, the partial pressure of oxygen does not significantly increase, but the levels of carbon dioxide become substantially lower. In 1903, Danish scientist Christian Bohr observed that the partial pressure of carbon dioxide in the blood affects the ability of hemoglobin to carry and release oxygen (the Bohr Effect). A low partial pressure of carbon dioxide in the blood causes hemoglobin cells to hold more tightly to the oxygen they are carrying. A high pressure of carbon dioxide allows the hemoglobin to release the oxygen into the tissues of the body. This is, of course, the exact opposite of how a person who is short of breath feels. A person who is hyperventilating feels that they cannot get enough air. In reality they have about the same oxygenation in their arterial blood but too little carbon dioxide. This leads to Buteyko’s counterintuitive advice that to slow one’s breathing will actually improve oxygenation."
Oxygenation and Cancer
The web site of a Buteyko practitioner describes experiences his fellow practitioners in Russia and a number of western countries have observed: ”when the index of body oxygenation gets up to 35-40 s [a measure of how long someone can hold their breath], tumors start to disappear”[xiii]
He cites a study indicating that higher oxygenation increased effectiveness of cancer treatments[xiv].
A study in the Ukraine found that slowing breathing increased longevity of breast cancer patients: “It was established that elimination of hyperventilation and hypocapnia [low CO2] in patients with breast cancer (T1-2N1M0) after the completion of the special treatment led to increased three-year survival rate, better quality of life.”[xv]
One study indicated that breathing rates of cancer patients are an independent predictor of their survival rates.[xvi].
How to translate these ideas into practice?
These studies suggest that low oxygen might indeed contribute, along with food, to the ominous shift towards anaerobic metabolism, and proliferative growth. Let’s bring it home now to look at how daily lifestyle habits: how we breathe and how we eat might have an effect on quieting cancer.
How we breathe and how we eat have a profound effect on general health. In fact, the best way to determine if you are on the right track as you make lifestyle changes, is to notice if you are feeling better in the day to day. In my mere four years of practice, I have found that fine tuning carbohydrate ratios is a prime tool for helping clients with various health issues. More significantly, Alan Gaby, an MD who has been practicing nutritional medicine for 30 years, and Phillip Maffetone, a nutritionist who has worked with world ranked endurance athletes for decades have both found that coaching clients to fine tune their carbohydrate ratios has been one of the most helpful changes that they, as practitioners, offer. Maffetone is a believer in the beneficial affects of saturated fat in the diet, an unpopular view in the last 60 years in the US. The success that his internationally ranked endurance athletes have achieved lends credibility to his words. He finds that training athletes to metabolize fats as a fuel improves their performance. In his words: “Aerobic muscle fibers burn fat for energy…. As the body gets better at burning fat for energy, the aerobic function improves…. Too many athletes don’t burn sufficient amounts of fat and because of this never achieve their athletic potential.” As not everyone’s needs are the same, a process of dramatically reducing carbohydrates and then increasing them to find an individual’s preferred ratios is a helpful approach on this process of discovery.
What an extraordinary simple tool: slowing one’s breathe, but according to Buteyko practitioners and others, to do so could offer significant support for normalizing cancer cells. Rapid breathing is both an expression of, and a perpetuator of the stress response. As with dietary improvements, one finds an immediate benefit from breath work: slowing the breath is wonderfully calming.
If I had cancer, I would seek to answer both the question of whether I was eating too many carbohydrates for my constitution, and the question about whether I was breathing more rapidly than was optimal. There is an aspect of self empowerment in this discovery process and much that one can achieve on one’s own, but having support from a nutritionist and/or a Buteyko practitioner could be helpful in determining how significant these two issues are for you as an individual and the best steps towards making changes in your habits.
At worst, I suggest that modifications in breathing patterns and diet can help a person feel more calm and healthy. At best, they could, perhaps, aid in turning cancerous cells towards a more normal pattern of behavior.
[i] Annu Rev Cell Dev Biol. 2011 Nov 10;27:441-64. Aerobic glycolysis: meeting the metabolic requirements of cell proliferation.Lunt SY, Vander Heiden MG.Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA. [email protected]
[ii] Lawson, L. D. and Kummerow. Lipids 14(1979): 501-503, and Garg, M.L.Lipids (1989): 334-339
[iii] Gauthier, t., C. Denis-Prouviel, and J. Murat. “ Respiration of mitochondria isolated from differentiated and undifferentiated colon cancer cells in the presence of various substrates and ADP generating systems.” International Journal of Biochemistry 22 (1990): 411-417
[iv] Cancer as a metabolic disease Thomas N Seyfried* and Laura M Shelton, Nutrition and Metabolism 2010,7:7
http://www.nutritionandmetabolism.com/content/7/1/7
[v] http://news.uga.edu/releases/article/study-suggests-new-approach-to-explain-cancer-growth-low-oxygen-levels/
[vi] Oncol Res. 1997;9(6-7):383-90., Oxygen delivery: implications for the biology and therapy of solid tumors. Rockwell S. Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, CT 06520-8040, USA. [email protected]
[vii] Molecular responses to hypoxia in tumor cells Manfred Kunzand Saleh M Ibrahim, University of Rostock, Germany, Molecular Cancer 2003, 2:23 doi:10.1186/1476-4598-2-23
[viii] Oncogene. 2003 Sep 1;22(37):5907-14. Investigating hypoxic tumor physiology through gene expression patterns. Denko NC, Fontana LA, Hudson KM, Sutphin PD, Raychaudhuri S, Altman R, Giaccia AJ. Division of Radiation and Cancer Biology, Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA 94305, USA. [email protected]
[ix] Int J Radiat Oncol Biol Phys. 1986 Aug;12(8):1279-82. Acute hypoxia in tumors: implications for modifiers of radiation effects. Chaplin DJ, Durand RE [xi] Slow breathing reduces chemoreflex response to hypoxia and hypercapnia, and increases baroreflex sensitivity.Bernardi L, Gabutti A, Porta C, Spicuzza L.Department of Internal Medicine, University of Pavia and IRCCS Ospedale S. Matteo, Pavia, Italy. [email protected] PMID: 11725167 [xii] For the full text visit: http://www.revivinghealth.com/breathing-article.html
[xiii] Is The Buteyko Self-Oxygenation Breathing Therapy Better Cancer Cure Than Foods And Diets by Artour Rakhimov, http://www.articlecity.com/articles/health/article_9668.shtml
[xiv] "Perfusion insufficiency and the resultant hypoxia are recognized as important mechanisms of resistance to anticancer therapy. Modification of the tumor microenvironment to increase perfusion and oxygenation of tumors may improve on the efficacy of these [anticancer] treatments..."Powell ME, Hill SA, Saunders MI, Hoskin PJ, Chaplin DJ, Human tumour blood flow is enhanced by nicotinamide and carbogen breathing, Cancer Res 1997 Dec 1; 57(23): p. 5261-5264.
[xv] S. N. Paschenko, Zaporozhsky State Institute of Further Medical Education, Zaporozhie, Ukraine
Oncology (Kiev, Ukraine), 2001, v. 3, No.1, p. 77-78 The PDF file of this article (in Russian) is available at http://www.oncology.kiev.ua/archiv/9/s_9_020.php an English translation can be found at:http://www.normalbreathing.com/diseases-cancer-1-clinical-trial.php
[xvi] Chiang JK, Lai NS, Wang MH, Chen SC, Kao YH, A proposed prognostic 7-day survival formula for patients with terminal cancer, BMC Public Health, 2009 Sep 29; 9(1): p.365.
[i] Ralf W MossPhD the Seventh Issue of Advances in Cancer
This thread of thought comes from various sources. Here is an overview of where we are headed. Three authors from the early 20th century observed a significant increase in the incidence of cancer in populations transitioning from their ancestral diets to a modern diet. Also in the early 20th century, the Warberg Hypothesis, of 1929 describes the shift in metabolism on a cellular level as a fundamental cause of cancer. Our next authors draw a connection between diet and metabolic change. But, you might ask, how could I make a convincing case with such dated literature? Since the 1950s, with the discovery of the double helix there has been a shift in the world of research towards a molecular understanding of health, specifically towards an understanding of the genome and its relationship to illness. The powerful effects of dietary change are complex and difficult to isolate and quantify. They do not have the elegance of a molecular understanding which to our modern way of thinking equates with true science. However, as I continued to study, I discovered to my delight, that there is currently a renewal of interest in a biochemical understanding of cancer. This new focus is seen in the world of integrative medicine, but also in more mainstream corridors: a 2012 book from a professor at Yale and a review of recent work at Harvard’s teaching college both herald the return of popularity of the Warberg hypothesis with its focus on metabolism.
Anaerobic metabolism means metabolism without oxygen. Having studied briefly the work of Buteyko practitioners, who work with breathing as a tool for health, I wondered if low oxygen levels might further contribute to the shift towards anaerobic metabolism. Not many people are familiar with the work of Constantine Buteyko. The practitioners trained in his approach contend there has been, in the last century, increasing hypoxia (low oxygen in cells) due to changes in the way we breathe. A look at the literature reveals an interesting interplay between hypoxia, metabolism and cancer. In order to speak persuasively about this thread of connection, the writing becomes necessarily dense, but hang in there: in the end we return to the simple lifestyle solutions of breathing and diet.
The shift from ancestral to modern diets
Let’s start with a look at changes in diet. Dr. Joseph Romig was a physician who worked with both primitive and modernized Eskimos and Indians at the turn of the last century. In his 36 years of contact, he never saw a case of cancer among natives eating their traditional foods. Among those who had modernized their diet, he saw cancer frequently. Vilhalmur Stefansson, was both physician and anthropologist and also worked in Alaska. In his book Cancer, Disease of Civilization, he cites missionary records indicating that the Eskimos did not suffer from cancer prior to the changes in their diet upon contact with American civilization. As civilization reached them at the turn of the century, they began to experience greater incidences of many diseases, including cancer. A dentist and pioneer in the world of nutrition, Weston Price made similar observations among South Pacific Islanders and others that he visited during his extensive travels. Although there were many aspects which changed in these diets at that time of transition, the increasing consumption of refined carbohydrates was a significant factor and the one relevant to this train of thought.
Differentiated or dedifferentiated
Christian Allan PhD and Wolfgang Lutz MD’, authors of Life Without Bread (2000: we are getting considerably more modern here) take the position that the increase of carbohydrates in the diet might be an essential factor in the increase in cancer. They start at the very beginning with a description of the evolution of cells.
In the beginning of life on earth, simple cells had not evolved to have differing functions in a larger organism. They were undifferentiated. These cells are called prokaryotic cells. Prokaryotic cells are defined by not having internal organelles (nuclei or mitochondria among others) and by relying on anaerobic forms of metabolism. Not relying on oxygen for metabolism was a good plan in an early atmosphere low in oxygen. As life evolved into more complex organisms, cells became differentiated to perform specific functions. These more evolved cells had a new and much more efficient way of generating energy that worked in an atmosphere with more oxygen in it: their primary source of energy was an aerobic process in the mitochondria. Allan and Lutz contend that mitochondria evolved to digest fats, a more efficient fuel than sugar. These more evolved cells with mitochondria are called eukaryotic cells. Eukaryotic cells are defined as having internal organelles (including mitochondria and nuclei) depending on oxygen for their metabolism and performing specialized functions (i.e. they are differentiated).
Why do we care about this esoteric information? In the early 1950s, according to Allan and Lutz, the understanding of cancer could be summarized by the following statement: “Cancer cells are cells that have reverted to more primitive cells that behave less like eukaryotic cells and more like prokaryotic cells.”
This concept of differentiation is, in fact, currently used in the diagnosis of cancer. The level of cellular differentiation is used as a measure of cancer progression. The grade given to a cancer is a measure of how differentiated a cell in a tumor is. A lack of differentiation is considered a hallmark of an aggressive cancer.
Aerobic or Anaerobic
The relationship between aerobic and anaerobic as a key factor in cancer development was addressed in the 1956 by Nobel laureate Otto Warberg. In his “The Origin of Cancer” (Science Magazine) he observed that most cancer cells predominantly produce energy in an anaerobic process rather than the aerobic process used by most normal cells. Known as Warberg’s hypothesis, this understanding guided research about cancer at that time. It is currently recognized that tumor cells typically have glycolytic (the anaerobic or non oxidative process) rates that are up to 200 times higher than those of their normal tissues of origin. What could be the cause of this change of energy production in the mitochondria? Warberg speculates about an “insult to mitochondria”.
Anaerobic metabolism and genetic instability
In his 2012 book Cancer as a Metabolic Disease ,Thomas Sayfreid PhD from Yale, draws on and develops Warberg’s hypothesis with a new interpretation of the role of genetics. Although inherited genes do influence the growth of cancer, current theory looks more closely at the genetic change that happens during the course of a lifetime. The genes of cells can be injured by a series of mutations which make it possible for cancer to grow: they transform a quiescent cell into a proliferating cell. According to Seyfried, anaerobic metabolism is what causes genome instability. In his words “all hallmarks of cancer including the Warburg effect can be linked to impaired respiration and energy metabolism”. He adds: “the downstream effects of damaged mitochondrial function” is the inability of a cell to maintain its differentiated state. “Sayfried’s perspective differs from his colleagues in that he regards the normal cell to be basically proliferative, like the primitive bacteria that it evolved from, not naturally quiescent, as most other biologists believe”.[i] In his view, cancer involves a return to a former state and a loss of control rather than the acquisition of new mutations that cause the cell to replicate wildly.
Does cellular fuel influence cellular metabolism?
But, let’s get back to Warberg’s question of how the mitochondria might have been insulted. The use of PET scans to detect cancer draws attention to the role of fuel in cancer cells. PET scans involve radio labeling of tissues with the highest glucose uptake: such as the brain, the liver and most cancers. Some would argue that the cause for the high requirement of glucose in cancer cells is rapid growth, but could that characteristic requirement give us clues about both cause and treatment of cancer?
Researcher Sophia Y. Lunt from the Massachusetts Institute of Technology observes that: “increased glucose metabolism is selected for in proliferating cells throughout nature. .. ranging from microbes to lymphocytes.”[i]
The Carbohydrate Theory, proposed by Allan and Lutz, suggests that a diet too high in carbohydrates, leading to high levels of glucose in the blood, can cause cells to dedifferentiate. They suggest that the ratio of fat to glucose in a cell’s fuel is reflected in the number of mitochondria in the cell. (Remember: a defining attribute of a dedifferentiated cell is the loss of mitochondria.) As an example of this they mention the cells around the heart which have more mitochondria than other cells. Studies indicate that the heart’s preferred fuel is fat,[ii]
The effects of various energy sources on cell metabolism were studied by researchers who studied “cell lines” in France[iii]. A cell line is a group of human cells which have been conditioned to grow outside of the body in a medium. These are primarily cancer cells, as their level of dedifferentiation facilitates their ability to live outside the body. The researchers found that the more primitive cells used less oxygen and more anaerobic fermentation for their energy production. They also found that in these same, less differentiated cells, the respiration (the aerobic process) improved in the absence of glucose, suggesting the hopeful thought that a reduction of glucose may be a way to redifferentiate cells.
Thomas Seyfried’s work supports this hopeful theory noting numerous studies indicating that dietary changes lower circulating glucose and significantly reduce growth and progression of various different cancers: mammary, brain, colon, lung and prostate.[iv]
While writing this paper, I received an article about the thrust of research at Mass General Hospital, Harvard’s teaching hospital. Dr. Mostoslavsky, a researcher at Mass General states: “It took us 80 years to bring the revealing observations of Otto Warberg back from obscurity”. “Now that we widely acknowledge cancer metabolism as a main player in cancer, it will take much less time to exploit metabolism in tackling this devastating disease.” A promising beginning, but the article continues with a statement that shows a distrust of a dietary approach: “It is impossible to deprive a patient’s cancer cells of glucose, because the liver will synthesize additional sugar if the blood stream has an insufficient supply.” It is certainly true that there cannot be a complete removal of glucose from the blood stream, and nor would one wish to do so. However, the statement shows a lack of understanding of enormous impact of refined foods and sugar consumption in the modern diet. The consumption of sugar has risen in the US to a current average of 161 pounds per person per year, and other modern foods are quickly converted to sugars. The consumption of these foods often results in high and erratic blood sugar levels, as reflected in the dramatic increase in diabetes among other health problems.
Breathing, metabolism and cancer
We have been exploring the causal relationship between cellular fuel, anaerobic metabolism and cancer growth, now let’s take a side trip and look at how breathing might fit into the equation.
Might the shift to anaerobic metabolism also be triggered by low levels of oxygen in the cells, known as hypoxia? The literature offers an interesting answer to this question. A study from the University of Georgia states that oxygen levels can be a key trigger for growth of some kinds of cancer. “As oxygen decreases, the cells switch to glycolysis [anaerobic metabolism] to produce their energy. Glycolysis is drastically less efficient way to obtain energy, and so the cancer cell must work even harder to obtain even more food, specifically glucose, to survive. When oxygen levels dip dangerously low, angiogenesis, or the process of creating new blood vessels, begins.”[v] Angiogenesis is essential for cancer to grow.
Several studies indicate a relationship between hypoxia and the rate of growth of cancer. A study from Yale University School of Medicine found: “The physiological effects of hypoxia and the associated micro environmental inadequacies increase mutation rates, select for cells deficient in normal pathways of programmed cell death, and contribute to the development of an increasingly invasive, metastatic phenotype”.[vi] Another study states: “tissue hypoxia has been regarded as a central factor for tumor aggressiveness and metastasis”.[vii] Yet another study says: “Clinical evidence shows that tumor hypoxia is an independent prognostic indicator of poor patient outcome. Hypoxic tumors have altered physiologic processes, including increased regions of angiogenesis, increased local invasion, increased distant metastasis and altered apoptotic programs” [viii].
The DJ Chaplin, author of one of the studies cited above mused about the origins of hypoxia, “Surprisingly little is known, however, about the natural history of such hypoxic cells”.[ix]
Why the increase in Hypoxia?
The perspective of Buteyko practitioners offers one answer to the question of why there is an increase in hypoxia. In the 1930s Ukrainian doctor Konstantin Buteyko observed rapid breathing rates among severely ill patients. While working with these patients, he developed a method to slow their breathing which proved helpful in their recovery from various illnesses. Practitioners of his technique take the counterintuitive position that hypoxia is caused by rapid breathing rates. In their view, increased modern respiration rates of12-20 breaths per minute (in contrast to breath rates of 6-8 breaths per minute in the 1890s as noted in older text books) are the cause of increased levels of hypoxia. This understanding is affirmed by the research of L. Bernardi and co-researchers at the University of Pavia in Italy.[xi]
For an explanation of Buyeyko’s understanding of breathing and hypoxia here is an excerpt of an article that I wrote for the Nutritional Therapist:
"There is a surprising paradox at the core of Buteyko. When more air is breathed than is required, the cells are actually deprived of oxygen. With more rapid breathing, the partial pressure of oxygen does not significantly increase, but the levels of carbon dioxide become substantially lower. In 1903, Danish scientist Christian Bohr observed that the partial pressure of carbon dioxide in the blood affects the ability of hemoglobin to carry and release oxygen (the Bohr Effect). A low partial pressure of carbon dioxide in the blood causes hemoglobin cells to hold more tightly to the oxygen they are carrying. A high pressure of carbon dioxide allows the hemoglobin to release the oxygen into the tissues of the body. This is, of course, the exact opposite of how a person who is short of breath feels. A person who is hyperventilating feels that they cannot get enough air. In reality they have about the same oxygenation in their arterial blood but too little carbon dioxide. This leads to Buteyko’s counterintuitive advice that to slow one’s breathing will actually improve oxygenation."
Oxygenation and Cancer
The web site of a Buteyko practitioner describes experiences his fellow practitioners in Russia and a number of western countries have observed: ”when the index of body oxygenation gets up to 35-40 s [a measure of how long someone can hold their breath], tumors start to disappear”[xiii]
He cites a study indicating that higher oxygenation increased effectiveness of cancer treatments[xiv].
A study in the Ukraine found that slowing breathing increased longevity of breast cancer patients: “It was established that elimination of hyperventilation and hypocapnia [low CO2] in patients with breast cancer (T1-2N1M0) after the completion of the special treatment led to increased three-year survival rate, better quality of life.”[xv]
One study indicated that breathing rates of cancer patients are an independent predictor of their survival rates.[xvi].
How to translate these ideas into practice?
These studies suggest that low oxygen might indeed contribute, along with food, to the ominous shift towards anaerobic metabolism, and proliferative growth. Let’s bring it home now to look at how daily lifestyle habits: how we breathe and how we eat might have an effect on quieting cancer.
How we breathe and how we eat have a profound effect on general health. In fact, the best way to determine if you are on the right track as you make lifestyle changes, is to notice if you are feeling better in the day to day. In my mere four years of practice, I have found that fine tuning carbohydrate ratios is a prime tool for helping clients with various health issues. More significantly, Alan Gaby, an MD who has been practicing nutritional medicine for 30 years, and Phillip Maffetone, a nutritionist who has worked with world ranked endurance athletes for decades have both found that coaching clients to fine tune their carbohydrate ratios has been one of the most helpful changes that they, as practitioners, offer. Maffetone is a believer in the beneficial affects of saturated fat in the diet, an unpopular view in the last 60 years in the US. The success that his internationally ranked endurance athletes have achieved lends credibility to his words. He finds that training athletes to metabolize fats as a fuel improves their performance. In his words: “Aerobic muscle fibers burn fat for energy…. As the body gets better at burning fat for energy, the aerobic function improves…. Too many athletes don’t burn sufficient amounts of fat and because of this never achieve their athletic potential.” As not everyone’s needs are the same, a process of dramatically reducing carbohydrates and then increasing them to find an individual’s preferred ratios is a helpful approach on this process of discovery.
What an extraordinary simple tool: slowing one’s breathe, but according to Buteyko practitioners and others, to do so could offer significant support for normalizing cancer cells. Rapid breathing is both an expression of, and a perpetuator of the stress response. As with dietary improvements, one finds an immediate benefit from breath work: slowing the breath is wonderfully calming.
If I had cancer, I would seek to answer both the question of whether I was eating too many carbohydrates for my constitution, and the question about whether I was breathing more rapidly than was optimal. There is an aspect of self empowerment in this discovery process and much that one can achieve on one’s own, but having support from a nutritionist and/or a Buteyko practitioner could be helpful in determining how significant these two issues are for you as an individual and the best steps towards making changes in your habits.
At worst, I suggest that modifications in breathing patterns and diet can help a person feel more calm and healthy. At best, they could, perhaps, aid in turning cancerous cells towards a more normal pattern of behavior.
[i] Annu Rev Cell Dev Biol. 2011 Nov 10;27:441-64. Aerobic glycolysis: meeting the metabolic requirements of cell proliferation.Lunt SY, Vander Heiden MG.Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA. [email protected]
[ii] Lawson, L. D. and Kummerow. Lipids 14(1979): 501-503, and Garg, M.L.Lipids (1989): 334-339
[iii] Gauthier, t., C. Denis-Prouviel, and J. Murat. “ Respiration of mitochondria isolated from differentiated and undifferentiated colon cancer cells in the presence of various substrates and ADP generating systems.” International Journal of Biochemistry 22 (1990): 411-417
[iv] Cancer as a metabolic disease Thomas N Seyfried* and Laura M Shelton, Nutrition and Metabolism 2010,7:7
http://www.nutritionandmetabolism.com/content/7/1/7
[v] http://news.uga.edu/releases/article/study-suggests-new-approach-to-explain-cancer-growth-low-oxygen-levels/
[vi] Oncol Res. 1997;9(6-7):383-90., Oxygen delivery: implications for the biology and therapy of solid tumors. Rockwell S. Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, CT 06520-8040, USA. [email protected]
[vii] Molecular responses to hypoxia in tumor cells Manfred Kunzand Saleh M Ibrahim, University of Rostock, Germany, Molecular Cancer 2003, 2:23 doi:10.1186/1476-4598-2-23
[viii] Oncogene. 2003 Sep 1;22(37):5907-14. Investigating hypoxic tumor physiology through gene expression patterns. Denko NC, Fontana LA, Hudson KM, Sutphin PD, Raychaudhuri S, Altman R, Giaccia AJ. Division of Radiation and Cancer Biology, Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA 94305, USA. [email protected]
[ix] Int J Radiat Oncol Biol Phys. 1986 Aug;12(8):1279-82. Acute hypoxia in tumors: implications for modifiers of radiation effects. Chaplin DJ, Durand RE [xi] Slow breathing reduces chemoreflex response to hypoxia and hypercapnia, and increases baroreflex sensitivity.Bernardi L, Gabutti A, Porta C, Spicuzza L.Department of Internal Medicine, University of Pavia and IRCCS Ospedale S. Matteo, Pavia, Italy. [email protected] PMID: 11725167 [xii] For the full text visit: http://www.revivinghealth.com/breathing-article.html
[xiii] Is The Buteyko Self-Oxygenation Breathing Therapy Better Cancer Cure Than Foods And Diets by Artour Rakhimov, http://www.articlecity.com/articles/health/article_9668.shtml
[xiv] "Perfusion insufficiency and the resultant hypoxia are recognized as important mechanisms of resistance to anticancer therapy. Modification of the tumor microenvironment to increase perfusion and oxygenation of tumors may improve on the efficacy of these [anticancer] treatments..."Powell ME, Hill SA, Saunders MI, Hoskin PJ, Chaplin DJ, Human tumour blood flow is enhanced by nicotinamide and carbogen breathing, Cancer Res 1997 Dec 1; 57(23): p. 5261-5264.
[xv] S. N. Paschenko, Zaporozhsky State Institute of Further Medical Education, Zaporozhie, Ukraine
Oncology (Kiev, Ukraine), 2001, v. 3, No.1, p. 77-78 The PDF file of this article (in Russian) is available at http://www.oncology.kiev.ua/archiv/9/s_9_020.php an English translation can be found at:http://www.normalbreathing.com/diseases-cancer-1-clinical-trial.php
[xvi] Chiang JK, Lai NS, Wang MH, Chen SC, Kao YH, A proposed prognostic 7-day survival formula for patients with terminal cancer, BMC Public Health, 2009 Sep 29; 9(1): p.365.
[i] Ralf W MossPhD the Seventh Issue of Advances in Cancer