This is the original text of Nobel Prize Laureate Dr. Otto Warburg's classic, "The Metabolism of Tumours." In this book Dr. Warburg, MD, PhD, and distinguished scientists demonstrate, through empirical evidence that: “Cancer, above all other diseases, has countless secondary causes. But, even for cancer, there is only one prime cause. Summarized in a few words, the prime cause of cancer is the replacement of the respiration of oxygen in normal body cells by fermentation of sugar.” All the experiments, in their original text, are included in this book.

Genetic alterations in cancer, in addition to being the fundamental drivers of tumorigenesis, can give rise to a variety of metabolic adaptations that allow cancer cells to survive and proliferate in diverse tumor microenvironments. This metabolic flexibility is different from normal cellular metabolic processes and leads to heterogeneity in cancer metabolism within the same cancer type or even within the same tumor. In this book, we delve into the complexity and diversity of cancer metabolism, and highlight how understanding the heterogeneity of cancer metabolism is fundamental to the development of effective metabolism-based therapeutic strategies. Deciphering how cancer cells utilize various nutrient resources will enable clinicians and researchers to pair specific chemotherapeutic agents with patients who are most likely to respond with positive outcomes, allowing for more cost-effective and personalized cancer therapeutic strategies.

Several fundamentally important questions form the basis for this book. What are the relationships between tumour formation and tumour pH? What are the effects of tumour pH and hypoxia on carcinogenesis or tumorigenesis? What are the therapeutic consequences of tumour pH? It is hypothesised that low extracellular pH is not only an important consequence of tumour growth but may also promote further tumorigenic transformation. Furthermore, in vitro studies suggest that low pH strongly affects the efficacy of chemo- and radiotherapy. Better understanding of the influence of pH on tumour growth, coupled with manipulation of the pH of the tumour microenvironment, may lead to the development of more effective therapies.

The book addresses controversies related to the origins of cancer and provides solutions to cancer management and prevention. It expands upon Otto Warburg's well-known theory that all cancer is a disease of energy metabolism. However, Warburg did not link his theory to the "hallmarks of cancer" and thus his theory was discredited. This book aims to provide evidence, through case studies, that cancer is primarily a metabolic disease requring metabolic solutions for its management and prevention. Support for this position is derived from critical assessment of current cancer theories. Brain cancer case studies are presented as a proof of principle for metabolic solutions to disease management, but similarities are drawn to other types of cancer, including breast and colon, due to the same cellular mutations that they demonstrate.

The Optimal Terrain Ten Protocol to Reboot Cellular Health Since the beginning of the twentieth century, cancer rates have increased exponentially--now affecting almost 50 percent of the American population. Conventional treatment continues to rely on chemotherapy, surgery, and radiation to attack cancer cells. Yet research has repeatedly shown that 95 percent of cancer cases are directly linked to diet and lifestyle. The Metabolic Approach to Cancer is the book we have been waiting for--it offers an innovative, metabolic-focused nutrition protocol that actually works. Naturopathic, integrative oncologist and cancer survivor Dr. Nasha Winters and nutrition therapist Jess Higgins Kelley have identified the ten key elements of a person's "terrain" (think of it as a topographical map of our body) that are crucial to preventing and managing cancer. Each of the terrain ten elements--including epigenetics, the microbiome, the immune system, toxin exposures, and blood sugar balance--is illuminated as it relates to the cancer process, then given a heavily researched and tested, non-toxic and metabolic, focused nutrition prescription. The metabolic theory of cancer--that cancer is fueled by high carbohydrate diets, not "bad" genetics--was introduced by Nobel Prize-laureate and scientist Otto Warburg in 1931. It has been largely disregarded by conventional oncology ever since. But this theory is resurging as a result of research showing incredible clinical outcomes when cancer cells are deprived of their primary fuel source (glucose). The ketogenic diet--which relies on the body's production of ketones as fuel--is the centerpiece of The Metabolic Approach to Cancer. Further, Winters and Kelley explain how to harness the anticancer potential of phytonutrients abundant in low-glycemic plant and animal foods to address the 10 hallmarks of cancer--an approach Western medicine does with drug based therapies. Their optimized, genetically-tuned diet shuns grains, legumes, sugar, genetically modified foods, pesticides, and synthetic ingredients while emphasizing whole, wild, local, organic, fermented, heirloom, and low-glycemic foods and herbs. Other components of their approach include harm-reductive herbal therapies like mistletoe (considered the original immunotherapy and common in European cancer care centers) and cannabinoids (which shrink tumors and increase quality of life, yet are illegal in more than half of the United States). Through addressing the ten root causes of cancer and approaching the disease from a nutrition-focused standpoint, we can slow cancer's endemic spread and live optimized lives.

This is book 2 of 5 of the “Understand Cancer” series. It is based on the best-available science. The SECONDARY causes of cancer were discussed in book one. This book continues from book one and discusses the PRIME cause of cancer as discovered by Nobel Prize Laureate Dr. Otto Warburg—considered by many as the founder of modern biochemistry. “There are prime and secondary causes of diseases. For example, the prime cause of the plague is the plague bacillus, but secondary causes of the plague are filth, rats, and the fleas that transfer the plague bacillus from rats to man. By a prime cause of a disease I mean one that is found in every case of the disease...Cancer, above all other diseases, has countless secondary causes. But, even for cancer, there is only one prime cause. Summarized in a few words, the prime cause of cancer is the replacement of the respiration of oxygen in normal body cells by a fermentation of sugar. All normal body cells meet their energy needs by respiration of oxygen, whereas cancer cells meet their energy needs in great part by fermentation. All normal body cells are thus obligate aerobes, whereas all cancer cells are partial anaerobes. From the standpoint of the physics and chemistry of life this difference between normal and cancer cells is so great that one can scarcely picture a greater difference. Oxygen gas, the donor of energy in plants and animals is dethroned in the cancer cells and replaced by an energy yielding reaction of the lowest living forms, namely, a fermentation of glucose.” —Dr. Otto Warburg

This textbook presents concise chapters written by internationally respected experts on various important aspects of cancer-associated metabolism, offering a comprehensive overview of the central features of this exciting research field. The discovery that tumor cells display characteristic alterations of metabolic pathways has significantly changed our understanding of cancer: while the first description of tumor-specific changes in cellular energetics was published more than 90 years ago, the causal significance of this observation for the pathogenesis of cancer was only discovered in the post-genome era. The first 10 years of the twenty-first century were characterized by rapid advances in our grasp of the functional role of cancer-specific metabolism as well as the underlying molecular pathways. Various unanticipated interrelations between metabolic alterations and cancer-driving pathways were identified and currently await translation into diagnostic and therapeutic applications. Yet the speed, quantity, and complexity of these new discoveries make it difficult for researchers to keep up to date with the latest developments, an issue this book helps to remedy.