diet and cancer

In today’s podcast we talk about everything to do with the “emperor of all maladies”, the big C. 

Myself and Professor Robert have met on a couple of occasions at conferences geared toward healthy lifestyle and cancer, and I could not think of a more educated and enthusiastic person to have on the podcast who is up to date with the evidence and continues to wave the flag for lifestyle medicine and oncology.

Professor Robert Thomas is a Consultant Oncologist at Bedford and Addenbrooke’s Hospitals, a clinical teacher at Cambridge University and visiting Professor of Sports and nutritional science at the University of Bedfordshire. He is lead of a Lifestyle and Cancer Research Unit conducting designing and conducting government backed studies evaluating the impact of exercise, diet and natural therapies. 

More recently, he led the analysis of the 155,000 patient data set (PLCO) which has linked sugar with an increased cancer and tea and broccoli with cancer prevention. In 2019, he wrote the book “Keep Healthy after Cancer”, and remains medical advisor for the lifestyle and cancer website Cancernet.co.uk.

We frame our conversation into 3 distinct areas to avoid confusion. What to eat to prevent cancer, during cancer and post cancer with the aim of reducing risk and improving outcomes. As cancer is an extremely broad field and confusing for even medical professionals to understand it’s biology, I want to remind listeners and viewers that this is general information and not to be taken as medical advice.

In today’s pod we talk about

• What Cancer is
• The balance of genetic vs acquired cancer and the influence of lifestyle on risk
• The general principles of how to avoid cancer
• What foods to eat
• How food exerts a positive impact on cancer risk
• How we investigate the anti-cancer impact of food
• Gut health and cancer
• The Warburg effect
• The implication of excess sugar on cancer risk
• What to eat during cancer
• The potential for ‘prehab’ initiatives
• Vitamin D, Polyphenol and Probiotic supplements, Vitamin Supplements
• Post Cancer lifestyle regimens to reduce the risk of recurrence
• What an anti-cancer diet looks like
• The Future of Oncology: Individualised medicine, Immunotherapy and Metabolic Oncology

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In this episode, Lew Cantley, Professor of cancer biology and Director of the Sandra and Edward Meyer Cancer Center at Weill Cornell Medical College in NYC, walks us through his amazing discovery of phosphoinositide 3-kinase (PI3K) and the implications for the care of patients with cancer. He explains various combinations of therapies being tested and used, including the possibility of pairing prescriptive nutritional therapies to increase the efficacy of drugs like PI3K inhibitors. Lew also explains the metabolic nature of cancer through the lens of his research into the connection between sugar consumption, insulin resistance, and tumor growth. Additionally, Lew provides some details about his exciting new clinical trial that is just now enrolling patients with stage 4 breast cancer and endometrial cancer.

We discuss:

• Teaching science through the lens of discovery—A better approach to learning science [5:15];
• The metabolic nature of cancer, mitochondria, and a more nuanced explanation of the Warburg Effect [8:30];
• The observation that convinced Lew to stop eating sugar [20:15];
• The connection between obesity, insulin resistance, and cancer [25:30];
• Sugar consumption and tumor growth—What did Lew’s 2019 paper find? [32:00];
• Natural sugar vs. HFCS, fruit vs. fruit juice, insulin response and cancer growth [43:00];
• Increasing efficacy of PI3K inhibitors with ketogenic diets, SGLT2 inhibitors, and metformin [53:30];
• Lew’s clinical trial enrolling stage 4 breast cancer and endometrial cancer patients [1:07:30];
• Pairing diet with drug could be the future of cancer treatment [1:09:30];
• PI3K inhibitors on the market, alpha vs. delta isoform, and the possibility of pairing them with a food prescription [1:16:15];
• What questions will Lew be focused on in the next chapter of his career? [1:22:15];
• Lew's early work that ultimately led to the discovery of PI3K [1:27:30];
• Studying the mechanism by which mitochondria make ATP [1:30:45];
• How understanding the mechanism by which insulin drove glucose uptake into a cell got Lew closer to finding PI3K [1:38:15];
• How Lew knew PI3K was important in driving the growth of cancer cells [1:55:00];
• Lew’s unlikely observation of phosphorylation at the 3' position of the inositol ring resulting in the formation of phosphatidylinositol-3-phosphate [1:59:00]; and
• More.

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