Part 3: The Warburg Effect Explained – What This Means in Real Life – Imaging, Diet, and Therapy

Find Part 1 – Here
And Part 2 – Here​

Introduction: From Theory to Terrain

The Warburg effect explains why many cancers rely on sugar. However, there are exceptions that remind us tumours can change their metabolic behaviour. What does this mean for us?

For patients, doctors, and families, science is only useful if it influences what we see, choose, or do.

So let’s discuss how this plays out in the real world: glowing scans, diets that alter the body’s environment, drugs that target metabolism, and a straightforward list of what to avoid.

Imaging: Scans as Metabolic Maps

One of the most useful applications of the Warburg effect is in diagnostic imaging. If tumours absorb glucose at higher rates, we can use that information.

• PET-CT scans use a radioactive sugar tracer. Most cancers appear bright on these scans because they crave glucose.
• Prostate cancer often does not show up well, so we need different tracers like PSMA PET, choline, or acetate.
• Brain cancers can be more complex. The brain loves glucose, which creates a high background noise on scans.

The key takeaway is that imaging isn’t one-size-fits-all. The scan that works for an oesophageal tumour – like mine – may be ineffective for prostate cancer.

Imaging isn’t just about finding tumours. It also reflects metabolism. It reveals, in real time, what fuel a tumour prefers.

Diet: Changing the Menu

This is where it can get a bit controversial. If many tumours depend on glucose, does cutting carbs and increasing ketones help?

• Ketogenic diets restrict carbs, which lowers insulin, raises ketones, and decreases glucose availability. Healthy cells can adapt to ketones, but many tumours cannot.
• Fasting and fasting-mimicking diets lower glucose levels and IGF-1, temporarily stressing cancer cells while giving healthy cells a better chance.
• Exercise improves mitochondrial efficiency, increases oxygen delivery, and helps fight tumour hypoxia.

Does the ketogenic diet cure cancer? No. But does it make biochemical sense in light of the Warburg effect? Yes. For many, it can be a safe addition.

However, exceptions are important:

• A prostate tumour that relies on amino acids may not be affected by carbs.
• A glioblastoma that depends on glutamine might ignore glucose altogether.
• The “reverse Warburg” effect means some tumours can outsource sugar burning to nearby cells.

For patients, this means diet is not a cure-all. It’s a tool that needs to be heavily personalised – I consulted with the Amazing Amanda King – Naturopath & Nutritionist – to personalise my own diet.

Drugs: Repurposing and Reinforcing

Several existing drugs and experimental compounds focus on cancer metabolism.

• Metformin is a diabetes drug that inhibits mitochondrial complex I, lowers insulin levels, and may slow tumour growth.
• Propranolol is a beta-blocker that reduces stress signals, blood vessel growth, and the potential for metastasis.
• Dichloroacetate (DCA) encourages cells to return to mitochondrial respiration. It is promising in theory but still experimental and should not be used without supervision.
• Glutaminase inhibitors are being tested on glutamine-dependent cancers.
• MCT inhibitors block lactate transporters, starving tumours that depend on lactate.

These drugs are not miracle cures. They represent a shift in focus: instead of only targeting genes, we can target metabolism – the energy sources, not just the wiring.

Integrative Therapies: Synergy with Warburg

Other complementary therapies make sense considering tumour metabolism:

• HBOT (hyperbaric oxygen therapy) increases oxygen levels, helps combat hypoxia, and can work together with oxidative therapies.
• High-dose Vitamin C acts as a pro-oxidant in tumors with low catalase, creating stress through hydrogen peroxide.
• Artemisinin takes advantage of cancer’s iron load to generate oxidative free radicals.
• Mistletoe therapy has immunomodulatory effects and has shown evidence from European trials.

Again, none of these replace standard care. But when used carefully, they may change the metabolic landscape in favour of fighting cancer.

What Not to Do

This part is just as important. Metabolism has become a buzzword, leading to a lot of misleading information.

Here’s the straightforward list:

• Don’t think all cancers are sugar-dependent. Some rely on glutamine, others on fatty acids. Test issues rather than guessing.
• Don’t jump into extreme diets without guidance. Rapid carb restriction during chemotherapy, for instance, can lead to malnutrition, muscle loss, or electrolyte imbalances.
• Don’t trust in miracle “cures.” Unregulated compounds like 3-bromopyruvate, harmful industrial solvents marketed as metabolic hacks, or excessive doses of DCA can cause harm.
• Don’t abandon standard treatments. Surgery, radiotherapy, and chemotherapy remain essential. Metabolic therapies should complement, not replace, them.
• Don’t assume “more is better.” Overusing supplements, antioxidants, or intense fasting can backfire. Context and timing are crucial.

Cancer thrives in chaos. If you add confusion in the name of “metabolic therapy,” you may actually help the tumour more than yourself.

My Perspective: Stacking the Odds

When I began exploring metabolism, it wasn’t to replace my oncologist’s treatment plan. My scans showed the Warburg effect clearly. My tumour was sugar-dependent, and I wanted to explore every available option.

So, I combined keto, fasting, metformin, HBOT, and high-dose Vitamin C – thoughtfully, with research, under supervision, and with an understanding of my limitations.

I never saw these as “alternatives.”* Instead, I viewed them as ways to improve my chances. Cancer is clever, adaptable, and relentless. You can’t defeat it with ideology. Instead, you win with small advantages.

*I also refer to them as adjunct or complimentary, never alternative – as they’re in addition to, not as an alternative to, standard care.

Conclusion: Precision, Not Dogma

The Warburg effect explains why many cancers show up on scans and why some treatments work. The exceptions remind us that cancer is more diverse and adaptable than any single theory.

The practical message is clear:

• Use imaging and metabolomics to understand your tumour’s fuel.
• Use diet and drugs to target weaknesses – but do so carefully.
• Avoid dogma, miracle claims, and risky DIY methods.

Cancer isn’t one disease; it’s hundreds of metabolic strategies disguised as one. This means that the smart way to fight it is by tailoring your treatment to its metabolism – not to ideology, hype, or unfounded beliefs.

The next time you hear someone say, “cancer is just bad genes” or “all cancer feeds on sugar,” take a moment – The truth is more complex, challenging, and, importantly, more hopeful. Complexity leads to opportunities. And opportunities are what cancer genuinely fears.

​References

• Seyfried TN, Shelton LM. Cancer as a metabolic disease. Nutr Metab (Lond). 2010;7:7.
• Allen BG, Bhatia SK, Anderson CM, et al. Ketogenic diets and cancer therapy: balancing the evidence. Clin Oncol. 2014;26(8):475–485.
• Chen J, et al. Targeting mitochondrial oxidative phosphorylation in cancer therapy. Nat Rev Drug Discov. 2022;21(9):665–684.
• Monti DA et al. Pilot study of hyperbaric oxygen and high-dose vitamin C in advanced cancer. J Transl Med. 2012;10:23.
• Vander Heiden MG. Targeting cancer metabolism: a therapeutic window opens. Nat Rev Drug Discov. 2011;10(9):671–684.