The Cancer Code: A Revolutionary New Understanding of a Medical Mystery (The Wellness Code Book 3)

by Jason Fung

In 1986, Dr. Bailar questioned the effectiveness of the entire cancer research program in an editorial in the New England Journal of Medicine.3 In the article, Dr. Bailar noted that from 1962 to 1982, the number of Americans who died of cancer increased by 56 percent (see Figure 1.2). Adjusting for population growth, this still represented a 25 percent increase in the rate of death from cancer, at a time when death rates from virtually every other disease were dropping quickly; crude death rates from causes other than cancer had decreased by 24 percent.

Nobel Prize laureate James Watson, the co-discoverer of DNA’s double helix, ruefully noted in a 2009 opinion piece published in the New York Times that cancer killed 560,000 Americans in 2006, 200,000 more than in 1970, the year before the “war” began.

One particularly macabre invention from 1653 was the breast guillotine, for amputation of the affected breast.

In the 1930s, stomach cancer was the most common cause of cancer death in the United States and Europe.20 Yet, by 2019, it ranked only as the seventh leading cause of cancer-related deaths in the United States. One of the most virulent cancers in the world was steadily losing momentum, but we had just about no idea why.

Expensive stuff is generally of higher quality. Nike shoes are generally more expensive and of higher quality than dollar-store shoes. This does not apply to cancer medicine, where a high-priced drug does not necessarily work better than a cheaper drug. Many expensive drugs may not even work at all.41 This is obviously a big problem when drug costs are the single largest cause of personal bankruptcy in the United States.

One of the clearest illustrations of this principle is found in the condition known as Barrett’s esophagus. This is most commonly caused by gastroesophageal reflux disease (GERD), also known as reflux or, colloquially, heartburn. Normally, stomach acid stays in the stomach and does not back up into the esophagus. The lining of the stomach is designed to withstand the strong acids produced, but the lining cells of the esophagus are not. When stomach acid refluxes upward, the esophageal lining sustains damage, which causes the pain of heartburn. In response, the cell lining of the esophagus changes to one more closely resembling the stomach and intestines, in a process called metaplasia.

Barrett’s esophagus is often considered a precursor to cancer, and has been increasing in recent decades. It converts to cancer of the esophagus at an annual rate of approximately 0.3 percent,12 which is about five times higher than normal. The most significant risk factor for GERD and Barrett’s esophagus is obesity.

The news gets even worse for the children of baby boomers, those born in the 1980s and ’90s, a generation sometimes called the “echo boom.” Not only are they the heaviest generation in history, but their risk of cancer is higher even at comparable weights, likely due to hyperinsulinemia (discussed in the next chapter).

In the 1940s, Dr. Albert Tannenbaum, former president of the American Association for Cancer Research, discovered that, astoundingly, carbohydrate restriction alone in mice provided greater protection against cancer than overall calorie restriction.

Breast cancer cells express six times the levels of insulin receptors compared to normal breast cells.

More insulin equals more cancer. It’s a pretty simple concept. The longer one injects insulin, the higher the risk of cancer.

The nutrient sensor insulin is also a highly potent growth factor.

Shockingly, of all the growth parameters commonly measured (birth weight, weight, height, age of menarche), the largest risk factor for breast cancer is height (see Figure 16.1).3 In the United Kingdom, the Million Women Study found that the tallest women suffered 37 percent more cancer, particularly breast cancer.4 Each increase of ten centimeters in height was associated with a 16 percent increase in risk of cancer.

Drugs that activate AMPK (mimicking low cellular energy stores) are known for promoting health. Examples include the diabetes drug metformin; resveratrol, from grapes and red wine; epigallocatechin gallate (EGCG), from green tea and chocolate; capsaicin from peppers; turmeric, garlic, and the traditional Chinese medical herb berberine. Calorie restriction also activates AMPK, which may explain some of its purported benefits with regard to aging.

The three most important nutrient-sensing pathways in humans are insulin, mTOR, and AMPK. Each nutrient-sensing pathway provides different yet complementary information (see Figure 17.2). Insulin increases primarily in response to dietary carbohydrates and protein, and responds within minutes. mTOR increases primarily in response to dietary protein and plays out over eighteen to thirty hours. AMPK responds to overall cellular energy, which reflects the intake of all macronutrients. Its total effect runs over the longer term, from days to weeks.

Cancer paradigm 3.0, the evolutionary model, can be divided into three phases: Transformation: The normal cell’s first step toward cancer is an evolutionary response to chronic, sublethal injury. The cancer phenotype develops as a survivalist mechanism that requires rejecting multicellular life. This is the seed of cancer. Progression: The nutrient sensors insulin, mTOR, and AMPK influence growth factor availability and provide a fertile environment for cancerous proliferation. This is the soil. Metastasis: The early shedding of cancer cells into the bloodstream exposes the cells to intense selection pressure for survival. As the primary tumor site is reseeded by its own progeny, natural selection pressure favors more aggressive and primitive traits.

The popularity of smoking tobacco in the United States began to increase around 1900, gaining momentum during World Wars I and II, and peaked in 1964, when 42 percent of Americans smoked.

The seminal event in the history of cancer prevention was the 1964 declaration by Luther Terry, then the surgeon general of the U.S. Public Health Service, that smoking caused lung cancer.

Smoking rates in the United States steadily declined over the ensuing years, reaching 15.5 percent by 2016.6

Over the last forty years in the United States, liver cancer diagnoses have tripled and deaths have more than doubled. There is little mystery as to why this is so: liver cancer is one of the obesity-related cancers, with obese and overweight individuals suffering almost double the risk compared to healthy-weight individuals.10 Fatty liver disease can cause chronic inflammation, leading to cirrhosis and liver cancer. Pancreatic cancer, also an obesity-related cancer, is increasing in incidence, by about 1 percent per year from 2006 to 2015.

One in ten women will have a positive mammogram, but only 5 percent of those positives are actually found to be cancer. Put another way, 95 percent of women with a positive mammogram are subjected to invasive procedures for no eventual benefit. This includes biopsies, lumpectomies, and sometimes unnecessary chemotherapy.

In the United States, the false positive rate is 30 to 50 percent.

For the most part, dietary prevention of cancer boils down to one key strategy: avoiding diseases of hyperinsulinemia, including obesity and type 2 diabetes.

Studies have demonstrated that in type 2 diabetics, metformin may potentially reduce the risk of cancer by as much as 21 percent to 57 percent.