Otto Warburg Cracks the Code of Cancer Cell Metabolism

Dr. Otto Warburg was the first scientist to discover a key hallmark of what makes cancer cells grow. It’s known as the “Warburg Effect” and is how cancer cells basically create their energy in a very different way than normal cells do. Healthy, non-cancerous cells generate energy, a process called metabolism, using oxygen but cancer cells don’t use oxygen at all to make their energy. Instead, what Warburg found was that cancer cells use an ancient, non-oxygen dependent fermentation pathway using bacteria and nutrients like glucose to generate the massive amounts of energy they require to grow uncontrollably. Thanks to him, the metabolic theory of cancer was born.

Otto Warburg and the “Warburg Effect”

In 1931, German medical doctor and highly acclaimed biochemist Otto Warburg won a Nobel Prize for one of his many discoveries in cellular mechanics. Unfortunately, his ground-breaking work in cancer cell metabolism was essentially forgotten for over fifty years – the mid-century discoveries of DNA structure stole all the limelight. Yet, since its revival by cancer researchers like Efraim Racker who, in 1972, coined the term Warburg Effect, science has been reignited to study more about what makes cancer cells grow. In 2012, Dr. Thomas Seyfried, Ph.D., published the groundbreaking treatise: Cancer as a Metabolic Disease: On the Origin, Management, and Prevention of Cancer which explained how cancer can and should be defined as a metabolic disease as opposed to genetic. With Seyfried’s book, public interest pivoted back to Warburg’s work, especially since the wide promise of genetic research finding the cure for cancer coming back empty-handed. 

This original idea to study cancer metabolism and pathology (disease behavior) began – first and foremost – with Warburg. He was a highly ambitious man, who also happened to be pals with another life-changing inventor – Albert Einstein. As a young man in the early 1920s Warburg aspired to be the one to make big discoveries around the cure for cancer. The race to cure cancer had already begun. And while he did not discover “the” cure he was the first to identify a critical cancer cell characteristic. And, similar to some of Einstein’s revelations, Warburg’s pivotal cancer finding had everything to do with one concept: energy.

In humans, our form of energy is called Adenosine Triphosphate, or ATP for short. Our cells generate ATP from the food we eat by using oxygen, similar to how a campfire needs logs (or nutrients like glucose) and air to get started. But cancer cells are mutated, they are abnormal. What Warburg discovered is that the mutated cells generate their energy through an inefficient, oxygen-less fermentation process called anaerobic respiration. What makes cancer cell metabolism so inefficient is the math. 

From one molecule of glucose (a type of carbohydrate) cancer cells produce a meager two molecules of ATP and two molecules of lactic acid as the bi-product. Meanwhile, healthy cells, using oxygen to produce energy via the process called aerobic respiration, can use one molecule of glucose to create a whopping thirty-six ATP molecules and six CO2 molecules as the bi-product. So, if cancer cells produce so much less ATP than healthy cells, how do they grow so fast? One reason is that cancer cells use more than sixty-times the amount of glucose than a normal cell does – producing a lot of energy in a rapid but rudimentary way. What’s more is that because cancer cells are exceptionally glucose hungry our modern Standard American diets certainly provide a lot of fuel for the fires of this disease!

When Otto Warburg peered into his test tubes and found cancer cells bathing in large amounts of fermentation’s signature bi-product, lactic acid, he made the famous conclusion that even if oxygen was available, cancer cells preferred to ferment. What’s curious, is that cells hadn’t relied on this process since ancient, primordial times, when planet Earth had an oxygen-less atmosphere and single cell organisms dominated. Cancer is a modern disease that relies on humanities oldest biotechnological tool – fermentation. 

Identifying this altered metabolic process is of significant importance because if there is a way to stop cancer cells from producing energy, in concept, they will starve and die – like removing oxygen from a fire. Thus, targeting cancer metabolism has become a core and clinically valid approach studied and used throughout various areas of medicine and science today. Providing specific and effective metabolic therapies is one of the many areas where Bioregulatory medicine especially shines. The BioMed Clinics in Rhode Island and Arizona offer multiple non-toxic and non-invasive metabolic treatment strategies including electron additions, cell voltage increases to improve mitochondrial functioning, lymphatic drainage, regular oxygen treatments, targeted nutrient and personalized botanical protocols, and the overarching recommendation to – obviously – limit sugar intake. Thanks to Warburg, we’ve learned more about cancer behavior, and most important, how Bioregulatory medicine can point an effective extinguisher directly at the fires of this multi-faceted and pervasive disease. 

Further Reading & References

The Metabolic Approach to Cancer: Integrating Deep Nutrition, the Ketogenic Diet, and Nontoxic Bio-Individualized Therapies. By Dr. Nasha Winters and Jess Higgins Kelley. Chelsea Green Publishing; 2017.

The Song of the Cell: An Exploration of Medicine and the New Human. By Siddhartha Mukherjee. Simon & Schuster; 2022.

Tripping Over the Truth: How the Metabolic Theory of Cancer is Overturning One of Medicine’s Most Entrenched Paradigms. By Travis Christofferson. Chelsea Green Publishing; 2019.

Liu, Chang, Ying Jin, and Zhimin Fan. “The Mechanism of Warburg Effect-Induced Chemoresistance in Cancer.” Frontiers in Oncology 11 (2021). https://www.frontiersin.org/articles/10.3389/fonc.2021.698023.

Urbano, Ana M. “Otto Warburg: The Journey towards the Seminal Discovery of Tumor Cell Bioenergetic Reprogramming.” Biochimica et Biophysica Acta (BBA) – Molecular Basis of Disease 1867, no. 1 (January 1, 2021): 165965. https://doi.org/10.1016/j.bbadis.2020.165965.

About the Author

Jess Higgins Kelley, MNT, ONC is an internationally recognized journalist, nutritionist and educator. She is an author of two books The Metabolic Approach to Cancer and Bioregulatory Medicine and is also the Founder and Director of the Oncology Nutrition Institute.