New Metabolic Approaches to Cancer Treatment

“Cancer cells love to have lots of iron. ” – Ahmed Elsakka, MD “Methionine is an essential amino acid involved in protein synthesis and methylation processes, which are critical for cancer cell growth. In a clinical study, 5-fluorouracil alone failed to shrink tumors, but when combined with methionine restriction, a significant tumor-shrinking effect was observed.

Advanced cancer patients and caregivers are continually searching for optimal treatment options. It’s often challenging because treatment options are continuously advancing and some forms of cancer have become drug-resistant.

One area of great potential is metabolic approaches to controlling cancer – working to inhibit the systems that drive cancer growth and disrupting cancer cells’ energy production – a method that makes cells more vulnerable when paired with other cancer treatments. What are the new metabolic therapies at the cutting edge of cancer care that cancer patients and caregivers need to know about? Dr.

Ahmed Elsakka, Director of Research at the Metabolic Terrain Institute of Health, is uniquely qualified to discuss clinical metabolism, cancer metabolism, and clinical applied biochemistry in the prevention, diagnosis, and treatment of cancer and other complex metabolic diseases.

He is a metabolic therapy specialist, clinician, and scientist with expertise in various research fields, including neurometabolism, ozone therapy, regenerative medicine, photodynamic therapy, sonodynamic therapy, methionine metabolism, ferroptosis, tissue healing, and metabolic management of cancer. He was the Senior Researcher and Medical Director of the Egyptian Foundation for Research and Community Development.

After completing his medical education at the prestigious Faculty of Medicine of Alexandria University, Egypt, and a rigorous residency program in Egypt, Dr. Elsakka pursued advanced studies in neurometabolism at Johns Hopkins University in the United States, focusing on the impact of ketogenic diets in epilepsy and other neurological disorders.

His deep exploration into cellular energetics, particularly the role of ketogenic diets in cancer cell metabolism, piqued his interest in cancer research at submolecular levels. Notably, he collaborated with Professor Thomas Seyfried, a global leader in cancer metabolism studies. Together, they co-authored multiple scientific papers. Dr.

Elsakka further obtained a postgraduate diploma in clinical applied biochemistry from Harvard Medical School, a certificate in epigenetics and gene expression from Melbourne University in Australia, and a Masters of clinical nutrition and metabolism from the National Nutritional Institute in Cairo, Egypt.

He is associated with prominent organizations, including the Global Society of Metabolic Therapy (as the co-founder), the Global Leadership Panel at Fight Cancer Global, the Egyptian Functional Medicine Association, and the Egyptian Medical Society for Ozone Therapy and Complementary Medicine.

Moreover, his expertise extends to drug delivery systems, nanotechnology, and phytochemical extraction, having collaborated with a medication facility in Brazil to conduct workshops and train their company’s teams. Why might you want to better understand how cancer metabolism can be used to treat your cancer?

Cancer treatments aim to identify unique characteristics of cancer cells—such as genetic mutations, metabolic dependencies, or rapid growth—and target those features to hinder or kill the cancer cells. For example, traditional chemotherapies often attack rapidly dividing cells, while newer therapies target specific molecular pathways or immune responses.

Understanding cancer “metabolism” – how cancer cells use carbohydrates, fats, and proteins from food to get the energy they need to grow and spread – and how it is different from the metabolism of normal cells can lead to additional treatment options.

Compared to healthy cells, cancer cells use more glucose, produce less energy when making what they need to multiply and spread, and favor fermentation over breaking down glucose in the presence of oxygen. Unlike surgery, chemotherapy, or radiation, metabolic therapies often work by altering cancer cell metabolism, either slowing growth or inducing cell death through mechanisms like ferroptosis.

Over time, this can lead to tumor shrinkage and cell death. Researchers are looking for ways to block the unique metabolic processes of cancer cells while leaving healthy cells alone by reducing the food supply to the cancer cells and disrupting the messaging systems (“pathways”) used by cancer cells. For example, inhibiting “glycolysis” – the process of breaking down glucose to release energy – may help stop the development of cancer cells.

New pathways are being explored through the possible roles of iron and oxygen. What can you do to address your cancer using a metabolic approach? Metabolic approaches to treating cancer are in the early stages of research. They are not part of the standard of care, but show much promise.

Oncologists are not taught about the metabolic pathways beyond the “Warburg effect” (a “hallmark” of cancer cells – cancer cells preferentially break down sugar using glycolysis to produce energy, rather than using the more efficient approach of normal cells). There are multiple pathways that cancer can use to increase its nutrient uptake. Blocking those pathways can weaken the cancer.

Examples of metabolic treatments include “ferroptosis” (a type of cell death triggered by the accumulation of iron within cells), sound, light, methionine (an essential amino acid) restriction, and nanotechnology. What is the role of iron in cancer and ferroptosis as a new cell death mechanism? Cancer cells require high levels of iron for growth and proliferation.

However, iron also plays a dual role: while it can facilitate tumor growth, excessive iron accumulation can lead to “ferroptosis”, a form of iron-dependent cell death.

This occurs due to the buildup of iron and the subsequent failure of the antioxidant defense mechanisms in cancer cells, leading to lethal “lipid peroxidation” - a chemical process that damages cell membranes by oxidizing fatty compounds that perform a variety of functions in your body. How can sound and light be applied to control cancer? In photodynamic therapy (PDT), a photosensitizing drug is administered and accumulates in cancer cells.

When exposed to a specific wavelength of light, the photosensitizer is activated, transferring energy to molecular oxygen and generating reactive oxygen species (ROS). This oxidative burst damages cellular components, leading to cancer cell death. In sonodynamic therapy (SDT), ultrasound waves are used to activate “sonosensitizing” (sound sensitizing) drugs within cancer cells.

This activation generates reactive oxygen species (ROS), which induce oxidative stress and cancer cell death. Unlike photodynamic therapy, SDT can penetrate deeper tissues, making it suitable for internal tumors.

The energy emits ligh t through a phenomenon called sonoluminescence (light that is produced from sound), stimulating the photosensitizer drug as mentioned above, causing the similar photodynamic effect that results in the generation of ROS and killing of the cancer cell. However, sonodynamic therapy may increase the size of the tumor in some cases.

Still, the metabolic uptake of the tumor of sugar which is measured in PET scans will be less in the metabolism, and more in the size that is shown on the scan. This is called “pseudoprogression” – it’s not a true progression. How can methionine restriction control cancer? Methionine restriction diets aid cancer control by reducing oxidative stress to inhibit tumor growth.

Cancer cells are “addicted” to methionine because their growth is dependent on the substance glutathione. Glutathione depletion via methionine-restricted diets can induce endoplasmic reticulum (ER) stress. This, paired with the depletion of antioxidant stores, induces cell death. What are emerging developments in nanotechnology that can impact cancer care?

Nanotechnology has emerged as a transformative tool in cancer treatment, enabling ultra- specific drug delivery systems that enhance the stability, bioavailability, and targeting of therapeutic agents. Though research is primarily conducted on cell cultures and animal models, research found that the minimum effective dosage of sulfasalazine (anticancer medicine) was reduced, with nanotechnology delivery, from 12 grams to 125 milligrams.

Nanotechnology’s c ontinued development enhances the oral bioavailability of the drug itself. In recent labs, nanotechnology has come in the form of polymer-based particles, inorganic materials (including silica-coated, iron, gold, and silver particles), and lipid-based nanoparticles that are highly effective at passing through membranes and targeting specific cells. How would you know whether a metabolic approach might be right for you?

If you are interested in exploring innovative and scientifically grounded approaches to cancer treatment, metabolic therapies may be worth considering. However, evaluating these treatments can be challenging, as they are not yet part of the standard of care and require further clinical validation.

Most patients and caregivers who lean to the natural mindset solve this difficult treatment evaluation challenge by finding and relying on a quality natural healing center and organizing a team, including some combination of (1) a doctor, (2) a nutritionist or naturopath who specializes in oncology, and (3) resources at the integrated oncology department of a nearby academic research cancer center.

You need to be prepared to pay out-of-pocket for these therapies. You might see a doctor in a natural healing center every three months to advise you, which can cost something like $600/hour. A supplement program can cost over $650/month if you are buying only the best quality supplements. How can I learn more about the metabolic approach to cancer?

Brad Power This is the Cancer Patient Lab. Today we’re honored to have Dr. Ahmed Elsakka with us. He’s going to be talking to us about his work – how cancer can grow and get fed – and the metabolic approach. He’s a colleague of Dr. Nasha Winters, who's been on our session before, and who recommended him to us. This is for informational purposes only. This is not medical advice.