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Ibrahim Halil Sahin: Differentiate ‘cancer prevention’ and ‘treatment of advanced stage cancer’

Ibrahim Halil Sahin/X

Dec 22, 2024, 07:52

Ibrahim Halil Sahin: Differentiate ‘cancer prevention’ and ‘treatment of advanced stage cancer’

Ibrahim Halil Sahin, Assistant Professor at UPMC Hillman Cancer Center, shared on X:

“‘Low sugar diet’ question comes up in daily practice frequently as it is believed that ‘sugar feeds cancer’

It is so important to differentiate ‘cancer prevention’ and ‘treatment of advanced stage cancer’ and they are highly different process; with distinct molecular and biological dynamics.

Some key points on this matter particularly important for patients with GI cancer and CRC.

While low carb diet carries significant benefit for cancer prevention by reducing insulin levels (a growth factor for cancer cells) and reducing risk of metabolic syndrome (linked to increased risk of cancer), the low carb diet for advanced stage GI cancers can lead to significant challenges.

The main difference is that metastatic cancers most often adapt to harsh microenvironmental conditions including depleted oxygen and nutrition and they often gain capabilities to metabolize the proteins in the body to convert them to glucose (sugar) as their nutritional resource, known as ‘cachexia’.

If the theory of nutritional depletion would slow down progression of cancer then cachexia would have done so and improve the outcomes, but it does not.

Indeed cachexia itself is a prognostic factor for most of GI tumors and it is a major challenge for clinicians.

Therefore, adequate calorie intake (including carbs and proteins) is essantial for patients with advanced stage GI cancers.

What, on the other hand, I advocate for my patient is regular exercise which may improve the underlying metabolic disorder and is associated with improved outcomes.

So in summary, while precancerous processes are more likely to be sensitive to nutrition depletion, advanced stage tumors particular GI cancers do not benefit nutritional depletion and they are capable to induce muscle break down to create their energy resource and weight loss can cause clinical decline in the setting of underlying cachexia.”