#110

Original release date: 5/11/20
In this episode, Lew Cantley, Professor of cancer biology and Director of the Sandra and Edward Meyer Cancer Center at Weill Cornell Medical College in NYC, walks us through his amazing discovery of phosphoinositide 3-kinase (PI3K) and the implications for the care of patients with cancer. He explains various combinations of therapies being tested and used, including the possibility of pairing prescriptive nutritional therapies to increase the efficacy of drugs like PI3K inhibitors. Lew also explains the metabolic nature of cancer through the lens of his research into the connection between sugar consumption, insulin resistance, and tumor growth. Additionally, Lew provides some details about his exciting new clinical trial that is just now enrolling patients with stage 4 breast cancer and endometrial cancer.
We discuss:
-Teaching science through the lens of discovery-a better approach to learning science [5:15];
-The metabolic nature of cancer, mitochondria, and a more nuanced explanation of the Warburg Effect [8:30];
-The observation that convinced Lew to stop eating sugar [20:15];
-The connection between obesity, insulin resistance, and cancer [25:30];
-Sugar consumption and tumor growth-What did Lew’s 2019 paper find? [32:00];
-Natural sugar vs. HFCS, fruit vs. fruit juice, insulin response and cancer growth [43:00];
-Increasing efficacy of PI3K inhibitors with ketogenic diets, SGLT2 inhibitors, and metformin [53:30];
-Lew’s clinical trial enrolling stage 4 breast cancer and endometrial cancer patients [1:07:30];
-Pairing diet with drug could be the future of cancer treatment [1:09:30];
-PI3K inhibitors on the market, alpha vs. delta isoform, and the possibility of pairing them with a food prescription [1:16:15];
-What questions will Lew be focused on in the next chapter of his career? [1:22:15];
-Lew’s early work that ultimately led to the discovery of PI3K [1:27:30];
-Studying the mechanism by which mitochondria make ATP [1:30:45];
-How understanding the mechanism by which insulin drove glucose uptake into a cell got Lew closer to finding PI3K [1:38:15];
-How Lew knew PI3K was important in driving growth of cancer cells [1:55:00];
-Lew’s unlikely observation of phosphorylation at the 3′ position of the inositol ring resulting in the formation of phosphatidylinositol-3-phosphate [1:59:00]; and
-More.
Show notes page: peterattiamd.com/lewcantley/
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About:
The Peter Attia Drive is a weekly, ultra-deep-dive podcast focusing on maximizing health, longevity, critical thinking…and a few other things. With over 30 million episodes downloaded, it features topics including fasting, ketosis, Alzheimer’s disease, cancer, mental health, and much more.
Peter is a physician focusing on the applied science of longevity. His practice deals extensively with nutritional interventions, exercise physiology, sleep physiology, emotional and mental health, and pharmacology to increase lifespan (delay the onset of chronic disease), while simultaneously improving healthspan (quality of life).
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[@wmartonejr]

Peter, based on your interviews and the studies of your guests, it would appear there’s enough scientific evidence to support a legal case to ban food manufacturers & food retailers from infusing any consumable products with liquified &/or concentrated sucrose &/or fructose. Who is going to take up that cross?

[@katetuhoro4623]

That would take a brave person.

[@wmartonejr]

@@katetuhoro4623 interesting how even the most capable of people aren’t willing to acknowledge the elephant in the room. Consumable manufactured products should at least carry the same regulations (ie warning labels, advertising restrictions, etc) imposed on tobacco and alcohol. What’s essential for life (chemical free water) is different than what can be consumed for entertainment (bottle varieties of alcohol). If we can appreciate the differences between two clear liquids, why do we not appreciate the same between what is grown, hunted & harvested from what is made inspired through commerce? Similarly, one of these should be deemed essential while the other “consumable for entertainment”.

[@martinirving3824]

Listening to the discussion around 0;40 to 0;50 minutes makes me realize how smart Gary Taubes was on this subject. In GC, BC, there's a chapter where he discusses the pre-winter weight gain factor through (temporary) acquired insulin resistance in both humans and the extreme example of hibernating bears. Modern humans are fattening on the glucose-fructose combination year around leading to chronic hyperinsulinemia and subsequent associated diseases; particularly diabetes and cancers. It is what it is. The modern industrial diet is carcinogenic and atherogenic. Plain as day. Get off the liquid sugar. Lewis Cantley did in 1975, That's why he looks as healthy as he does in his seventies.

[@richarddunterman2743]

I really appreciate this discussion Peter. Learning so much.

[@iamdedlok]

amazing talk! Thanks Peter and Lew !

[@luciususiholo6956]

Wonder when he's gonna have Lew back on

[@fredjones2116]

Peter: you repeatedly ........ interrupt Lewis; ................ hold back; bite on your shirt sleeve; choke on it;practice silence; let the person you are interviewing, have time to talk......... Lewis is quiet; repeatedly praising him doesn't make up for interrupting him ........

[@74stickers10]

Not only with Lewis.

[@dcingym3]

Peter, does Juicing cause the same problem? Many people do juicing to squeeze the liquid out of fruits/ vegetables that may contain fructoce. Can you please comment on that?

[@Vicky-Blue]

How do you find the clinical trial? I can’t find it on clinicaltrials.gov

[@miriamgorre1867]

What do you think of Letrozole as a cancer treatment ?

[@bobbarker5884]

After learning Dr. Seyfrieds theories I feel like Cantleys approach is taking the long way with probably less result. Maybe just me, but I am surprised Dr. Attia isn't more impressed with Dr. Seyfried and his work. Less sexy right?

[@joesuboleski7033]

Right! There is no money in Dr Seyfried’s approach.

[@katetuhoro4623]

Very interesting to listen to

[@brettjenkins1864]

I am generally a free marketer in all respects. After listening to this I would have no problems with at minimum with some type of very prevalent warning label on anything with added sugar. Similar to tobacco warnings. Might even be convinced for add bans as well. We are growing sugar addicts in this country and the world and it is killing us.

[@netto682]

👏👏👏👏👏

[@netto682]

👍🇧🇷

[@stoianmihail8480]

The volume is either too low or I am getting deaf