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What does the ‘Warburg effect’ have to do with breast cancer?

May 3rd, 2017

We’ve all heard that cancer is a disease of the genes and decades of research has resulted in a whole field of exploration and progress in this area – genetic testing, whole genome sequencing, genomics – all geared toward helping us understand why genes mutate and become cancerous.

NBCF funds many breast cancer research projects focused on genetics because there is high potential for this information to bring us closer to a better understanding of cancer and personalised treatments. Knowing what happens to the genes can indicate which treatments may or may not work and can also help women make choices to prevent breast cancer.

However, the sheer volume of data that results from genome sequencing has reinforced researchers’ concerns that cancer is dauntingly complex. But there is another way to think about cancer.

What is the Warburg effect?

An angle researchers are increasingly exploring may help explain the origins of cancer – how a tumour forms at the very beginning – and could provide insights into how to stop it. This is not a new idea; German scientist called Otto Warburg came up with a hypothesis about this in 1924, but it lost traction after his death in 1970 when the scientific world turned its focus to genetics.

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The so-called ‘Warburg effect’ says that healthy cells require oxygen to turn fuel (such as glucose) into energy to grow, a process called metabolism. However, where the oxygen supply is limited, some cells adapt to the new environment and use a process called fermentation to metabolise the fuel. The cells then start to behave like cancer – they grow uncontrollably, avoid death and are more likely to cause DNA mutations.

The importance of Warburg’s finding nearly 100 years ago lies in its identification of cancer’s origins and growth as a metabolic process – a process that occurs within all living things to maintain life. So, if cancer cells need fuel to grow, the logical solution would be to stop the Warburg effect and halt this kind of metabolism by finding a way to starve the cancer cells.

How does the Warburg effect affect breast cancer?

In addition to funding research in genetics, NBCF has funded breast cancer research that has its foundations in the work done by Warburg last century. These researchers are investigating how to turn cancer cell metabolism on and off and how to starve cancer cells of the fuel they need to live.

Associate Professor Sean McGee from Deakin University has just finalised his investigation into how breast cancer cells alter their metabolism to help them survive and identified a potential treatment strategy that would make breast cancer more susceptible to existing treatments. The results from this short project are likely to pave the way for a larger study.

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NBCF-funded A/Prof Jeff Holst’s breast cancer research has its foundations in the Warburg effect.

Associate Professor Jeff Holst his team at the Centenary Institute have shown they can stop breast cancer cells from growing by blocking the proteins that pump this key nutrient into the tumour cells.

“Unlike normal cells, many cancer cells rely on glutamine instead of glucose for the energy they need to divide and grow. We have discovered a way to stop tumours from growing by starving them of this essential nutrient,” says Associate Professor Holst.

So, is cancer a genetic or metabolic disease?

What researchers know is that breast cancer is a complex disease and there are still many more questions than answers. Tackling the problem from both genetic and metabolic perspectives both unquestionably have merit and will ultimately lead to better prevention, treatment and care for those affected by breast cancer.