You may have heard that "sugar feeds cancer cells", fueling their rapid growth. Or that stopping sugar from our diets can deplete or stimulate cancer growth.
The question here is is there any truth in these claims?
The oft-repeated claim that sugar feeds cancer cells is true, but in a very strict sense - and yes, that may seem scary, but of course it's not the whole truth.
In reality, cells need food and take it in the form of energy, which is supplied by sugar. Thus, along with normally functioning cells, most of the sugar entering the body is absorbed by cancer cells.
The simplest forms of sugar are single-molecule sugars, such as glucose and fructose. These can combine to form more complex sugars such as table sugar (sucrose).
All carbohydrates are also sugars, which means that foods you wouldn't consider sweet - like potatoes, pasta and cereals - eventually break down to simple sugars in the body.
This is the kernel of truth underlying the concern about the sugar-cancer link - yes, sugar feeds cancer cells, and our bodies cannot dictate which cells to send energy to and which not to.
What happens if we eliminate sugar intake altogether?
"Stopping the sugar from reaching the cancer cells would mean that your body's healthy cells would also have an energy shortage and "craving" for the necessary sugar"says Cancer Council Australia's Executive Director, Professor Sanjay Aranda.
"I think it would make you lose weight and make your immune system less effective and more likely for the cancer to progress.
What's more, our bodies are smart - they have other ways of getting glucose. Even if you try to stop sugar, the body will simply convert fat and protein stores into glucose."
How do cancer cells grow?
While sugar fuels cancer, the real picture of how cancer cells grow is "much more complex", says University of New South Wales biologist Dr Darren Saunders.
He says there is strong evidence that some cancer cells also feed on amino acids (building blocks of proteins) or lipids (substances including fats and oils).
These sources are used as metabolic fuel to power the necessary processes in the cell and as raw material to build new cells, in the same way sugar can be used. But they also have a secondary purpose - to help cancer cells protect themselves from chemical damage. It's a complex picture - different types of cancer cells use different fuel sources at different times. This affects the direction of diagnosis and treatment, says Dr Saunders.
"We're looking more and more for differences in individual cancers between patients instead of trying to treat them all the same and treat them all the same."
Eating too much sugar is still bad, right?
Eating too much sugar can lead to a whole host of health problems, including a greater risk of developing malignancies.
Just as fat can be converted to sugar when needed, the opposite can also happen - sugar is stored as fat when the body doesn't make it.
"We estimated that just over 3 per cent of the total number of cancers diagnosed in Australia are obesity or overweight related", she says.
While limiting sugar intake does not deplete cancer cells, it may help reduce the risk of developing some types, says Professor Aranda.
"In fact, sugar is not the evil, but the volume in which it is eaten and the link to obesity."
Dr Saunders agrees with the statement and confirms:
"Eating too much sugar is a suggestive factor for harmful excess weight, but we can't go to the other extreme based on that and say - Stop eating sugar to starve the tumor!", he says.
"It really comes down to an individual basis. It's impossible to make a statement that applies to everyone at the same time."
What is the way forward?
Eliminating sugar from your diet won't help because you'll be depriving other cells of a valuable source of energy.
But what if cancer cells could selectively starve themselves of glucose? This is a growing research focus for oncologists worldwide.
In 2015, research published in the journal Nature Communications found an overproduction of a particular protein, PARP14. It allows cancer cells to accelerate their growth by consuming glucose. Reducing the levels of this protein in cells starves and kills them.
"There are a few different ways to approach it, but they're all usually based on either blocking the ways that cells can access the fuel, or the ways that they can use the fuel and turn it into other things that they need to grow." says Dr Saunders.
And he stresses that it's not as simple as just turning off the sugar supply to the cancer cells.
"There are some cancer cells you can kill by blocking their sugar supply, others you can kill by blocking their lipid supply, and still others by blocking their amino acid supply.
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