Fri, May-20-11, 09:13
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Positron Emission Tomography and the Warburg Effect
Definitely follow the link at the bottom of the article to see the gif animation of the PET scan of a person with several tumors. My bolding in the article.
Quote:
Medical Physics, especially Medical Imaging, is such an exciting area to be working in these days, and the above movie illustrates this very well. It is a Maximum Intensity Projection view of Positron Emission Tomography (PET) scans of a person with several tumours. Thanks to Jens Langner (http://www.jens-langner.de/) for this gif animation.
To do a PET scan, a drug or substance is 'labelled' with a radioactive tracer and this is introduced into the body. According to the type of drug or substance, it will concentrate in a particular area of the body and the gamma rays given off by the radioactive tracer can then be imaged using a special camera.
The most commonly used radiotracer in clinical PET scanning is fludeooxyglucose, an analogue of glucose that is labelled with fluorine-18, which is radioactive. This labelled glucose accumulates in tissues with high glucose uptake, such as the brain, the liver, and most cancers.
Glucose is a simple sugar called a monosaccharide. This is what all starchy foods are broken down into in the body. When people talk about 'blood sugar', they are talking about glucose.
When we eat starchy foods such as bread, pasta, potatoes, bananas, rice, cereals and many other foods, this all gets converted to glucose and this floods into our bloodstream. All digestible carbohydrates are sugars.
So, PET scans are used to diagnose cancers, because most cancers use a lot more glucose (sugar) than most normal body cells. This is referred to as the 'Warburg Effect'. This is why tumours stand out so much in a PET scan.
So, what is the 'Warburg Effect'?
Otto Warburg won the Nobel prize in Physiology or Medicine in 1931 for his work on the metabolism and respiration of cancer cells. The Warburg effect describes the enhanced conversion of glucose to lactate by tumour cells, even in the presence of adequate oxygen that would ordinarily be used for oxidative phosphorylation. Simply put, cancer cells are gluttons for sugar. Some people may have disagreed with this idea in the past, but when you see the tumours showing up so obviously in a PET scan, it is hard to say that the Warburg effect doesn't exist.
Now, I have known for several years about the Warburg Effect and to me it seems a very fundamental and important difference between normal cells and cancer cells that should be exploited.
So, I was shocked when I searched through every medical textbook on cancer in the university bookshop. I looked through the index of each book, and only one of the several dozens that I inspected had any mention of Otto Warburg!
The one book I could find that does mention it ('Molecular Biology of Cancer' by Lauren Pecorino) only has a few sentences. She says:
'Some tumour cells seem to be addicted to increased glucose uptake...'
'The observation that cancer cells carry out aerobic glycolysis converting glucose to lactate in the presence of oxygen, was made in the 1920s and is called the Warburg effect.'
'...it is of interest that the Warburg effect is the basis for an important imaging technique used to detect tumours in the clinic. PET scans work on the basis that tumour cells exhibit a greater uptake of glucose than normal cells.'
Another book that mentions Warburg is 'Cancer:Between Glycolysis and Physical Restraint') by Laurent Schwartz.
The author notes that many cancer cells respire by glycolysis and says the following:
'...there is no glycolysis without glucose. Over a few dozen years, articles were published correlating the effect of glucose depletion and tumour inhibition. Sugar depletion has little effect on normal cells (they can use other nutrients), but it produces reproductive inhibition in even the most aggressive tumor cells.'
That's all great... but now here's where I start banging my head against the wall:
'Depriving the cancer patient of glucose has little chance of curing him. The liver is rich in glycogen and in case of depletion in glucose, the liver degrades its stores of glycogen and pours it into the blood.'
Of course, the liver doesn't have an infinite supply of glycogen. According to 'Human Nutrition' edited by Geissler and Powers, the liver stores about 50 - 120g of glycogen and the muscles store another 350 - 400g.
Glucose is stored as glycogen in the body. When carbohydrates are eaten and broken down into glucose (plus other sugars such as fructose), a small amount of this glucose is stored as glycogen in the liver and muscles, and any that isn't used for energy is stored as the saturated fat, palmitic acid.
If you don't eat carbohydrates, there is no glucose to convert to glycogen and any glycogen in the liver will be used up and won't be replaced. The liver isn't an infinite supply of glycogen. Surely the only way to keep the liver supplying sugar (glucose) from glycogen is to keep filling the body with the foods that supply glucose in the first place ie starches such as pasta, bread, cereals and rice.
I shall write more on glycolysis later. Meanwhile, seeing PET images of tumours glowing with glucose is a good way to keep me away from the doughnuts (and pasta).
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http://medphyzz.blogspot.com/2011/0...graphy-and.html
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