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Cancer cells survive in low-energy mode

It seems strange, say researchers, but new evidence from Johns Hopkins shows that cancer cells seem to gain momentum when they switch to a low-energy oxygen mode.

"There must be a strong advantage to cancer cells to stop using a highly efficient process in favor of one that generates much less energy," according to researcher Gregg Semenza whose findings appear
in the May 8 issue of Cancer Cell.

Usually, cancer cells are powered by mitochondria and they use oxygen to create energy. But researchers found when studying Von Hippel-Lindau syndrome (VHL), a genetic disorder causing tumors throughout the body, that VHL switches on a gene that makes cells favor glucose and not oxygen.

A cancer cell's appetite for glucose is very strong and so researchers, scientists at the National Cancer Institute, and pharmaceutical experts are further exploring this phenomenon so it can be useful in cancer therapy.

Uncertain future for drug used to shrink tumors

Canadian researcher Evangelos Michelakis, associate professor of medicine at the University of Alberta in Edmonton, has stumbled upon something quite remarkable -- a potentially new anti-cancer agent called dichloroacetate, or DCA.

DCA is nothing new -- it's long been used for treatment of rare metabolic disorders -- but using it to fight cancer puts an entirely new spin on the potential of this drug.

"This is one of the most exciting results I've ever had," Michelakis said. "But I can't be overenthusiastic until it works on a human."

Michelakis and his colleagues have successfully used DCA to shrink human lung, breast, and brain tumors in both lab rats and test tubes. And while this type of research may not ordinarily generate a lot of excitement, this specific study is creating a buzz because DCA has been safely used in humans for decades, without adverse side effects.

"One of the big concerns about drugs is that they can harm people but we already know this drug is safe," Michelakis says. "It doesn't even affect normal cells."

One of the fundamental premises of cancer biology is that mitochondria -- the energy producing units of cells -- are permanently damaged by cancer. What DCA does is revive the mitochondrial function, encouraging the death of cancer cells.

The overwhelming hope is that DCA will move right to human testing. But the overwhelming fear is that it will not -- because of economic reasons. There is no longer a patent on DCA so it is not owned by any one company. With little chance of one group making a large profit, there may be no incentive for pharmaceutical companies to invest in research.

Sadly, this drug -- that appears to work remarkably well -- may never benefit cancer patients. All because no one stands to make billions of dollars from it.

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