Peter Attia· MD
So this would suggest three distinct but not necessarily mutually exclusive explanations for the Warburg effect. The first being what Warburg proposed, which is in cancer, there is an injury to the mitochondria. As a result of that injury, the cancer... produces, it takes an inefficient path to go. Then there's the 2009 explanation proposed by Thompson, Cantley, Vander Heiden in that science paper that was sort of a very important landmark paper that said, no, no, that's probably not it. It's the glycolysis and the lactate production is a byproduct of metabolic demand for building blocks. It's the cellular nucleotides that are necessary to build the cells. So the mitochondria work okay. What you're seeing is a deliberate and obligate choice to grow and the need to grow literally from a mass balance perspective requires taking this pathway versus that pathway. And now you're saying, well, a possible third explanation is the cancer relies on lactate as a signaling molecule. And again, These could all be true on some level.