Sugar, Sugar

As fictious rock bands go, The Archies did all right for themselves (my apologies if I shattered any cherished illusions in my fellow Boomers/Busters). In 1969, the band claimed the top spot on the Billboard Hot 100 year-end chart with its mega-hit “Sugar, Sugar,” beating out “Aquarius/Let the Sunshine In” by the real-life Fifth Dimension. Ah, such memories!

This band may have spun sugar into gold, but to many people thinking about cancer sugar is neither sweet nor precious. In office conversations with persons dealing with a cancer diagnosis and their family members and friends, we frequently discuss nutrition. Often I hear questions about the place of table sugar, either by itself or as an ingredient in numerous tasty but not always “good for you” foods such as pastries and candy. Many people believe that eating sugar increases the risk of developing cancer or can accelerate the growth of cancer cells. Sugar “feeds” cancer, or so this belief maintains. Consequently, someone with cancer should avoid ingesting any sugar.

Does eating simple sugar (as opposed to complex carbohydrates such as starch) cause cancer or worsen the prospects for someone who has cancer and is under treatment for it? The unvarnished answer is: No.

What is the origin of this idea, then? Why is sugar so often cast in the role of nutritional villain?

Table sugar is sucrose, a compound of glucose and fructose. Glucose, with oxygen, is the source of energy that fuels all cellular metabolism. If we don’t get glucose, our cells make it out of other compounds, including fats and proteins. Our bodies cannot use fructose without modification; about half of it is converted to glucose and the remainder turned into lactic acid (the stuff that makes your muscles feel tired when you exercise strenuously). So, one way or another, human cells will get their sugar (glucose) fix. Human cancer cells function the same way, except that they often operate at a higher metabolic rate, meaning they chew up glucose and oxygen faster than most normal cells, cardiac muscle and neurons being exceptions. This property of cancer cells is known as the Warburg Effect. Otto Warburg was a German chemist who studied cancer and cellular metabolism in the first half of the 20th century. Positron emission tomography (PET) scans take advantage of the Warburg Effect to help identify areas of abnormally high metabolism as a clue to the location of cancer cells.

So, cancer cells, like all of our cells, have a sweet tooth. But this seems to play no role in their becoming cancerous in the first place, nor does sugar make the cancer cells any more active or dangerous than they already are. The sugar is there for the taking. Even if someone with cancer avoids eating sugar in any form, her body will simply make it from what is ingested. To date, no scientific study has shown a link between sugar ingestion and higher incidence of cancer or worse outcomes in existing cancer. However, an association definitely exists between obesity and increased risk of cancer. Overall excessive consumption of calories, including sugar sources, will bring on obesity. We want to avoid obesity with all its attendant adverse effects on health, cancer included.

So, if you are dealing with cancer, you can still enjoy that favorite candy bar or cream-filled doughnut, and you can top a generous slice of your favorite pie with a dollop of ice cream. Just exercise restraint and moderation. And make sure you’re eating as nutritiously as possible. The CHMC oncology service provides consultation with clinical nutritionists who are eager to help you make the most of your eating habits. Then, right along with The Archies, you can be “Feelin’ So Good.”