The Genius Otto Warburg on Cancer

Dr. Otto Warburg : Nobel Laureate

Otto Heinrich Warburg (October 8, 1883, Freiburg im Breisgau – August 1, 1970, Berlin), son of physicist Emil Warburg, was a German physiologist, medical doctor and Nobel laureate. Warburg was one of the twentieth century’s leading cell biologists

In 1918 Warburg was appointed Professor at the Kaiser Wilhelm Institute for Biology in Berlin-Dahlem (part of the Kaiser-Wilhelm-Gesellschaft). By 1931 he was named Director of the Kaiser Wilhelm Institute for Cell Physiology there, which founded the previous year by a donation of the Rockefeller Foundation to the Kaiser Wilhelm Gesellschaft (since renamed the Max Planck Society).

Warburg investigated the metabolism of tumors and the respiration of cells, particularly cancer cells, and in 1931 was awarded the Nobel Prize in Physiology or Medicine for his “discovery of the nature and mode of action of the respiratory enzyme.”

In 1944, Warburg was nominated again for the Nobel Prize in Physiology or Medicine by Albert Szent-Györgyi, for his work on nicotinic acid amide and the discovery of flavine (in yellow enzymes).^] It is rumored and reported by some sources that he was selected for a second Nobel Prize in Physiology or Medicine in 1944 but was not allowed to accept the Prize due to the policies of the German government of the time. According to the Nobel Foundation, this rumor is not true; although he was considered a worthy candidate, he was not selected for the prize

Awarded the Nobel Prize for Physiology or Medicine in 1931 for his research on cellular respiration, explains: “The growth of cancer cells is initiated by a relative lack of oxygen. Cancer cannot live in an oxygen-rich environment…

Cancer has only one prime cause. It is the replacement of normal oxygen respiration of the body’s cells by an anaerobic (i.e., oxygen deficient) cell respiration.” Going into greater detail in The Prime Cause and Prevention of Cancer, he writes: “…the cause of cancer is no longer a mystery, we know it occurs whenever any cell is denied 60% of its oxygen requirements. Cancer, above all other diseases, has countless secondary causes. But, even for cancer, there is only one prime cause.

Summarized in a few words, the prime cause of cancer is the replacement of the respiration of oxygen in normal body cells by a fermentation of sugar. All normal body cells meet their energy needs by respiration of oxygen, whereas cancer cells meet their energy needs in great part by fermentation. All normal body cells are thus obligate aerobes, whereas all cancer cells are partial anaerobes.”

Warburg hypothesis

In 1924, Warburg hypothesized that cancer, malignant growth, and tumor growth are caused by the fact that tumor cells mainly generate energy (as e.g. adenosine triphosphate / ATP) by non-oxidative breakdown of glucose (a process called glycolysis). This is in contrast to “healthy” cells which mainly generate energy from oxidative breakdown of pyruvate. Pyruvate is an end-product of glycolysis, and is oxidized within the mitochondria. Hence and according to Warburg, cancer should be interpreted as a mitochondrial dysfunction.

“Cancer, above all other diseases, has countless secondary causes. But, even for cancer, there is only one prime cause. Summarized in a few words, the prime cause of cancer is the replacement of the respiration of oxygen in normal body cells by a fermentation of sugar.” — Dr. Otto H. Warburg in Lecture

Warburg continued to develop the hypothesis experimentally, and held several prominent lectures outlining the theory and the data.

The concept that cancer cells switch to glycolysis has become widely accepted, even if it is not seen as the cause of cancer. Some suggest that the Warburg phenomenon could be used to develop anticancer drugs.Meanwhile, cancer cell glycolysis is the basis of positron emission tomography (18-FDG PET), a medical imaging technology that relies on this phenomenon.

Otto Warburg edited and has much of his original work published in The Metabolism of Tumours (tr. 1931) and wrote New Methods of Cell Physiology (1962). An unabashed Anglophile, Otto Warburg was thrilled when Oxford University awarded him an honorary doctorate. Otto Warburg was awarded the Order Pour le Mérite in 1952. Warburg was known to tell other universities not to bother with honorary doctorates, and to ask officials to mail him medals he had been awarded so as to avoid a ceremony that would separate him from his beloved laboratory.

Warburg also wrote about oxygen’s relationship to the pH of cancer cells internal environment. Since fermentation was a major metabolic pathway of cancer cells, Warburg reported that cancer cells maintain a lower pH, as low as 6.0, due to lactic acid production and elevated CO₂. He firmly believed that there was a direct relationship between pH and oxygen. Higher pH means higher concentration of oxygen molecules while lower pH means lower concentrations of oxygen.

When frustrated by the lack of acceptance of his ideas, Warburg was known to quote an aphorism he attributed to Max Planck that:

Science doesn’t progress because scientists change their minds, but rather because scientists attached to erroneous views die, and are replaced.

When Dr. Josef Issels, an intrepid doctor who became famous for his use of non-mainstream therapies to treat cancer, was arrested and later found guilty of malpractice in what Issels alleged was a highly politicized case, Warburg offered to testify on Issels’ behalf at his appeal to the German Supreme Court. All of Issels’ convictions were overturned.

About the Issels treatment

Issels believed that cancer was caused by the weakening of the human immune system and hence had to be cured by strengthening it again.

He wrote a number of books, including a biography “My fight against Cancer,” about his understanding of cancer, as well as sundry scientific articles.

Issels died of pneumonia at the age of 90. His obituary in the Journal of Complementary and Alternative Medicine described him as the “Father of Integrative Medicine”