Is Autophagy Good Or Bad For Cancer Treatment?

It really depends on which side you’re on, to be honest.

From my observations of the content that is being published in the Medium Coronavirus Blog, a lot of the medical research professionals are looking at the repurposing of current drugs to halt the replication of the COVID-19 coronavirus if one gets an infection from it.

The focus is on finding a drug that can work across the board. However, current tested drugs such as hydroxychloroquine and remdesivir provide a mixed bag of results — they seem to work for some individuals, but not others. My analysis of the situation in Why is There a Mad Dash to Manufacture Effective Drugs to Combat the COVID-19 Coronavirus? outlines the sequential process by which virus-infected cells are eliminated by the body. Autophagy is a key component of the elimination process, and yet… the medical research papers and the Medium Coronavirus Blog writers don’t even give it a lick of an afterthought. You don’t see it even being mentioned anywhere.

But what exactly is autophagy, and why is it important to know what it does?

According to Dr Priya Khorana, PhD, in nutrition education from Columbia University,

Autophagy is the body’s way of cleaning out damaged cells, in order to regenerate newer, healthier cells.

“Auto” means self and “phagy” means eat. So the literal meaning of autophagy is “self-eating.”

When a cell has outlived its usefulness, it gets tagged by the p62 protein and is marked for elimination, much like how a defective product at a supermarket is tagged for disposal, or marked down at a discounted price (for the customer to dispose of it).

With this p62 protein tag on the cell, the immune system’s phagocytes (hence the “phagy” term) are signalled to digest the tagged cell and decompose its deoxyribonucleic acid (DNA) strands back down to its constituent nucleic acids, all for the purpose of reusing these nucleic acids to synthesise new DNA strands for cell reproduction.

Autophagy is closely related to phagocytosis, which also deals with the digestion of dead cells. In the case of virus infections, immune cells and antibodies tag the infected cells, which are then programmed to commit suicide via apoptosis.

Phagocytes are called upon to digest these dead infected cells to get the nucleic acids (both from the cell DNA and the virus RNA/DNA strands), again for the purpose of synthesising new DNA strands for cell reproduction.

There’s a caveat, though. When the speed of phagocytosis is reduced, the apoptotic cells tend to release pro-inflammatory biochemical products, much like how a dead body that is left on the streets will decompose and give off noxious odours if it is left uncleared on the streets.

Therefore, the speed and efficiency of the phagocytosis process is key in an immune system’s response towards viral infections. But this speed is not a quantifiable process, and one can appear “healthy” on the surface even when their internal phagocytosis process is not well or properly regulated. No doctor will attempt to quantify the efficiency of an autophagy/phagocytosis process in a human body and use it as a benchmark to determine how healthy that person is.

Houston, we have a problem…

But therein lies the problem. Everyone does make use of autophagy/phagocytosis to eliminate dead or defective cells. Autophagy is what keeps the cell populations of a healthy human adult at equilibrium — we want to have a healthy liver, for instance. But if our liver cells reproduce at a faster rate than the old liver cells are being killed off via autophagy, then what happens? Would the size and the weight of our liver not be constantly increasing? We don’t want that to happen, we want the weight of our livers to be kept approximately constant. Ditto for our bones, our brain, our heart and all the other organs in our body. We want them regulated.

So we can say that autophagy regulates the cell populations in our body. Very good. What happens, then, when autophagy becomes problematic? If the population of a certain cell type is allowed to grow unimpeded, then we would be looking at odd growths around the body.

Would we not see them in the development of odd cancer tumours around the body?

Some growths are benign — they do not cause ill effects. They can just be removed via surgery. Other growths are malignant and can be very bad for the body indeed.

Hence, the idea is to ensure that our autophagy process (and therefore our immune system) is working like a well-oiled machine constantly. But it’s not an easy thing to achieve in this modern lifestyle, as I do highlight in Four Ways That Our Lifestyle Affects Our Immune System. How many people can say that they’re getting:

1. Quality sleep with the optimal number of hours each night?
2. Optimal quality nutrition?
3. Proper stress management?
4. Adequate exercise at the right intensity and frequency?

Every unchecked or suboptimal factor will lead to the immune system function behaving suboptimally in the long run.

As a result, our defensive systems suffer…

We are constantly bombarded with a ton of things that can potentially threaten the functioning of our immune system. Whether we are consuming pesticides in our food or water supply, or being exposed to excessive ultraviolet rays, or sleeping insufficient hours because of all the stress that we are facing from work… the threats are there.

Finally, one day, we may end up with some of these symptoms that the immune system has gone wrong, as I have written in my other Medium articles:

1. Osteoporosis (Why Does Osteoporosis Affect Post-Menopausal Women More Significantly Than Other People?)
2. Osteoarthritis (What The Deuce Is Different Between Osteoarthritis and Rheumatoid Arthritis?)
3. Type 2 diabetes (Type 2 Diabetes — A Case of The Immune System Gone Bad, Too?)
4. Heart disease (Now Seriously, What’s So Tricky About Cholesterol?)
5. Neurodegenerative disease (Brain Degeneration Ain’t All That It’s Cracked Up To Be).
6. Allergic reactions (The Anatomy of An Allergic Reaction).

And every symptom that is being manifested would provide an indication of how messed up the immune system is at that point in time, which then also provides an indication as to how much more risk a person is at of permitting a cancer tumour to grow in their bodies.

However, as I have mentioned in On The Concept of Genetics, And What It Entails In Our Lives, some people may be born with inherent defects in their DNA as a result of faulty transmissions from their parent sperm/egg cells, which may also increase their susceptibility to developing cancer tumours at a younger age, as we can see in the cases of children being born with leukaemia (a blood cancer problem), for instance.

Nonetheless, if we were born “healthy”, the lifestyle that we adopt as children, teenagers, young adults and working adults will play a more significant role in our body’s response to cancer. Or even coronavirus infections.

And when one has cancer, it ain’t that great…

So now, assuming that one has gotten to the stage where one has cancer derived from a suboptimal immune system being unable to perform autophagy efficiently enough, they may read up on autophagy and find out that their autophagy mechanisms are compromised, then proceed to attempt to improve their autophagy processes with various non-FDA approved treatments such as intermittent fasting, resveratrol, antioxidants or whatever.

(Note: These treatments are not approved by the FDA because they themselves show mixed results. They are not necessarily good or bad — they just may or may not be useful in helping one’s condition improve.)

The problem with supporting autophagy at this point, though, is that…

Cancer cells are biological organisms, much like the other 38 trillion cells in our body. Normal functioning cells undergo autophagy for the renewal of the organ or the system that they are a part of. For example, the red blood cells that help to transport oxygen in our blood have an average lifespan of 115 days, and get killed off after that while being replaced by new red blood cells.

Isolated cancer cells can get killed off by autophagy without reproducing new cells. With all the bombardment from ultraviolet rays and free radicals and the toxins that we consume, we are forcing new DNA mutations among those 38 trillion cells, and it is necessary to get them all killed off via autophagy before they accumulate into a tumour mass.

The cancer cells that have accumulated into a tumour mass have essentially formed their own malignant “organ” within the body. The autophagy of any of the cancer cells in this “organ” would allow for the reproduction of newer and healthier cancer cells, which promotes the survivability of the cancer tumour.

So while autophagy may kill off isolated mutated cells, they may actually strengthen the survivability of a cancerous tumour, as is outlined in this research article.

Moral of the story: when one has cancer tumours in their body, please consult a doctor and not attempt to self-medicate with non-FDA approved treatments. Especially if they don’t know what is going on within their body. Hopefully this helps to shed some light on cancer!

What does it mean when a cancer patient is in remission, then?

So let’s say now that one undergoes chemo/radio/whatever therapy to kill off the cancer cells in their body. There are many different approved analytical tests out there to quantify how many cancer cells one has left in their body. A cancer patient is in remission when the test shows that there are no detectable cancer cells left, meaning that the cancer cell count is too low to be quantified.

While one may rejoice and think that they are free of cancer, that isn’t exactly what the test indicates. The cancer cell count may be lower than the detectable limits of the test, but the cancer cells can still multiply back over a period of time.

Therefore, it isn’t surprising to see cancer patients who are in remission, where the therapies have helped to eliminate the most part of those cancer cells. However, if their autophagy process has not improved and still can’t kill off those cancer cells, then it is very possible that these cancer cells will grow back over time and make a comeback, forcing a relapse of that patient back into a state of cancer.

What we want to achieve is something similar to a genocide. We want to extinguish 100% of those cancer cells in the same way as Adolf Hitler sought racial “purification” and superiority. But as the same way that his Nazi forces were unable to establish a 100% extinction rate of the Jews, most cancer therapies will likewise be unable to establish a 100% extinction rate of the cancer cells in our body. They will always be there — but their populations have to be regulated extremely well. (Note: I do not mean that the Jewish population ought to be regulated, for anyone who chooses to take this analogy out of context – it was included solely to show the aims of a chemo/radio/whatever therapy treatment and I do not condone genocides in any way, ever.)

Credits to Shin Jie Yong for the idea behind this article.

Joel Yong, PhD, is a biochemical engineer/scientist, an educator and a writer. He has authored 3 ebooks (available on Amazon.com in Kindle format) and co-authored 6 journal articles in internationally peer-reviewed scientific journals. His main focus is on finding out the fundamentals of biochemical mechanisms in the body that the doctors don’t educate the lay people about, and will then proceed to deconstruct them for your understanding — as an educator should.

Do feel free to subscribe to my mailing list for more exclusive content!