5. Gluconeogenesis

This is a metabolic process where proteins, fats and lactic acid are converted into glucose. See Figure 3  It takes place during the period of fasting or starvation.

However, cancer initiated gluconeogenesis is a highly damaging event and is responsible for many of the cachectic symptoms seen in cancer patients.

In cachexia, muscles and blood serum are broken down to form amino acids. Stored fats and blood lipids are converted into glycerol The amino acids and glycerol thus formed and with the lactic acid produced in anaerobic glycolysis are converted into glucose in the liver and kidney. This process is known as “Gluconeogenesis”. More than 250gm. of glucose may he produced within 24 hours by this process.

Figure 3 shows cancer-induced gluconeogenesis

The glucose is used by the cancer cells as a fuel of growth and multiplication. Cancer cells consume glucose at a rate which is 5 times higher than normal cells.

Any excess is passed out in the urine.

As in Type 1 insulin dependent diabetes, a patient if not treated may lose as much as 10-20% of body weight within a month. This is a frightful condition. The loss of proteins contributes to the weakness and anemia as often seen in cancer patients.