Metabolic Oncology: From Theory To Clinical Application | Dr. Tomás Duraj | The Metabolic Link Ep. 84

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Dec 30, 2025

Dr. Tomás Duraj, a physician-scientist at Boston College, specializes in cancer metabolism, focusing on glioblastoma treatment. He challenges conventional mutation-focused therapies, arguing for the potential of ketogenic metabolic therapy to exploit cancer's metabolic vulnerabilities. Dr. Duraj introduces the Glucose-Ketone Index as a key biomarker and advocates for protecting healthy cells during treatment. He suggests small pilot studies for better insights, offering a promising view of the future of metabolic oncology.

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INSIGHT

Long-Term Survival Is The Real Problem

Long-term survival in many cancers remains extremely low despite modest median survival gains.
Dr. Tomás Duraj urges shifting focus from short median gains to increasing long-term survivors.

INSIGHT

Mutations May Be Effects, Not Always Causes

The somatic mutation theory struggles with infinite heterogeneity and inconsistent causality.
Duraj suggests mutations may be mediators, not sole drivers, of cancer.

INSIGHT

Cancer As an Ancient Metabolic Regression

The mitochondrial metabolic theory frames cancer as an energy-production failure favoring substrate-level phosphorylation.
Duraj links cancer metabolism to ancient prokaryotic fermentative pathways and mitochondrial dysfunction.

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Glioblastoma has a long-term survival rate under 1% at ten years. After decades of research focusing primarily on mutation-targeted therapies, median survival has improved by only a few months. Dr. Tomás Duraj believes there's a better path forward.

Dr. Duraj is a physician-scientist at Boston College working on the metabolic vulnerabilities of cancer. In this Metabolic Health Summit presentation, he outlines a clinical framework for studying ketogenic metabolic therapy — one built on biomarker-driven protocols, not dietary guesswork.

The core argument: cancer cells depend on specific metabolic pathways for survival. Block those pathways while providing alternative fuels to healthy cells, and you create a therapeutic window that most tumors can't escape.

Why cancer cells metabolically resemble organisms from 2 billion years ago
The limits of the somatic mutation theory and why most targeted gene therapies have underdelivered
Substrate level phosphorylation vs. oxidative phosphorylation — and why the distinction matters
The Glucose-Ketone Index as a measurable, actionable biomarker
The press-pulse strategy: sustained metabolic pressure paired with targeted interventions
How to protect healthy tissue before targeting tumor metabolism
Repurposed pharmacological approaches and the need for publicly funded clinical trials
The case for small, non-randomized pilot studies with highly motivated patients

Metabolic therapy represents the future of medicine: a coherent clinical strategy grounded in decades of research and increasingly recognized by physicians and scientists across disciplines. For practitioners seeking complementary approaches that extend the reach of oncological therapeutics, this presentation lays out a practical roadmap for integrating emerging insights with standard care.

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