In Transformer: The Deep Chemistry of Life and Death, Nick Lane explores the complex role of metabolism in cancer development. On page 194, he discusses how different mutations are found in separate regions of the same tumor, indicating that no single mutation is responsible for starting the cancer. This suggests that cancer evolves over time through a variety of genetic changes rather than a single, traceable cause.

Lane references Otto Warburg's theory, which argues that cancer cells shift their energy production to favor glycolysis even in the presence of oxygen—a process known as the Warburg effect. This metabolic shift may be a driving factor behind cancer growth, not just a result of genetic mutations. The focus on altered metabolism challenges the view that cancer is purely a genetic disease, opening new possibilities for therapeutic approaches targeting cellular energy pathways.