Cancer is characterized by aberrant metabolism, which significantly impacts drug resistance, cancer stem cells, metastasis, and tumorigenesis. Abnormal metabolic pathways disrupt cellular signal transduction, providing energy, building blocks, and redox capabilities for uncontrolled cancer cell proliferation. Research explores the impact of dietary modifications and minute substances on metabolic enzymes. Genetic abnormalities and tumor microenvironment signals contribute to metabolic diversity in malignancies. Contemporary cancer therapies aim to overcome metabolic plasticity. This review discusses the relationships between biochemical pathways and recent research on cancer metabolism, highlighting new drug classes targeting cancer metabolism. It also presents progress in nanomedicine and nano-bio interactions for disease detection. The Warburg effect, where cancer cells prefer glycolysis over oxidative phosphorylation, is a key metabolic feature. Recent studies suggest cancer cells may still use oxidative phosphorylation. Oncogenic signaling pathways like Hippo, Myc, and PI3K/AKT regulate metabolic genes and enzymes. The LKB1/AMPK pathway senses energy stress, activating stress tolerance in cancer cells. The PI3K-AKT/mTOR pathway controls cell growth and metabolism, with mutations in PI3K and PTEN contributing to cancer. The p53 pathway regulates metabolism, cell cycle, and apoptosis, while the Hippo pathway controls cell proliferation and metabolism. YAP/TAZ activity enhances glycolysis and promotes cancer progression. Nanoparticles for drug delivery exploit the EPR effect, accumulating in tumors. Particle size, charge, and hydrophobicity influence circulation and targeting. Stimuli-responsive nanomedicines release drugs in response to pH, redox, or temperature changes. Nanomedicine improves drug delivery, targeting, and treatment outcomes. Applications in surgery, chemotherapy, immunotherapy, radiotherapy, and photothermal/photodynamic therapy show promise. Nanomedicine also enhances imaging and diagnosis through multifunctional nanoparticles. Gene therapy introduces therapeutic genes to target cancer cells, using siRNA, shRNA, and miRNA to silence oncogenes and tumor suppressors. Non-viral vectors like liposomes and nanoparticles offer safer alternatives to viral vectors. Challenges include biological barriers, toxicity, and synthesis difficulties. Future perspectives involve overcoming these barriers through vascular normalization, active transport, and improved nanocarrier design. Nanomedicine holds great potential for targeted, less toxic cancer therapies but requires further research to address safety, efficacy, and clinical translation.Cancer is characterized by aberrant metabolism, which significantly impacts drug resistance, cancer stem cells, metastasis, and tumorigenesis. Abnormal metabolic pathways disrupt cellular signal transduction, providing energy, building blocks, and redox capabilities for uncontrolled cancer cell proliferation. Research explores the impact of dietary modifications and minute substances on metabolic enzymes. Genetic abnormalities and tumor microenvironment signals contribute to metabolic diversity in malignancies. Contemporary cancer therapies aim to overcome metabolic plasticity. This review discusses the relationships between biochemical pathways and recent research on cancer metabolism, highlighting new drug classes targeting cancer metabolism. It also presents progress in nanomedicine and nano-bio interactions for disease detection. The Warburg effect, where cancer cells prefer glycolysis over oxidative phosphorylation, is a key metabolic feature. Recent studies suggest cancer cells may still use oxidative phosphorylation. Oncogenic signaling pathways like Hippo, Myc, and PI3K/AKT regulate metabolic genes and enzymes. The LKB1/AMPK pathway senses energy stress, activating stress tolerance in cancer cells. The PI3K-AKT/mTOR pathway controls cell growth and metabolism, with mutations in PI3K and PTEN contributing to cancer. The p53 pathway regulates metabolism, cell cycle, and apoptosis, while the Hippo pathway controls cell proliferation and metabolism. YAP/TAZ activity enhances glycolysis and promotes cancer progression. Nanoparticles for drug delivery exploit the EPR effect, accumulating in tumors. Particle size, charge, and hydrophobicity influence circulation and targeting. Stimuli-responsive nanomedicines release drugs in response to pH, redox, or temperature changes. Nanomedicine improves drug delivery, targeting, and treatment outcomes. Applications in surgery, chemotherapy, immunotherapy, radiotherapy, and photothermal/photodynamic therapy show promise. Nanomedicine also enhances imaging and diagnosis through multifunctional nanoparticles. Gene therapy introduces therapeutic genes to target cancer cells, using siRNA, shRNA, and miRNA to silence oncogenes and tumor suppressors. Non-viral vectors like liposomes and nanoparticles offer safer alternatives to viral vectors. Challenges include biological barriers, toxicity, and synthesis difficulties. Future perspectives involve overcoming these barriers through vascular normalization, active transport, and improved nanocarrier design. Nanomedicine holds great potential for targeted, less toxic cancer therapies but requires further research to address safety, efficacy, and clinical translation.