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What Foods are Recommended for Cancer?
is a very common question. Personalized Nutrition Plans are foods and supplements which are personalized to a cancer indication, genes, any treatments and lifestyle conditions.

Foods for Retinoblastoma!

Jul 28, 2023

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Introduction

Foods for Retinoblastoma should be personalized for each individual and also must adapt when cancer treatment or tumor genetic change. The personalization and adaptation must consider all the active ingredients or bioactives contained in different foods with respect to cancer tissue biology, genetics, treatments, lifestyle conditions and diet preferences. Hence while nutrition is one of the very important decisions for a cancer patient and individual at risk of cancer to make – how to choose foods to eat is not an easy task.

Retinoblastoma is a rare childhood eye cancer that develops in the retina. It is caused by mutations in the retinoblastoma gene (RB1) and can affect one or both eyes. Symptoms of retinoblastoma may include leukocoria (pupil of the eye appearing white), decreased vision, and strabismus (misalignment of the eyes), pain, enlarged or bulging eye, blood in the front chamber of the eye or infection, swelling or inflammation of the eye or surrounding tissue. The identification of the retinoblastoma red reflex during eye examinations is crucial for early detection. Genetics play a significant role in retinoblastoma, as it can be inherited or occur spontaneously. Treatment options for retinoblastoma depend on the extent of the tumor and may include chemotherapy, radiation therapy, cryotherapy, and enucleation (surgical removal of the eye). Strict adherence to treatment guidelines is crucial for optimal outcomes. Prognosis and survival rates vary depending on factors such as the stage of the disease and specific genetic alterations. The management of retinoblastoma requires a multidisciplinary approach involving pediatric oncologists, ophthalmologists, and genetic counselors.



For Retinoblastoma does it matter what vegetables, fruits, nuts, seeds one eats?

A very common nutrition question asked by cancer patients and individuals at-genetic risk of cancer is – for cancers like Retinoblastoma does it matter what foods I eat and which I do not? Or if I follow a plant-based diet is that enough for cancer like Retinoblastoma?

For example does it matter if vegetable Towel Gourd is consumed more compared to American Pokeweed? Does it make any difference if fruit Durian is preferred over Pomegranate? Also if similar choices are made for nuts/seeds like Almond over European Chestnut and for pulses like Lentils over Catjang Pea. And if what I eat matters – then how does one identify foods which are recommended for Retinoblastoma and is it the same answer for everyone with the same diagnosis or genetic risk?

Yes! Foods you eat matters for Retinoblastoma!

Food recommendations may not be the same for everyone and can be different even for the same diagnosis and genetic risk.

All cancers like Retinoblastoma can be characterized by a unique set of biochemical pathways - the signature pathways of Retinoblastoma. Biochemical pathways like DNA Repair, Hypoxia, Cell Cycle, Cell Cycle Checkpoints are part of the signature definition of Retinoblastoma.

All foods (vegetables, fruits, nuts, seeds, pulses, oils etc.) and nutritional supplements are made up of more than one active molecular ingredient or bio-actives in different proportions and quantities. Each active ingredient has a unique mechanism of action – which can be activation or inhibition of different biochemical pathways. Simply stated foods and supplements which are recommended are those which do not cause an increase of molecular drivers of cancer but reduce them. Else those foods should not be recommended. Foods contain multiple active ingredients – hence when evaluating foods and supplements you need to consider the impact of all active ingredients cumulatively rather than individually.

For example Durian contains active ingredients Myricetin, Apigenin, Caffeine, Isoliquiritigenin, Allicin. And Pomegranate contains active ingredients Myricetin, Apigenin, Oleic Acid, Betulinic Acid, Isoliquiritigenin and possibly others.

A common mistake made when deciding and choosing foods to eat for Retinoblastoma – is to evaluate only selected active ingredients contained in foods and ignore the rest. Because different active ingredients contained in foods may have opposing effects on cancer drivers – you cannot cherry pick active ingredients in foods and supplements for making a nutrition decision for Retinoblastoma.

YES – FOOD CHOICES MATTER FOR CANCER. NUTRITION DECISIONS MUST CONSIDER ALL ACTIVE INGREDIENTS OF FOODS.

Skills Needed for Nutrition Personalization for Retinoblastoma?

Personalized nutrition for cancers like Retinoblastoma consists of recommended foods / supplements; not recommended foods / supplements with example recipes which prioritize use of recommended foods. An example of personalized nutrition can be seen at this link.

Deciding which foods are recommended or not is extremely complicated, requiring expertise in Retinoblastoma biology, food science, genetics, biochemistry along with good understanding of how cancer treatments work and associated vulnerabilities by which the treatments could stop being effective.

MINIMUM KNOWLEDGE EXPERTISE NEEDED FOR NUTRITION PERSONALIZATION FOR CANCER ARE: CANCER BIOLOGY, FOOD SCIENCE, CANCER TREATMENTS AND GENETICS.

Foods to Eat After Cancer Diagnosis!

No two cancers are the same. Go beyond the common nutrition guidelines for everyone and make personalized decisions about food and supplements with confidence.

Characteristics of cancers like Retinoblastoma

All cancers like Retinoblastoma can be characterized by a unique set of biochemical pathways – the signature pathways of Retinoblastoma. Biochemical pathways like DNA Repair, Hypoxia, Cell Cycle, Cell Cycle Checkpoints are part of the signature definition of Retinoblastoma. Each individual’s cancer genetics can be different and hence their specific cancer signature could be unique.

The treatments which are effective for Retinoblastoma need to be cognizant of the associated signature biochemical pathways for each cancer patient and individual at genetic risk. Therefore different treatments with different mechanisms of actions are effective for different patients. Similarly and for the same reasons foods and supplements need to be personalized for each individual. Hence some foods and supplements are recommended for Retinoblastoma when taking cancer treatment Etoposide, and some foods and supplements are not recommended.

Sources like cBioPortal and many others provide population representative patient anonymized data from clinical trials for all cancer indications. This data consists of clinical trial study details like sample size / number of patients, age groups, gender, ethnicity, treatments, tumor site and any genetic mutations.

RB1, CRTC1, BCOR, ABL2 and SMARCA2 are the top ranked reported genes for Retinoblastoma. RB1 is reported in 57.8 % of the representative patients across all clinical trials. And CRTC1 is reported in 16.7 %. The combined population patient data cover ages from 1 to 21. 52.8 % of the patient data are identified as men. The Retinoblastoma biology along with reported genetics together define the population represented signature biochemical pathways for this cancer. If the individual cancer tumor genetics or genes contributing to the risk are also known then that should also be used for nutrition personalization.

NUTRITION CHOICES SHOULD MATCH WITH EACH INDIVIDUAL’S CANCER SIGNATURE.

Foods for Retinoblastoma!

Food and Supplements for Retinoblastoma

For Cancer Patients

Cancer patients on treatment or on palliative care need to make decisions on food and supplements – for the needed dietary calories, for managing any treatment side effects and also for improved cancer management. All plant-based foods are not equal and choosing and prioritizing foods which are personalized and customized to ongoing cancer treatment is important and complicated. Here are some examples providing guidelines for making nutrition decisions.

Choose Vegetable TOWEL GOURD or AMERICAN POKEWEED?

Vegetable Towel Gourd contains many active ingredients or bioactives such as Apigenin, Oleic Acid, Isoliquiritigenin, Allicin, Daidzein. These active ingredients manipulate various biochemical pathways like DNA Repair, Hypoxia and PI3K-AKT-MTOR Signaling and others. Towel Gourd is recommended for Retinoblastoma when ongoing cancer treatment is Etoposide. This is because Towel Gourd modifies those biochemical pathways which have been scientifically reported to sensitize the effect of Etoposide.

Some of the active ingredients or bioactives in vegetable American Pokeweed are Myricetin, Apigenin, Isoliquiritigenin, Allicin, Daidzein. These active ingredients manipulate various biochemical pathways like DNA Repair and PI3K-AKT-MTOR Signaling and others. American Pokeweed is not recommended for Retinoblastoma when ongoing cancer treatment is Etoposide because it modifies those biochemical pathways which make the cancer treatment resistant or less responsive.

VEGETABLE TOWEL GOURD IS RECOMMENDED OVER AMERICAN POKEWEED FOR Retinoblastoma AND TREATMENT Etoposide.

Choose Fruit POMEGRANATE or DURIAN?

Fruit Pomegranate contains many active ingredients or bioactives such as Myricetin, Apigenin, Oleic Acid, Betulinic Acid, Isoliquiritigenin. These active ingredients manipulate various biochemical pathways like Hedgehog Signaling, Hypoxia, DNA Repair and PI3K-AKT-MTOR Signaling and others. Pomegranate is recommended for Retinoblastoma when ongoing cancer treatment is Etoposide. This is because Pomegranate modifies those biochemical pathways which have been scientifically reported to sensitize the effect of Etoposide.

Some of the active ingredients or bioactives in fruit Durian are Myricetin, Apigenin, Caffeine, Isoliquiritigenin, Allicin. These active ingredients manipulate various biochemical pathways like DNA Repair and PI3K-AKT-MTOR Signaling and others. Durian is not recommended for Retinoblastoma when ongoing cancer treatment is Etoposide because it modifies those biochemical pathways which make the cancer treatment resistant or less responsive.

FRUIT POMEGRANATE IS RECOMMENDED OVER DURIAN FOR Retinoblastoma AND TREATMENT Etoposide.

Choose Nut ALMOND or EUROPEAN CHESTNUT?

Almond contains many active ingredients or bioactives such as Oleic Acid, Isoliquiritigenin, Allicin, Daidzein, Curcumin. These active ingredients manipulate various biochemical pathways like Hypoxia and PI3K-AKT-MTOR Signaling and others. Almond is recommended for Retinoblastoma when ongoing cancer treatment is Etoposide. This is because Almond modifies those biochemical pathways which have been scientifically reported to sensitize the effect of Etoposide.

Some of the active ingredients or bioactives in European Chestnut are Myricetin, Apigenin, Isoliquiritigenin, Allicin, Daidzein. These active ingredients manipulate various biochemical pathways like PI3K-AKT-MTOR Signaling and others. European Chestnut is not recommended for Retinoblastoma when ongoing cancer treatment is Etoposide because it modifies those biochemical pathways which make the cancer treatment resistant or less responsive.

ALMOND IS RECOMMENDED OVER EUROPEAN CHESTNUT FOR Retinoblastoma AND TREATMENT Etoposide.

For Individuals with Genetic Risk of Cancer

The question asked by individuals who have genetic risk of Retinoblastoma or familial history is “What Should I Eat Differently from Before?” and how they should choose foods and supplements to manage risks of the disease. Since for cancer risk there is nothing actionable in terms of treatment – decisions of foods and supplements become important and one of the very few actionable things which can be done. All plant-based foods are not equal and based on identified genetics and pathway signature – the choices of food and supplements should be personalized.

Choose Vegetable CAULIFLOWER or MUSTARD SPINACH?

Vegetable Cauliflower contains many active ingredients or bioactives such as Curcumin, Lupeol, Daidzein, Formononetin, Beta-sitosterol. These active ingredients manipulate various biochemical pathways like Cell Cycle, P53 Signaling, Cell Cycle Checkpoints and MYC Signaling and others. Cauliflower is recommended for risk of Retinoblastoma when associated genetic risk is ABL2. This is because Cauliflower increases those biochemical pathways which counteract the signature drivers of it.

Some of the active ingredients or bioactives in vegetable Mustard Spinach are Apigenin, Curcumin, Lupeol, Daidzein, Formononetin. These active ingredients manipulate various biochemical pathways like DNA Repair, PI3K-AKT-MTOR Signaling and Cell Cycle Checkpoints and others. Mustard Spinach is not recommended when risk of Retinoblastoma when associated genetic risk is ABL2 because it increases the signature pathways of it.

VEGETABLE CAULIFLOWER IS RECOMMENDED OVER MUSTARD SPINACH FOR ABL2 GENETIC RISK OF CANCER.

Choose Fruit NANCE or PUMMELO?

Fruit Nance contains many active ingredients or bioactives such as Apigenin, Curcumin, Lupeol, Daidzein, Formononetin. These active ingredients manipulate various biochemical pathways like Cell Cycle, P53 Signaling, DNA Repair and MYC Signaling and others. Nance is recommended for risk of Retinoblastoma when associated genetic risk is ABL2. This is because Nance increases those biochemical pathways which counteract the signature drivers of it.

Some of the active ingredients or bioactives in fruit Pummelo are Apigenin, Curcumin, Quercetin, Lupeol, Daidzein. These active ingredients manipulate various biochemical pathways like DNA Repair, PI3K-AKT-MTOR Signaling and Cell Cycle Checkpoints and others. Pummelo is not recommended when risk of Retinoblastoma when associated genetic risk is ABL2 because it increases the signature pathways of it.

FRUIT NANCE IS RECOMMENDED OVER PUMMELO FOR ABL2 GENETIC RISK OF CANCER.

Choose Nut COMMON HAZELNUT or CHESTNUT?

Common Hazelnut contains many active ingredients or bioactives such as Curcumin, Quercetin, Lupeol, Daidzein, Formononetin. These active ingredients manipulate various biochemical pathways like DNA Repair, Cell Cycle, Angiogenesis and MYC Signaling and others. Common Hazelnut is recommended for risk of Retinoblastoma when associated genetic risk is ABL2. This is because Common Hazelnut increases those biochemical pathways which counteract the signature drivers of it.

Some of the active ingredients or bioactives in Chestnut are Apigenin, Curcumin, Ellagic Acid, Lupeol, Daidzein. These active ingredients manipulate various biochemical pathways like DNA Repair, PI3K-AKT-MTOR Signaling and Cell Cycle Checkpoints and others. Chestnut is not recommended when risk of Retinoblastoma when associated genetic risk is ABL2 because it increases the signature pathways of it.

COMMON HAZELNUT IS RECOMMENDED OVER CHESTNUT FOR ABL2 GENETIC RISK OF CANCER.


In Conclusion

Foods and Supplements chosen are important decisions for cancers like Retinoblastoma. Retinoblastoma patients and individuals with genetic-risk always have this question: “What foods and nutritional supplements are recommended for me and which are not?” There is a common belief which is a misconception that all plant-based foods could be beneficial or not but would not be harmful. Certain foods and supplements can interfere with cancer treatments or promote molecular pathway drivers of cancer.

There are different types of cancer indications like Retinoblastoma, each with different tumor genetics with further genomic variations across each individual. Further every cancer treatment and chemotherapy has a unique mechanism of action. Each food like Towel Gourd contains various bioactives in different quantities, which have an impact on different and distinct sets of biochemical pathways. The definition of personalized nutrition is individualized food recommendations for the cancer indication, treatments, genetics, lifestyle and other factors. Nutrition personalization decisions for cancer require knowledge of cancer biology, food science and an understanding of different chemotherapy treatments. Finally when there are treatment changes or new genomics is identified – the nutrition personalization needs re-evaluation.

The addon nutrition personalization solution makes the decision making easy and removes all the guesswork in answering the question, “What foods should I choose or not choose for Retinoblastoma?”. The addon multi-disciplinary team includes cancer physicians, clinical scientists, software engineers and data scientists.


Personalized Nutrition for Cancer!

Cancer changes with time. Customize and modify your nutrition based on cancer indication, treatments, lifestyle, food preferences, allergies and other factors.

References

Scientifically Reviewed by: Dr. Cogle

Christopher R. Cogle, M.D. is a tenured professor at the University of Florida, Chief Medical Officer of Florida Medicaid, and Director of the Florida Health Policy Leadership Academy at the Bob Graham Center for Public Service.

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