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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 Acral Melanoma!

Jul 23, 2023

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Introduction 

Foods for Acral Melanoma 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. 

Acral Melanoma, a unique form of melanoma, typically manifests on the hands, feet, and under the nails, presenting distinct symptoms such as changes in nail pigmentation or skin lesions. This melanoma subtype can be examined through dermoscopy, with acral lentiginous melanoma often observed on the foot, and pictures of these manifestations helping in visual understanding. The pathology outlines of acral melanoma, including in situ forms, are crucial for accurate diagnosis, and the ICD-10 coding system provides its classification. Treatment varies based on the stage and mutation type, with the prognosis and survival rates depending on factors like how fast the melanoma spreads and its overall aggressiveness. Online platforms like Reddit offer community discussions on personal experiences and information. Understanding what acral melanoma looks like and what causes it, is essential for early detection and effective management, as this melanoma subtype can develop in areas not typically exposed to sunlight.



For Acral Melanoma 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 Acral Melanoma 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 Acral Melanoma?

For example does it matter if vegetable Cabbage is consumed more compared to Chinese Broccoli? Does it make any difference if fruit Malus (crab Apple) is preferred over Black Mulberry? Also if similar choices are made for nuts/seeds like Common Hazelnut over European Chestnut and for pulses like Gram Bean over Moth Bean. And if what I eat matters – then how does one identify foods which are recommended for Acral Melanoma and is it the same answer for everyone with the same diagnosis or genetic risk? 

Yes! Foods you eat matters for Acral Melanoma!

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

All cancers like Acral Melanoma can be characterized by a unique set of biochemical pathways - the signature pathways of Acral Melanoma. Biochemical pathways like Oncogenic Cancer Epigenetics, Suppressive Histone Methylation, PI3K-AKT-MTOR Signaling, MAPK Signaling are part of the signature definition of Acral Melanoma.

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 Malus (crab Apple) contains active ingredients Lupeol, Isoliquiritigenin, Formononetin, Catechol, Phloretin. And Black Mulberry contains active ingredients Quercetin, Lupeol, Isoliquiritigenin, Formononetin, Catechol and possibly others. 

A common mistake made when deciding and choosing foods to eat for Acral Melanoma – 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 Acral Melanoma. 

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

Skills Needed for Nutrition Personalization for Acral Melanoma?

Personalized nutrition for cancers like Acral Melanoma 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 Acral Melanoma 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 Acral Melanoma

All cancers like Acral Melanoma can be characterized by a unique set of biochemical pathways – the signature pathways of Acral Melanoma. Biochemical pathways like Oncogenic Cancer Epigenetics, Suppressive Histone Methylation, PI3K-AKT-MTOR Signaling, MAPK Signaling are part of the signature definition of Acral Melanoma. Each individual’s cancer genetics can be different and hence their specific cancer signature could be unique.

The treatments which are effective for Acral Melanoma 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 Acral Melanoma when taking cancer treatment Checkpoint Pdl1, 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. 

DNMT3A, TET2, PPM1D, ASXL1 and ATM are the top ranked reported genes for Acral Melanoma. DNMT3A is reported in 31.6 % of the representative patients across all clinical trials. And TET2 is reported in 11.8 %. The combined population patient data cover ages from 5 to 96. 60.8 % of the patient data are identified as men. The Acral Melanoma 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 Acral Melanoma!

Food and Supplements for Acral Melanoma

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 CABBAGE or CHINESE BROCCOLI?

Vegetable Cabbage contains many active ingredients or bioactives such as Quercetin, Lupeol, Isoliquiritigenin, Formononetin, Catechol. These active ingredients manipulate various biochemical pathways like Angiogenesis, WNT Beta Catenin Signaling, Natural Killer Cell Activation and Interferon Signaling and others. Cabbage is recommended for Acral Melanoma when ongoing cancer treatment is Checkpoint Pdl1. This is because Cabbage modifies those biochemical pathways which have been scientifically reported to sensitize the effect of Checkpoint Pdl1.

Some of the active ingredients or bioactives in vegetable Chinese Broccoli are Lupeol, Isoliquiritigenin, Formononetin, Catechol, Phloretin. These active ingredients manipulate various biochemical pathways like Dendritic Cell Maturation, CD8 T-cell Activation and Antigen Presentation and others. Chinese Broccoli is not recommended for Acral Melanoma when ongoing cancer treatment is Checkpoint Pdl1 because it modifies those biochemical pathways which make the cancer treatment resistant or less responsive.

VEGETABLE CABBAGE IS RECOMMENDED OVER CHINESE BROCCOLI FOR Acral Melanoma AND TREATMENT Checkpoint Pdl1.

Choose Fruit BLACK MULBERRY or MALUS (CRAB APPLE)?

Fruit Black Mulberry contains many active ingredients or bioactives such as Quercetin, Lupeol, Isoliquiritigenin, Formononetin, Catechol. These active ingredients manipulate various biochemical pathways like Macrophage M2, JAK-STAT Signaling, Natural Killer Cell Activation and Angiogenesis and others. Black Mulberry is recommended for Acral Melanoma when ongoing cancer treatment is Checkpoint Pdl1. This is because Black Mulberry modifies those biochemical pathways which have been scientifically reported to sensitize the effect of Checkpoint Pdl1.

Some of the active ingredients or bioactives in fruit Malus (crab Apple) are Lupeol, Isoliquiritigenin, Formononetin, Catechol, Phloretin. These active ingredients manipulate various biochemical pathways like Dendritic Cell Maturation, CD8 T-cell Activation and Antigen Presentation and others. Malus (crab Apple) is not recommended for Acral Melanoma when ongoing cancer treatment is Checkpoint Pdl1 because it modifies those biochemical pathways which make the cancer treatment resistant or less responsive.

FRUIT BLACK MULBERRY IS RECOMMENDED OVER MALUS (CRAB APPLE) FOR Acral Melanoma AND TREATMENT Checkpoint Pdl1.

Choose Nut COMMON HAZELNUT or EUROPEAN CHESTNUT?

Common Hazelnut contains many active ingredients or bioactives such as Quercetin, Lupeol, Isoliquiritigenin, Formononetin, Catechol. These active ingredients manipulate various biochemical pathways like JAK-STAT Signaling, Angiogenesis, Antigen Presentation and T-Regulatory Cell Differentiation and others. Common Hazelnut is recommended for Acral Melanoma when ongoing cancer treatment is Checkpoint Pdl1. This is because Common Hazelnut modifies those biochemical pathways which have been scientifically reported to sensitize the effect of Checkpoint Pdl1.

Some of the active ingredients or bioactives in European Chestnut are Quercetin, Ellagic Acid, Lupeol, Isoliquiritigenin, Formononetin. These active ingredients manipulate various biochemical pathways like Dendritic Cell Maturation, CD8 T-cell Activation and G-protein-coupled Receptor Signaling and others. European Chestnut is not recommended for Acral Melanoma when ongoing cancer treatment is Checkpoint Pdl1 because it modifies those biochemical pathways which make the cancer treatment resistant or less responsive.

COMMON HAZELNUT IS RECOMMENDED OVER EUROPEAN CHESTNUT FOR Acral Melanoma AND TREATMENT Checkpoint Pdl1.

For Individuals with Genetic Risk of Cancer

The question asked by individuals who have genetic risk of Acral Melanoma 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 Acral Melanoma pathway signature – the choices of food and supplements should be personalized. 

Choose Vegetable CELERY STALKS or ROMAINE LETTUCE?

Vegetable Celery Stalks contains many active ingredients or bioactives such as Apigenin, Curcumin, Linalool, Lupeol, Lycopene. These active ingredients manipulate various biochemical pathways like Oncogenic Cancer Epigenetics, RAS-RAF Signaling, Cell Cycle Checkpoints and Apoptosis and others. Celery Stalks is recommended for risk of Acral Melanoma when associated genetic risk is ASXL1. This is because Celery Stalks increases those biochemical pathways which counteract the signature drivers of it.

Some of the active ingredients or bioactives in vegetable Romaine Lettuce are Apigenin, Curcumin, Lupeol, Resveratrol, Protocatechuic Acid. These active ingredients manipulate various biochemical pathways like P53 Signaling and DNA Repair and others. Romaine Lettuce is not recommended when risk of Acral Melanoma when associated genetic risk is ASXL1 because it increases the signature pathways of Acral Melanoma.

VEGETABLE CELERY STALKS IS RECOMMENDED OVER ROMAINE LETTUCE FOR ASXL1 GENETIC RISK OF CANCER.

Choose Fruit NANCE or GRAPEFRUIT?

Fruit Nance contains many active ingredients or bioactives such as Apigenin, Curcumin, Lupeol, Protocatechuic Acid, Daidzein. These active ingredients manipulate various biochemical pathways like DNA Repair, RAS-RAF Signaling, MYC Signaling and Cell Cycle Checkpoints and others. Nance is recommended for risk of Acral Melanoma when associated genetic risk is ASXL1. This is because Nance increases those biochemical pathways which counteract the signature drivers of it.

Some of the active ingredients or bioactives in fruit Grapefruit are Curcumin, Lupeol, Lycopene, Daidzein, Beta-sitosterol. These active ingredients manipulate various biochemical pathways like DNA Repair and others. Grapefruit is not recommended when risk of Acral Melanoma when associated genetic risk is ASXL1 because it increases the signature pathways of Acral Melanoma.

FRUIT NANCE IS RECOMMENDED OVER GRAPEFRUIT FOR ASXL1 GENETIC RISK OF CANCER.

Choose Nut BUTTERNUT or CHESTNUT?

Butternut contains many active ingredients or bioactives such as Apigenin, Curcumin, Juglone, Lupeol, Lycopene. These active ingredients manipulate various biochemical pathways like Oncogenic Cancer Epigenetics, RAS-RAF Signaling, MYC Signaling and Cell Cycle Checkpoints and others. Butternut is recommended for risk of Acral Melanoma when associated genetic risk is ASXL1. This is because Butternut increases those biochemical pathways which counteract the signature drivers of it.

Some of the active ingredients or bioactives in Chestnut are Apigenin, Curcumin, Lupeol, Lycopene, Ellagic Acid. These active ingredients manipulate various biochemical pathways like DNA Repair and others. Chestnut is not recommended when risk of Acral Melanoma when associated genetic risk is ASXL1 because it increases the signature pathways of Acral Melanoma.

BUTTERNUT IS RECOMMENDED OVER CHESTNUT FOR ASXL1 GENETIC RISK OF CANCER.


In Conclusion

Foods and Supplements chosen are important decisions for cancers like Acral Melanoma. Acral Melanoma 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 Acral Melanoma, 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 Cabbage 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 Acral Melanoma?”. 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

1) Msk Impact 2017

2) Tumor mutational load predicts survival after immunotherapy across multiple cancer types.

3) Negative regulation of signal transducer and activator of transcription-3 signalling cascade by lupeol inhibits growth and induces apoptosis in hepatocellular carcinoma cells.

4) Effects of isoliquiritigenin on ovarian cancer cells.

5) Dietary D-glucarate effects on the biomarkers of inflammation during early post-initiation stages of benzo[a]pyrene-induced lung tumorigenesis in A/J mice.

6) Luteolin promotes apoptotic cell death via upregulation of Nrf2 expression by DNA demethylase and the interaction of Nrf2 with p53 in human colon cancer cells.

7) Gallic acid provokes DNA damage and suppresses DNA repair gene expression in human prostate cancer PC-3 cells.

https://www.ncbi.nlm.nih.gov/books/NBK559113

https://www.cancercenter.com/cancer-types/melanoma/types/acral-lentiginous-melanoma

https://www.healthline.com/health/acral-lentiginous-melanoma

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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