Foods for Gastrointestinal Neuroendocrine Tumors!

Introduction

Foods for Gastrointestinal Neuroendocrine Tumors 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.

For Gastrointestinal Neuroendocrine Tumors 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 Gastrointestinal Neuroendocrine Tumors 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 Gastrointestinal Neuroendocrine Tumors?

For example does it matter if vegetable Potato is consumed more compared to Cardoon? Does it make any difference if fruit Asian Pear is preferred over Mandarin Orange (clementine, Tangerine)? Also if similar choices are made for nuts/seeds like Walnut over Chestnut and for pulses like Hyacinth Bean over Common Bean. And if what I eat matters – then how does one identify foods which are recommended for Gastrointestinal Neuroendocrine Tumors and is it the same answer for everyone with the same diagnosis or genetic risk?

Yes! Foods you eat matters for Gastrointestinal Neuroendocrine Tumors!

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

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 Asian Pear contains active ingredients Protocatechuic Acid, Lupeol, Apigenin, Curcumin, Daidzein. And Mandarin Orange (clementine, Tangerine) contains active ingredients Linalool, Protocatechuic Acid, Lupeol, Curcumin, Daidzein and possibly others.

A common mistake made when deciding and choosing foods to eat for Gastrointestinal Neuroendocrine Tumors – 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 Gastrointestinal Neuroendocrine Tumors.

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

Skills Needed for Nutrition Personalization for Gastrointestinal Neuroendocrine Tumors?

Personalized nutrition for cancers like Gastrointestinal Neuroendocrine Tumors 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 Gastrointestinal Neuroendocrine Tumors 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.

Characteristics of cancers like Gastrointestinal Neuroendocrine Tumors

All cancers like Gastrointestinal Neuroendocrine Tumors can be characterized by a unique set of biochemical pathways – the signature pathways of Gastrointestinal Neuroendocrine Tumors. Biochemical pathways like Apoptosis, PI3K-AKT-MTOR Signaling, Oncogenic Histone Methylation, Oxidative Stress are part of the signature definition of Gastrointestinal Neuroendocrine Tumors. Each individual’s cancer genetics can be different and hence their specific cancer signature could be unique.

The treatments which are effective for Gastrointestinal Neuroendocrine Tumors 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 Gastrointestinal Neuroendocrine Tumors when taking cancer treatment Trabectedin, 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.

ALK, APC, DAXX, GNAS and KMT2D are the top ranked reported genes for Gastrointestinal Neuroendocrine Tumors. ALK is reported in 16.7 % of the representative patients across all clinical trials. And APC is reported in 16.7 %. The combined population patient data cover ages from to . 55.0 % of the patient data are identified as men. The Gastrointestinal Neuroendocrine Tumors 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.

Food and Supplements for Gastrointestinal Neuroendocrine Tumors

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 POTATO or CARDOON?

Vegetable Potato contains many active ingredients or bioactives such as Protocatechuic Acid, Lupeol, Curcumin, Daidzein, Cinnamaldehyde. These active ingredients manipulate various biochemical pathways like Apoptosis and PI3K-AKT-MTOR Signaling and others. Potato is recommended for Gastrointestinal Neuroendocrine Tumors when ongoing cancer treatment is Trabectedin. This is because Potato modifies those biochemical pathways which have been scientifically reported to sensitize the effect of Trabectedin.

Some of the active ingredients or bioactives in vegetable Cardoon are Lycopene, Protocatechuic Acid, Lupeol, Apigenin, Curcumin. These active ingredients manipulate various biochemical pathways like PI3K-AKT-MTOR Signaling and others. Cardoon is not recommended for Gastrointestinal Neuroendocrine Tumors when ongoing cancer treatment is Trabectedin because it modifies those biochemical pathways which make the cancer treatment resistant or less responsive.

VEGETABLE POTATO IS RECOMMENDED OVER CARDOON FOR Gastrointestinal Neuroendocrine Tumors AND TREATMENT Trabectedin.

Choose Fruit MANDARIN ORANGE (CLEMENTINE, TANGERINE) or ASIAN PEAR?

Fruit Mandarin Orange (clementine, Tangerine) contains many active ingredients or bioactives such as Linalool, Protocatechuic Acid, Lupeol, Curcumin, Daidzein. These active ingredients manipulate various biochemical pathways like Apoptosis, MYC Signaling and PI3K-AKT-MTOR Signaling and others. Mandarin Orange (clementine, Tangerine) is recommended for Gastrointestinal Neuroendocrine Tumors when ongoing cancer treatment is Trabectedin. This is because Mandarin Orange (clementine, Tangerine) modifies those biochemical pathways which have been scientifically reported to sensitize the effect of Trabectedin.

Some of the active ingredients or bioactives in fruit Asian Pear are Protocatechuic Acid, Lupeol, Apigenin, Curcumin, Daidzein. These active ingredients manipulate various biochemical pathways like PI3K-AKT-MTOR Signaling and others. Asian Pear is not recommended for Gastrointestinal Neuroendocrine Tumors when ongoing cancer treatment is Trabectedin because it modifies those biochemical pathways which make the cancer treatment resistant or less responsive.

FRUIT MANDARIN ORANGE (CLEMENTINE, TANGERINE) IS RECOMMENDED OVER ASIAN PEAR FOR Gastrointestinal Neuroendocrine Tumors AND TREATMENT Trabectedin.

Choose Nut WALNUT or CHESTNUT?

Walnut contains many active ingredients or bioactives such as D-limonene, Protocatechuic Acid, Lupeol, Curcumin, Apigenin. These active ingredients manipulate various biochemical pathways like Apoptosis and PI3K-AKT-MTOR Signaling and others. Walnut is recommended for Gastrointestinal Neuroendocrine Tumors when ongoing cancer treatment is Trabectedin. This is because Walnut modifies those biochemical pathways which have been scientifically reported to sensitize the effect of Trabectedin.

Some of the active ingredients or bioactives in Chestnut are Lycopene, Protocatechuic Acid, Lupeol, Apigenin, Curcumin. These active ingredients manipulate various biochemical pathways like PI3K-AKT-MTOR Signaling and others. Chestnut is not recommended for Gastrointestinal Neuroendocrine Tumors when ongoing cancer treatment is Trabectedin because it modifies those biochemical pathways which make the cancer treatment resistant or less responsive.

WALNUT IS RECOMMENDED OVER CHESTNUT FOR Gastrointestinal Neuroendocrine Tumors AND TREATMENT Trabectedin.

For Individuals with Genetic Risk of Cancer

The question asked by individuals who have genetic risk of Gastrointestinal Neuroendocrine Tumors 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 GIANT BUTTERBUR or KOHLRABI?

Vegetable Giant Butterbur contains many active ingredients or bioactives such as Curcumin, Apigenin, Formononetin, Isoliquiritigenin, Lupeol. These active ingredients manipulate various biochemical pathways like MAPK Signaling, RAS-RAF Signaling, Stem Cell Signaling and PI3K-AKT-MTOR Signaling and others. Giant Butterbur is recommended for risk of Gastrointestinal Neuroendocrine Tumors when associated genetic risk is ALK. This is because Giant Butterbur increases those biochemical pathways which counteract the signature drivers of it.

Some of the active ingredients or bioactives in vegetable Kohlrabi are Quercetin, Curcumin, Formononetin, Isoliquiritigenin, Lupeol. These active ingredients manipulate various biochemical pathways like MAPK Signaling, WNT Beta Catenin Signaling, Stem Cell Signaling and MYC Signaling and others. Kohlrabi is not recommended when risk of Gastrointestinal Neuroendocrine Tumors when associated genetic risk is ALK because it increases the signature pathways of it.

VEGETABLE GIANT BUTTERBUR IS RECOMMENDED OVER KOHLRABI FOR ALK GENETIC RISK OF CANCER.

Choose Fruit NANCE or PUMMELO?

Fruit Nance contains many active ingredients or bioactives such as Curcumin, Apigenin, Formononetin, Isoliquiritigenin, Lupeol. These active ingredients manipulate various biochemical pathways like MAPK Signaling, RAS-RAF Signaling, Stem Cell Signaling and PI3K-AKT-MTOR Signaling and others. Nance is recommended for risk of Gastrointestinal Neuroendocrine Tumors when associated genetic risk is ALK. 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 Quercetin, Curcumin, Apigenin, Formononetin, Isoliquiritigenin. These active ingredients manipulate various biochemical pathways like Cell Cycle Checkpoints and WNT Beta Catenin Signaling and others. Pummelo is not recommended when risk of Gastrointestinal Neuroendocrine Tumors when associated genetic risk is ALK because it increases the signature pathways of it.

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

Choose Nut BUTTERNUT or EUROPEAN CHESTNUT?

Butternut contains many active ingredients or bioactives such as Curcumin, Apigenin, Formononetin, Isoliquiritigenin, Lupeol. These active ingredients manipulate various biochemical pathways like MAPK Signaling, RAS-RAF Signaling, MYC Signaling and PI3K-AKT-MTOR Signaling and others. Butternut is recommended for risk of Gastrointestinal Neuroendocrine Tumors when associated genetic risk is ALK. This is because Butternut increases those biochemical pathways which counteract the signature drivers of it.

Some of the active ingredients or bioactives in European Chestnut are Quercetin, Curcumin, Apigenin, Ellagic Acid, Formononetin. These active ingredients manipulate various biochemical pathways like WNT Beta Catenin Signaling, Stem Cell Signaling and PI3K-AKT-MTOR Signaling and others. European Chestnut is not recommended when risk of Gastrointestinal Neuroendocrine Tumors when associated genetic risk is ALK because it increases the signature pathways of it.

BUTTERNUT IS RECOMMENDED OVER EUROPEAN CHESTNUT FOR ALK GENETIC RISK OF CANCER.

In Conclusion

Foods and Supplements chosen are important decisions for cancers like Gastrointestinal Neuroendocrine Tumors. Gastrointestinal Neuroendocrine Tumors 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 Gastrointestinal Neuroendocrine Tumors, 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 Potato 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 Gastrointestinal Neuroendocrine Tumors?”. The addon multi-disciplinary team includes cancer physicians, clinical scientists, software engineers and data scientists.

References

• Msk Access 2021
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• Shikimic acid promotes estrogen receptor(ER)-positive breast cancer cells proliferation via activation of NF-κB signaling.
• Induction of apoptosis by D-limonene is mediated by inactivation of Akt in LS174T human colon cancer cells.
• Mechanism of Juglone-Induced Cell Cycle Arrest and Apoptosis in Ishikawa Human Endometrial Cancer Cells.
• Protective versus promotional effects of white tea and caffeine on PhIP-induced tumorigenesis and beta-catenin expression in the rat.
• Growth stimulation of human pulmonary adenocarcinoma cells and small airway epithelial cells by beta-carotene via activation of cAMP, PKA, CREB and ERK1/2.