Foods for Phyllodes Tumors!

Introduction

Foods for Phyllodes 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.

Phyllodes tumors are rare fibroepithelial breast tumors that account for fewer than 0.5% of all breast cancers. These tumors can be benign, borderline or malignant and they have a high local recurrence rate, while the malignant form can metastasize, most frequently to the lungs. Boderline and malignant phyllodes tumor metastasis rate is about 25-31%, while the overall rate of phyllodes tumor metastasis is 4%. Breast phyllodes tumor lesions are often single, nodular, painless masses with a sublte onset and slow progression. Majority of patients with benign and borderline phyllodes tumors are cured with surgery. Adjuvant therapy post-surgery could include radiation therapy or chemotherapy to prevent recurrence of malignant phyllodes tumors. The 5-year survival rate for malignant phyllodes tumors is approximately 60-80%. Optimal nutrition (foods and natural supplements) complimentary to the tumor type and treatment context can further help to improve survival and quality of life. (Ref: Zhou Z-R et al, J of Thoracic Disease, 2016; Demain GA et al, J of Egyptian Natl’ Cancer Inst., 2016)

For Phyllodes 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 Phyllodes 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 Phyllodes Tumors?

For example does it matter if vegetable Olive is consumed more compared to Japanese Pumpkin? Does it make any difference if fruit Pummelo is preferred over Apricot? Also if similar choices are made for nuts/seeds like Cashew Nut over Colorado Pinyon and for pulses like Yellow Wax Bean over Common Bean. And if what I eat matters – then how does one identify foods which are recommended for Phyllodes Tumors and is it the same answer for everyone with the same diagnosis or genetic risk?

Yes! Foods you eat matters for Phyllodes 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 Pummelo contains active ingredients Quercetin, Caffeine, Curcumin, Genistein, Apigenin. And Apricot contains active ingredients Quercetin, Curcumin, Beta-carotene and possibly others.

A common mistake made when deciding and choosing foods to eat for Phyllodes 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 Phyllodes Tumors.

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

Skills Needed for Nutrition Personalization for Phyllodes Tumors?

Personalized nutrition for cancers like Phyllodes 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 Phyllodes 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 Phyllodes Tumors

All cancers like Phyllodes Tumors can be characterized by a unique set of biochemical pathways – the signature pathways of Phyllodes Tumors. Biochemical pathways like DNA Repair, TGFB Signaling, Oncogenic Histone Methylation, Extracellular Matrix Remodelling are part of the signature definition of Phyllodes Tumors. Each individual’s cancer genetics can be different and hence their specific cancer signature could be unique.

The treatments which are effective for Phyllodes 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 Phyllodes Tumors when taking cancer treatment Carboplatin, 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.

MED12, SETD2, RARA, AHR and ALOX15 are the top ranked reported genes for Phyllodes Tumors. MED12 is reported in 60.0 % of the representative patients across all clinical trials. And SETD2 is reported in 30.0 %. The combined population patient data cover ages from 22 to 79. 0.0 % of the patient data are identified as men. The Phyllodes 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 Phyllodes 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 OLIVE or JAPANESE PUMPKIN?

Vegetable Olive contains many active ingredients or bioactives such as Quercetin, Ferulic Acid, Curcumin. These active ingredients manipulate various biochemical pathways like DNA Repair and others. Olive is recommended for Phyllodes Tumors when ongoing cancer treatment is Carboplatin. This is because Olive modifies those biochemical pathways which have been scientifically reported to sensitize the effect of Carboplatin.

Some of the active ingredients or bioactives in vegetable Japanese Pumpkin are Quercetin, Ferulic Acid, Curcumin, Vitamin E, Beta-carotene. These active ingredients manipulate various biochemical pathways like DNA Repair and others. Japanese Pumpkin is not recommended for Phyllodes Tumors when ongoing cancer treatment is Carboplatin because it modifies those biochemical pathways which make the cancer treatment resistant or less responsive.

VEGETABLE OLIVE IS RECOMMENDED OVER JAPANESE PUMPKIN FOR Phyllodes Tumors AND TREATMENT Carboplatin.

Choose Fruit APRICOT or PUMMELO?

Fruit Apricot contains many active ingredients or bioactives such as Quercetin, Curcumin, Beta-carotene. These active ingredients manipulate various biochemical pathways like DNA Repair and others. Apricot is recommended for Phyllodes Tumors when ongoing cancer treatment is Carboplatin. This is because Apricot modifies those biochemical pathways which have been scientifically reported to sensitize the effect of Carboplatin.

Some of the active ingredients or bioactives in fruit Pummelo are Quercetin, Caffeine, Curcumin, Genistein, Apigenin. These active ingredients manipulate various biochemical pathways like DNA Repair and others. Pummelo is not recommended for Phyllodes Tumors when ongoing cancer treatment is Carboplatin because it modifies those biochemical pathways which make the cancer treatment resistant or less responsive.

FRUIT APRICOT IS RECOMMENDED OVER PUMMELO FOR Phyllodes Tumors AND TREATMENT Carboplatin.

Choose Nut CASHEW NUT or COLORADO PINYON?

Cashew Nut contains many active ingredients or bioactives such as Quercetin, Curcumin, Beta-carotene, Gallic Acid. These active ingredients manipulate various biochemical pathways like DNA Repair and others. Cashew Nut is recommended for Phyllodes Tumors when ongoing cancer treatment is Carboplatin. This is because Cashew Nut modifies those biochemical pathways which have been scientifically reported to sensitize the effect of Carboplatin.

Some of the active ingredients or bioactives in Colorado Pinyon are Caffeine, Curcumin, Genistein, Apigenin. These active ingredients manipulate various biochemical pathways like DNA Repair and others. Colorado Pinyon is not recommended for Phyllodes Tumors when ongoing cancer treatment is Carboplatin because it modifies those biochemical pathways which make the cancer treatment resistant or less responsive.

CASHEW NUT IS RECOMMENDED OVER COLORADO PINYON FOR Phyllodes Tumors AND TREATMENT Carboplatin.

For Individuals with Genetic Risk of Cancer

The question asked by individuals who have genetic risk of Phyllodes 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 WILD LEEK or RED BELL PEPPER?

Vegetable Wild Leek contains many active ingredients or bioactives such as Curcumin, Apigenin, Daidzein, Formononetin, Delphinidin. These active ingredients manipulate various biochemical pathways like NFKB Signaling, Retinoic Acid Signaling, MAPK Signaling and Growth Factor Signaling and others. Wild Leek is recommended for risk of Phyllodes Tumors when associated genetic risk is AHR. This is because Wild Leek increases those biochemical pathways which counteract the signature drivers of it.

Some of the active ingredients or bioactives in vegetable Red Bell Pepper are Curcumin, Daidzein, Formononetin, Quercetin, Linalool. These active ingredients manipulate various biochemical pathways like MAPK Signaling and Growth Factor Signaling and others. Red Bell Pepper is not recommended when risk of Phyllodes Tumors when associated genetic risk is AHR because it increases the signature pathways of it.

VEGETABLE WILD LEEK IS RECOMMENDED OVER RED BELL PEPPER FOR AHR GENETIC RISK OF CANCER.

Choose Fruit RED RASPBERRY or LINGONBERRY?

Fruit Red Raspberry contains many active ingredients or bioactives such as Curcumin, Ellagic Acid, Daidzein, Formononetin, Quercetin. These active ingredients manipulate various biochemical pathways like RAS-RAF Signaling, MYC Signaling, MAPK Signaling and Growth Factor Signaling and others. Red Raspberry is recommended for risk of Phyllodes Tumors when associated genetic risk is AHR. This is because Red Raspberry increases those biochemical pathways which counteract the signature drivers of it.

Some of the active ingredients or bioactives in fruit Lingonberry are Curcumin, Daidzein, Formononetin, Quercetin, Lycopene. These active ingredients manipulate various biochemical pathways like Retinoic Acid Signaling, Cell Cycle Checkpoints and P53 Signaling and others. Lingonberry is not recommended when risk of Phyllodes Tumors when associated genetic risk is AHR because it increases the signature pathways of it.

FRUIT RED RASPBERRY IS RECOMMENDED OVER LINGONBERRY FOR AHR GENETIC RISK OF CANCER.

Choose Nut COMMON HAZELNUT or EUROPEAN CHESTNUT?

Common Hazelnut contains many active ingredients or bioactives such as Curcumin, Daidzein, Formononetin, Quercetin, Lycopene. These active ingredients manipulate various biochemical pathways like MYC Signaling, P53 Signaling, MAPK Signaling and Growth Factor Signaling and others. Common Hazelnut is recommended for risk of Phyllodes Tumors when associated genetic risk is AHR. This is because Common Hazelnut increases those biochemical pathways which counteract the signature drivers of it.

Some of the active ingredients or bioactives in European Chestnut are Curcumin, Apigenin, Ellagic Acid, Daidzein, Formononetin. These active ingredients manipulate various biochemical pathways like TGFB Signaling and Oncogenic Histone Methylation and others. European Chestnut is not recommended when risk of Phyllodes Tumors when associated genetic risk is AHR because it increases the signature pathways of it.

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

In Conclusion

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

References

• Bfn Duke Nus 2015
• Genomic landscapes of breast fibroepithelial tumors.
• Functional lipidomics: Palmitic acid impairs hepatocellular carcinoma development by modulating membrane fluidity and glucose metabolism.
• BRCA1 and BRCA2 as molecular targets for phytochemicals indole-3-carbinol and genistein in breast and prostate cancer cells.
• Preventive effects of butyric acid, nicotinamide, calcium glucarate alone or in combination during the 7, 12-dimethylbenz (a) anthracene induced mouse skin tumorigenesis via modulation of K-Ras-PI3K-AKTpathway and associated micro RNAs.
• Research progress on the anticancer effects of vitamin K2.
• Vitamin C selectively kills KRAS and BRAF mutant colorectal cancer cells by targeting GAPDH.
• Triggering of transient receptor potential vanilloid type 1 (TRPV1) by capsaicin induces Fas/CD95-mediated apoptosis of urothelial cancer cells in an ATM-dependent manner.
• Growth stimulation of human pulmonary adenocarcinoma cells and small airway epithelial cells by beta-carotene via activation of cAMP, PKA, CREB and ERK1/2.
• Daidzein exerts anti-tumor activity against bladder cancer cells via inhibition of FGFR3 pathway.