Foods for Paget Disease Of The Breast!

Introduction

Foods for Paget Disease Of The Breast 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.

Paget’s disease of the breast is a rare form of breast cancer that affects the skin and nipple area. It is often associated with underlying ductal breast cancer. It is mostly diagnosed in the female gender although rare cases have been reported in men and usually affects patients older than 60 years of age. Symptoms of Paget’s disease of the breast include redness, itching, burning, and scaling of the nipple and surrounding skin. Treatment options for this disease may include surgery, radiation therapy, chemotherapy, hormone therapy or immunotherapy, depending on the stage and extent of the cancer. Radiology plays a crucial role in diagnosing and staging Paget’s disease of the breast, and histology is examined to confirm the presence of cancer cells. Early diagnosis and treatment of Paget’s disease of the breast can lead to a better prognosis and improved outcomes. It is important to consult a healthcare professional if you experience any symptoms or have concerns about breast health. The appropriate investigation, diagnosis, and treatment strategies can be determined based on an individual’s specific case.

For Paget Disease Of The Breast 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 Paget Disease Of The Breast 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 Paget Disease Of The Breast?

For example does it matter if vegetable Cabbage is consumed more compared to Butternut Squash? Does it make any difference if fruit Black Elderberry is preferred over Grapefruit/pummelo Hybrid? Also if similar choices are made for nuts/seeds like Butternut over Cashew Nut and for pulses like Black-eyed Pea over Pigeon Pea. And if what I eat matters – then how does one identify foods which are recommended for Paget Disease Of The Breast and is it the same answer for everyone with the same diagnosis or genetic risk?

Yes! Foods you eat matters for Paget Disease Of The Breast!

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 Black Elderberry contains active ingredients Apigenin, Curcumin, Catechol, Lupeol, Formononetin. And Grapefruit/pummelo Hybrid contains active ingredients Apigenin, Curcumin, Catechol, Lupeol, Formononetin and possibly others.

A common mistake made when deciding and choosing foods to eat for Paget Disease Of The Breast – 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 Paget Disease Of The Breast.

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

Skills Needed for Nutrition Personalization for Paget Disease Of The Breast?

Personalized nutrition for cancers like Paget Disease Of The Breast 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 Paget Disease Of The Breast 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 Paget Disease Of The Breast

All cancers like Paget Disease Of The Breast can be characterized by a unique set of biochemical pathways – the signature pathways of Paget Disease Of The Breast. Biochemical pathways like Cell Cycle Checkpoints, Growth Factor Signaling, PI3K-AKT-MTOR Signaling, MAPK Signaling are part of the signature definition of Paget Disease Of The Breast. Each individual’s cancer genetics can be different and hence their specific cancer signature could be unique.

The treatments which are effective for Paget Disease Of The Breast 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 Paget Disease Of The Breast when taking cancer treatment Letrozole, 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.

KMT2C, APOB, MTR, BRWD1 and ARID2 are the top ranked reported genes for Paget Disease Of The Breast. KMT2C is reported in 34.0 % of the representative patients across all clinical trials. And APOB is reported in 24.0 %. The combined population patient data cover ages from to . % of the patient data are identified as men. The Paget Disease Of The Breast 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 Paget Disease Of The Breast

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 BUTTERNUT SQUASH?

Vegetable Cabbage contains many active ingredients or bioactives such as Apigenin, Curcumin, Catechol, Lupeol, Formononetin. These active ingredients manipulate various biochemical pathways like Growth Factor Signaling, PI3K-AKT-MTOR Signaling and MYC Signaling and others. Cabbage is recommended for Paget Disease Of The Breast when ongoing cancer treatment is Letrozole. This is because Cabbage modifies those biochemical pathways which have been scientifically reported to sensitize the effect of Letrozole.

Some of the active ingredients or bioactives in vegetable Butternut Squash are Apigenin, Curcumin, Catechol, Lupeol, Formononetin. These active ingredients manipulate various biochemical pathways like PI3K-AKT-MTOR Signaling and others. Butternut Squash is not recommended for Paget Disease Of The Breast when ongoing cancer treatment is Letrozole because it modifies those biochemical pathways which make the cancer treatment resistant or less responsive.

VEGETABLE CABBAGE IS RECOMMENDED OVER BUTTERNUT SQUASH FOR Paget Disease Of The Breast AND TREATMENT Letrozole.

Choose Fruit GRAPEFRUIT/PUMMELO HYBRID or BLACK ELDERBERRY?

Fruit Grapefruit/pummelo Hybrid contains many active ingredients or bioactives such as Apigenin, Curcumin, Catechol, Lupeol, Formononetin. These active ingredients manipulate various biochemical pathways like Growth Factor Signaling, PI3K-AKT-MTOR Signaling and MYC Signaling and others. Grapefruit/pummelo Hybrid is recommended for Paget Disease Of The Breast when ongoing cancer treatment is Letrozole. This is because Grapefruit/pummelo Hybrid modifies those biochemical pathways which have been scientifically reported to sensitize the effect of Letrozole.

Some of the active ingredients or bioactives in fruit Black Elderberry are Apigenin, Curcumin, Catechol, Lupeol, Formononetin. These active ingredients manipulate various biochemical pathways like PI3K-AKT-MTOR Signaling and Cell Cycle Checkpoints and others. Black Elderberry is not recommended for Paget Disease Of The Breast when ongoing cancer treatment is Letrozole because it modifies those biochemical pathways which make the cancer treatment resistant or less responsive.

FRUIT GRAPEFRUIT/PUMMELO HYBRID IS RECOMMENDED OVER BLACK ELDERBERRY FOR Paget Disease Of The Breast AND TREATMENT Letrozole.

Choose Nut BUTTERNUT or CASHEW NUT?

Butternut contains many active ingredients or bioactives such as Apigenin, Curcumin, Catechol, Lupeol, Formononetin. These active ingredients manipulate various biochemical pathways like Growth Factor Signaling and PI3K-AKT-MTOR Signaling and others. Butternut is recommended for Paget Disease Of The Breast when ongoing cancer treatment is Letrozole. This is because Butternut modifies those biochemical pathways which have been scientifically reported to sensitize the effect of Letrozole.

Some of the active ingredients or bioactives in Cashew Nut are Curcumin, Catechol, Lupeol, Formononetin, Daidzein. These active ingredients manipulate various biochemical pathways like Growth Factor Signaling and PI3K-AKT-MTOR Signaling and others. Cashew Nut is not recommended for Paget Disease Of The Breast when ongoing cancer treatment is Letrozole because it modifies those biochemical pathways which make the cancer treatment resistant or less responsive.

BUTTERNUT IS RECOMMENDED OVER CASHEW NUT FOR Paget Disease Of The Breast AND TREATMENT Letrozole.

For Individuals with Genetic Risk of Cancer

The question asked by individuals who have genetic risk of Paget Disease Of The Breast 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 AMERICAN POKEWEED?

Vegetable Giant Butterbur contains many active ingredients or bioactives such as Apigenin, Curcumin, Lupeol, Lycopene, Daidzein. These active ingredients manipulate various biochemical pathways like Apoptosis, P53 Signaling, MAPK Signaling and Cell Cycle Checkpoints and others. Giant Butterbur is recommended for risk of Paget Disease Of The Breast when associated genetic risk is APOB. 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 American Pokeweed are Apigenin, Curcumin, Lupeol, Quercetin, Daidzein. These active ingredients manipulate various biochemical pathways like DNA Repair, Oncogenic Cancer Epigenetics and Folate Signaling and others. American Pokeweed is not recommended when risk of Paget Disease Of The Breast when associated genetic risk is APOB because it increases the signature pathways of it.

VEGETABLE GIANT BUTTERBUR IS RECOMMENDED OVER AMERICAN POKEWEED FOR APOB GENETIC RISK OF CANCER.

Choose Fruit RED RASPBERRY or PUMMELO?

Fruit Red Raspberry contains many active ingredients or bioactives such as Curcumin, Ellagic Acid, Lupeol, Quercetin, Daidzein. These active ingredients manipulate various biochemical pathways like Apoptosis, P53 Signaling, MAPK Signaling and Cell Cycle Checkpoints and others. Red Raspberry is recommended for risk of Paget Disease Of The Breast when associated genetic risk is APOB. 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 Pummelo are Apigenin, Curcumin, Lupeol, Quercetin, Lycopene. These active ingredients manipulate various biochemical pathways like DNA Repair and Extracellular Matrix Remodelling and others. Pummelo is not recommended when risk of Paget Disease Of The Breast when associated genetic risk is APOB because it increases the signature pathways of it.

FRUIT RED RASPBERRY IS RECOMMENDED OVER PUMMELO FOR APOB GENETIC RISK OF CANCER.

Choose Nut COMMON HAZELNUT or CHESTNUT?

Common Hazelnut contains many active ingredients or bioactives such as Curcumin, Lupeol, Quercetin, Lycopene, Daidzein. These active ingredients manipulate various biochemical pathways like Apoptosis, P53 Signaling, MAPK Signaling and Cell Cycle Checkpoints and others. Common Hazelnut is recommended for risk of Paget Disease Of The Breast when associated genetic risk is APOB. 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, Lycopene. These active ingredients manipulate various biochemical pathways like DNA Repair and PI3K-AKT-MTOR Signaling and others. Chestnut is not recommended when risk of Paget Disease Of The Breast when associated genetic risk is APOB because it increases the signature pathways of it.

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

In Conclusion

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

References

• Eriodictyol exerts potent anticancer activity against A549 human lung cancer cell line by inducing mitochondrial-mediated apoptosis, G2/M cell cycle arrest and inhibition of m-TOR/PI3K/Akt signalling pathway.
• Naringin sensitizes human prostate cancer cells to paclitaxel therapy.
• 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.
• Paederia foetida induces anticancer activity by modulating chromatin modification enzymes and altering pro-inflammatory cytokine gene expression in human prostate cancer cells.
• Potential role of nucleoside diphosphate kinase in myricetin-induced selective apoptosis in colon cancer HCT-15 cells.
• Gallic acid provokes DNA damage and suppresses DNA repair gene expression in human prostate cancer PC-3 cells.
• Ooi PS et al, Korean J Fam Med., 2019;
• https://my.clevelandclinic.org/health/diseases/17913-pagets-disease-of-the-breast
• Baysal H et al, 2023, doi: 10.14744/nci.2023.77010; Sisti A et al, Breast Dis., 2020, DOI: 10.3233/BD-200439