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What should I Eat?

is the most common question asked by cancer patients.
Choose food and nutritional supplements which avoids bad interactions with your cancer treatment and is good for you.

is the most common question asked by cancer patients. Choose food and nutritional supplements which avoids bad interactions with your cancer treatment and is good for you.

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For Which Cancer Types Should I Avoid Milk Thistle Supplement?

May 24, 2021

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Highlights

Nutritional supplements like Milk Thistle have many health benefits and are being widely used by cancer patients and those at-genetic-risk of cancer. But, is it safe to take Milk Thistle supplements for all types of cancer and without considering any ongoing treatments and other lifestyle conditions? A common belief but only a myth is that anything natural can only benefit me or do no harm. As one example, the use of grapefruit with certain medications is not recommended. Another example, the use of spinach with some blood thinning medications can cause adverse interactions and should be avoided. For cancer, nutrition which includes the food and natural supplements has been shown to influence outcomes. Hence a frequently asked question by cancer patients to dieticians and doctors is “What Should I eat and What Should I Avoid?”. 

Taking nutritional Milk Thistle supplements can benefit Merkel Cell Carcinoma patients on Hydroxyurea cancer treatment. But avoid Milk Thistle supplements if on Decitabine cancer treatment for Myeloproliferative Neoplasms. Similarly, taking nutritional supplement Milk Thistle can benefit healthy individuals who are at genetic risk of cancer due to mutation of gene CDKN2A. But avoid taking nutritional supplement Milk Thistle when at genetic risk of cancer due to mutation of gene MRE11.

The takeaway being – your individual context will influence your decision if nutritional supplement Milk Thistle is safe or not. And also that this decision needs to be constantly revisited as conditions change. Conditions like cancer type, current ongoing treatments and supplements, age, gender, weight, height, lifestyle and any genetic mutations identified matter. So a legitimate question for you to ask for any recommendation of food and natural supplement is how it is related to your individual context.



Brief Overview

Nutritional supplements – vitamins, herbs, minerals, probiotics, and other specialty categories are increasing. Supplements  are high concentrations of active ingredients which are also found in different foods. The difference being foods contain more than one active ingredient at lower diffused concentrations. Remember that each of these ingredients has its own science and biological mechanism at molecular level – hence choose  the right combination of supplements like Milk Thistle based on individual context and conditions. 

Milk Thistle Supplements for Cancer Treatment and genetic Risk

So the question is should you take the supplement Milk Thistle? Should you take it when at genetic risk of cancer for mutation of gene MRE11? Should you take it when at genetic risk of cancer for mutation of gene CDKN2A? Should you take it when diagnosed with Myeloproliferative Neoplasms? Should you take Milk Thistle supplement when diagnosed with Merkel Cell Carcinoma? Should you take it when on Decitabine treatment? Should you continue taking Milk Thistle supplement if you change your treatment from Decitabine to Hydroxyurea? So a general explanation like – it is natural or it increases immunity may not be acceptable and sufficient for choosing Milk Thistle. 

Cancer

Cancer remains an unsolved problem statement. The improved availability of personalized treatments and monitoring of cancer via blood and saliva have been significant factors to improve outcomes. The earlier the intervention – the better the influence on outcome. Genetic testing has the potential to assess cancer risk and susceptibility early. But besides regular monitoring in most cases there are no therapeutic intervention options available. After diagnosis with cancer such as Myeloproliferative Neoplasms or Merkel Cell Carcinoma, the treatments get personalized to tumor genomics and factors like staging of disease, age and gender. During cancer remission (after treatment cycle is complete) – monitoring is used for assessment of any relapse and accordingly decide next steps. A large majority of cancer patients and those at-risk do take nutritional supplements like Milk Thistle.

So the question is that are all genetic mutation risks and types of cancers to be considered as one when deciding the use of Milk Thistle? Are the biochemical pathway implications of genetic risk for cancer due to mutation of gene MRE11 the same as due to mutation of gene CDKN2A? Are the implications of Myeloproliferative Neoplasms the same as Merkel Cell Carcinoma? Is it one and the same if you are on treatment Decitabine or on Hydroxyurea? 

Milk Thistle – A Nutritional Supplement

Milk thistle is a therapeutic herb that contains a family of natural compounds, called flavonolignans. It has been used for treating liver and bile disorders for centuries.  The extract from the seeds of the plant is composed of these flavonolignans, collectively known as silymarin. The potential health benefits of milk thistle may be attributed to silymarin, which has strong antioxidant properties.

Milk Thistle supplements contain many active ingredients including Silibinin, Linoleic Acid and Vitamin E at different concentration levels. Silybin makes up 50% to 70% of silymarin. (Ludovico Abenavoli et al, Phytother Res., 2010) The molecular pathways which are regulated by Milk Thistle include Epithelial to Mesenchymal Transition, P53 Signaling, Angiogenesis, MAPK Signaling and JAK-STAT Signaling. These cellular pathways directly or indirectly regulate specific cancer molecular endpoints like growth, spread and death. Because of this biological regulation – for cancer nutrition, the right choice of supplements like Milk Thistle individually or in combination is an important decision to be made. When making decisions on the use of supplement Milk Thistle for cancer – do consider all these factors and explanations. Because just as true for cancer treatments – Milk Thistle use cannot be a one-size-fits-all decision for all types of cancers.

Choosing Milk Thistle Supplements for Your Cancer

The reason there is no easy way to answer the question “When should I avoid Milk Thistle for Cancer” is because “It Depends!”. Just like the same treatment does not work for every cancer patient, based on your individual context the Milk Thistle may be harmful or safe. Along with which cancer and associated genetics – the ongoing treatments, supplements, lifestyle habits, BMI and allergies are all factors deciding if Milk Thistle should be avoided or not and why.

1. Will Milk Thistle Supplements benefit Cancer Patients with Myeloproliferative Neoplasms undergoing Decitabine treatment?

Myeloproliferative Neoplasms is characterized and driven by specific genetic mutations like JAK2 and CALR leading to biochemical pathway changes in Epithelial to Mesenchymal Transition, MAPK Signaling, Angiogenesis, JAK-STAT Signaling and Cytokine Signaling. A cancer treatment like Decitabine works through a specific pathway mechanism of action. The goal is to have a good overlap between the treatment and cancer driving pathways for a personalized approach which is effective. In such a condition any food or nutritional supplement which has a contrary effect to the treatment or reduces the overlap should be avoided. As an example, Milk Thistle should be avoided for Myeloproliferative Neoplasms along with treatment Decitabine. Milk Thistle impacts pathways/processes like Epithelial to Mesenchymal Transition and MAPK Signaling which either promote drivers of the disease and/or nullify the treatment effect. Some of the factors which should be considered when choosing nutrition are type of cancer, treatments and supplements being taken currently (if any), age, gender, BMI, lifestyle and any genetic mutation information (if available).

2. Will Milk Thistle Supplements benefit Merkel Cell Carcinoma Patients undergoing Hydroxyurea Cancer Treatment?

Merkel Cell Carcinoma is characterized and driven by specific genetic mutations like TP53 and RB1 leading to biochemical pathway changes in P53 Signaling, JAK-STAT Signaling, Apoptosis, PI3K-AKT-MTOR Signaling and Cell Cycle. A cancer treatment like Hydroxyurea works through specific pathway mechanisms. The goal is to have a good overlap between the treatment and cancer driving pathways for a personalized approach. In such a condition any food or nutritional supplement which has a compatible effect to the treatment or reduces the overlap should be considered. As an example, Milk Thistle should be considered for Merkel Cell Carcinoma along with treatment Hydroxyurea. Milk Thistle impacts pathways/processes like P53 Signaling and JAK-STAT Signaling which either obstruct drivers of the disease (Merkel Cell Carcinoma) and/or improve the treatment (Hydroxyurea) effect. 

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3. Are Milk Thistle Supplements Safe for Healthy Individuals with MRE11 Mutation Associated Genetic Risk?

Different companies offer panels of genes to be tested for assessing genetic risk to different cancers. These panels cover genes associated with cancers of the breast, ovary, uterus, prostate, and gastrointestinal system and others. Genetic testing of these genes may confirm a diagnosis and help guide treatment and management decisions. Identification of a disease-causing variant may also guide testing and diagnosis of at-risk relatives. MRE11 is one of the genes generally available in panels for cancer risk testing.

MRE11 mutation causes biochemical pathways Angiogenesis, Estrogen Signaling, Stem Cell Signaling, DNA Repair and Growth Factor Signaling to get impacted. These pathways are direct or indirect drivers of cancer molecular endpoints. Milk Thistle should be avoided when the genetic panel identifies mutation of MRE11 for Breast Cancer. Milk Thistle impacts pathways/processes like Angiogenesis and Estrogen Signaling and creates adverse effects with MRE11 and related conditions.

4. Are Milk Thistle Supplements Safe for Healthy Individuals with CDKN2A Mutation Associated Genetic Risk?

CDKN2A is one of the genes available in panels for cancer risk testing. CDKN2A mutation causes biochemical pathways P53 Signaling, MAPK Signaling, Stem Cell Signaling, Cell Cycle and Cell Cycle Checkpoints to get impacted. These pathways are direct or indirect drivers of cancer molecular endpoints. Consider taking Milk Thistle supplement when the genetic panel identifies mutation in CDKN2A for Skin Cancer and Head And Neck Squamous Cell Carcinoma. Milk Thistle impacts pathways like P53 Signaling and MAPK Signaling and creates a supportive effect in those with CDKN2A mutation and related conditions. 

Which Cancer Types to Avoid Milk Thistle Supplement

* Other Factors are also included like BMI, Lifestyle Habits, Treatments

In Conclusion

The two most important things to remember are that cancer treatments and nutrition are never the same for everyone. Nutrition which includes food and nutritional supplements like Milk Thistle, is an effective tool which can be controlled by you, while facing cancer.

“What should I eat?” is the most frequently asked question to cancer dieticians and physicians. The right answer depends upon cancer type, underlying genomics, current treatments, any allergies, lifestyle information, and factors like BMI.

The addon personalized nutrition plan keeps you safe from adverse nutrition interactions.

Get started NOW with answering questions on type of cancer, current treatments, supplements, allergies, age group, gender, and lifestyle information.

Top 10 Foods and Supplements to Avoid for Cancer

Go beyond same nutrition guidelines for everyone and make personalized decisions with confidence.


Cancer patients often have to deal with different chemotherapy side effects which affect their quality of life and look out for alternative therapies for cancer. Taking the right nutrition and supplements based on scientific considerations (avoiding guesswork and random selection) is the best natural remedy for cancer and treatment related side-effects.


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