Nutritional supplements like Rosemary 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 Rosemary 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 Rosemary supplements can benefit Primary Central Nervous System Lymphoma patients on Epirubicin cancer treatment. But avoid Rosemary supplements if on Ifosfamide treatment for Testicular Germ Cell Tumors. Similarly, taking nutritional supplement Rosemary can benefit healthy individuals who are at genetic risk of cancer due to mutation of the gene SDHAF2. But avoid taking nutritional supplement Rosemary when at genetic risk of cancer due to mutation of gene BLM.
The takeaway being – your individual context will influence your decision if nutritional supplement Rosemary 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.
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 Rosemary based on individual context and conditions.
So the question is should you take the supplement Rosemary? Should you take it when at genetic risk of cancer for mutation of gene BLM? Should you take it when at genetic risk of cancer for mutation of the gene SDHAF2? Should you take it when diagnosed with Testicular Germ Cell Tumors? Should you take it when diagnosed with Primary Central Nervous System Lymphoma? Should you take it when on Ifosfamide treatment? Should you continue taking Rosemary supplement if you change your treatment from Ifosfamide to Epirubicin? So a general explanation like – it is natural or it increases immunity may not be acceptable and sufficient for choosing Rosemary.
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 Testicular Germ Cell Tumors or Primary Central Nervous System Lymphoma, 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 Rosemary.
So the question is that are all genetic mutation risks and types of cancers to be considered as one when deciding the use of Rosemary? Are the biochemical pathway implications of genetic risk for cancer due to mutation of gene BLM the same as due to mutation of gene SDHAF2? Are the implications of Testicular Germ Cell Tumors same as Primary Central Nervous System Lymphoma? Is it one and the same if you are on treatment with Ifosfamide or on Epirubicin?
Rosemary – A Nutritional Supplement
Rosemary is an aromatic plant with medicinal properties, native to the Mediterranean region. It is used as a condiment in culinary dishes. Rosemary is very popular and is now grown all over the world. It has strong antioxidant, anti-inflammatory and antimicrobial properties. Following are some of the potential health benefits of Rosemary:
- May boost immunity
- May improve brain function
- May improve blood circulation
- May relieve pain
- May help in digestion
However, excess intake of Rosemary supplements can lead to side-effects such as :
- Pulmonary edema
- Muscle Spasms
Rosemary supplements contain many active ingredients including Rosmarinic acid, Rosmanol, Caffeic Acid and Carnosic Acid at different concentration levels. The molecular pathways which are regulated by Rosemary include JAK-STAT Signaling, Cell Cycle, Estrogen Signaling, Stem Cell Signaling and Oxidative Stress. 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 Rosemary individually or in combination is an important decision to be made. When making decisions on the use of supplement Rosemary for cancer – do consider all these factors and explanations. Because just as true for cancer treatments – Rosemary use cannot be a one-size-fits-all decision for all types of cancers.
Choosing Rosemary Supplements for Your Cancer
The reason there is no easy way to answer the question “When should I avoid Rosemary for Cancer” is because “It Depends!”. Just like the same treatment does not work for every cancer patient, based on your individual context the Rosemary 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 Rosemary should be avoided or not and why.
1. Will Rosemary Supplements benefit Cancer Patients with Testicular Germ Cell Tumors undergoing Ifosfamide treatment?
Testicular Germ Cell Tumors is characterized and driven by specific genetic mutations like KIT and KRAS leading to biochemical pathway changes in JAK-STAT Signaling, Oxidative Stress, P53 Signaling, PI3K-AKT-MTOR Signaling and RAS-RAF Signaling. A cancer treatment like Ifosfamide 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, Rosemary should be avoided for Testicular Germ Cell Tumors along with treatment of Ifosfamide. Rosemary impacts pathways/processes like JAK-STAT Signaling and Oxidative Stress which either promote drivers of the disease and/or nullify the treatment effect. Additionally, Rosemary supplements contain active ingredients like Caffeic Acid and Carnosic Acid which can have CYP3A4 and/or CYP2C9 interactions with Ifosfamide treatment, and hence should be avoided by cancer patients undergoing this treatment. (Leslie J Dickmann et al, Drug Metab Dispos., 2012; Churdsak Jaikang et al, J. Med. Plants Res., 2011; Pius S Fasinu et al, Front Oncol., 2019) 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 Rosemary Supplements benefit Cancer Patients with Primary Central Nervous System Lymphoma undergoing Epirubicin Treatment?
Primary Central Nervous System Lymphoma is characterized and driven by specific genetic mutations like MYD88 and CD79B leading to biochemical pathway changes in Cell Cycle, NFKB Signaling, Apoptosis, B Cell Receptor Signaling and RAS-RAF Signaling. A cancer treatment like Epirubicin 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, Rosemary supplement should be considered for Primary Central Nervous System Lymphoma along with treatment Epirubicin. Rosemary supplement impacts pathways/processes like Cell Cycle and NFKB Signaling which either obstruct drivers of the disease and/or improve Epirubicin treatment effect.
3. Are Rosemary Supplements Safe for Healthy Individuals with BLM 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. BLM is one of the genes generally available in panels for cancer risk testing.
BLM mutation causes biochemical pathways/processes like Estrogen Signaling, Post Translation Modification, Stem Cell Signaling, DNA Repair and Angiogenesis to get impacted. These pathways are direct or indirect drivers of cancer molecular endpoints. Rosemary should be avoided when the genetic panel identifies mutation of BLM for Breast Cancer. Rosemary impacts pathways/processes like Estrogen Signaling and Post Translation Modification and creates adverse effects with BLM and related conditions.
4. Are Rosemary Supplements Safe for Healthy Individuals with SDHAF2 Mutation Associated Genetic Risk?
SDHAF2 is one of the genes available in panels for cancer risk testing. SDHAF2 mutation causes biochemical pathways/processes like Stem Cell Signaling, Hypoxia, Carbohydrate Metabolism, MAPK Signaling and Angiogenesis to get impacted. These pathways are direct or indirect drivers of cancer molecular endpoints. Consider taking Rosemary supplements when the genetic panel identifies mutation in SDHAF2 for Thyroid Cancer and Neuroendocrine Cancer. Rosemary impacts pathways/processes like Stem Cell Signaling and Hypoxia and creates a supportive effect in those with SDHAF2 mutation and related conditions.
* Other Factors are also included like BMI, Lifestyle Habits, Treatments
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 Rosemary, 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.
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