Foods for Myeloproliferative Neoplasms!

Introduction

Foods for Myeloproliferative Neoplasms 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.

Myeloproliferative neoplasms are a group of blood cancers that involve the overproduction of certain types of blood cells in the bone marrow. Accurate coding using the ICD-10 classification system ensures proper documentation of myeloproliferative neoplasms in medical records. Symptoms of myeloproliferative neoplasms can vary depending on the specific type but may include fatigue, night sweats, an enlarged spleen, and increased risk of blood clotting. The survival rate for myeloproliferative neoplasms depends on multiple factors, including the individual’s age, overall health, and response to treatment. The discovery of the JAK2 mutation has been significant in identifying and diagnosing these neoplasms. Classification of myeloproliferative neoplasms helps categorize and guide treatment approaches. Treatment for myeloproliferative neoplasms can vary and may involve medication, blood thinners, chemotherapy, or stem cell transplantation. Pathology outlines provide valuable information regarding the characteristics and features of myeloproliferative neoplasms, aiding in accurate diagnosis and treatment decisions. Understanding the causes and risk factors associated with myeloproliferative neoplasms is a focus of ongoing research. It is important to have comprehensive diagnostic criteria and guidelines, such as those established by the WHO, to ensure accurate diagnosis and appropriate management of myeloproliferative neoplasms. Recognizing the different types of myeloproliferative neoplasms contributes to better understanding and management of these complex blood disorders.

For Myeloproliferative Neoplasms 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 Myeloproliferative Neoplasms 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 Myeloproliferative Neoplasms?

For example does it matter if vegetable Cauliflower is consumed more compared to Swiss Chard? Does it make any difference if fruit Black Elderberry is preferred over Rabbiteye Blueberry? Also if similar choices are made for nuts/seeds like Butternut over European Chestnut and for pulses like Gram Bean over Pigeon Pea. And if what I eat matters – then how does one identify foods which are recommended for Myeloproliferative Neoplasms and is it the same answer for everyone with the same diagnosis or genetic risk?

Yes! Foods you eat matters for Myeloproliferative Neoplasms!

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 Quercetin, Apigenin, Myricetin, Isoliquiritigenin, Curcumin. And Rabbiteye Blueberry contains active ingredients Quercetin, Linalool, Geraniol, Gallic Acid, Eugenol and possibly others.

A common mistake made when deciding and choosing foods to eat for Myeloproliferative Neoplasms – 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 Myeloproliferative Neoplasms.

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

Skills Needed for Nutrition Personalization for Myeloproliferative Neoplasms?

Personalized nutrition for cancers like Myeloproliferative Neoplasms 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 Myeloproliferative Neoplasms 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 Myeloproliferative Neoplasms

All cancers like Myeloproliferative Neoplasms can be characterized by a unique set of biochemical pathways – the signature pathways of Myeloproliferative Neoplasms. Biochemical pathways like Suppressive Histone Methylation, Noncoding RNA Signaling, JAK-STAT Signaling, Cytokine Signaling are part of the signature definition of Myeloproliferative Neoplasms. Each individual’s cancer genetics can be different and hence their specific cancer signature could be unique.

The treatments which are effective for Myeloproliferative Neoplasms 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 Myeloproliferative Neoplasms when taking cancer treatment Dasatinib, 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.

JAK2, CALR, TET2, KMT2D and EP300 are the top ranked reported genes for Myeloproliferative Neoplasms. JAK2 is reported in 43.6 % of the representative patients across all clinical trials. And CALR is reported in 9.7 %. The combined population patient data cover ages from to . 0.0 % of the patient data are identified as men. The Myeloproliferative Neoplasms 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 Myeloproliferative Neoplasms

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 CAULIFLOWER or SWISS CHARD?

Vegetable Cauliflower contains many active ingredients or bioactives such as Isoliquiritigenin, Curcumin, Lupeol, Genistein, Phloretin. These active ingredients manipulate various biochemical pathways like Cell Cycle, Epithelial to Mesenchymal Transition, Inflammation and MYC Signaling and others. Cauliflower is recommended for Myeloproliferative Neoplasms when ongoing cancer treatment is Dasatinib. This is because Cauliflower modifies those biochemical pathways which have been scientifically reported to sensitize the effect of Dasatinib.

Some of the active ingredients or bioactives in vegetable Swiss Chard are Quercetin, Apigenin, Isoliquiritigenin, Curcumin, Kaempferol. These active ingredients manipulate various biochemical pathways like Stem Cell Signaling and Extracellular Matrix Remodelling and others. Swiss Chard is not recommended for Myeloproliferative Neoplasms when ongoing cancer treatment is Dasatinib because it modifies those biochemical pathways which make the cancer treatment resistant or less responsive.

VEGETABLE CAULIFLOWER IS RECOMMENDED OVER SWISS CHARD FOR Myeloproliferative Neoplasms AND TREATMENT Dasatinib.

Choose Fruit RABBITEYE BLUEBERRY or BLACK ELDERBERRY?

Fruit Rabbiteye Blueberry contains many active ingredients or bioactives such as Quercetin, Linalool, Geraniol, Gallic Acid, Eugenol. These active ingredients manipulate various biochemical pathways like Cell Cycle, Epithelial to Mesenchymal Transition, Inflammation and MYC Signaling and others. Rabbiteye Blueberry is recommended for Myeloproliferative Neoplasms when ongoing cancer treatment is Dasatinib. This is because Rabbiteye Blueberry modifies those biochemical pathways which have been scientifically reported to sensitize the effect of Dasatinib.

Some of the active ingredients or bioactives in fruit Black Elderberry are Quercetin, Apigenin, Myricetin, Isoliquiritigenin, Curcumin. These active ingredients manipulate various biochemical pathways like Stem Cell Signaling, PI3K-AKT-MTOR Signaling and MYC Signaling and others. Black Elderberry is not recommended for Myeloproliferative Neoplasms when ongoing cancer treatment is Dasatinib because it modifies those biochemical pathways which make the cancer treatment resistant or less responsive.

FRUIT RABBITEYE BLUEBERRY IS RECOMMENDED OVER BLACK ELDERBERRY FOR Myeloproliferative Neoplasms AND TREATMENT Dasatinib.

Choose Nut BUTTERNUT or EUROPEAN CHESTNUT?

Butternut contains many active ingredients or bioactives such as Apigenin, Myricetin, Isoliquiritigenin, Curcumin, Lycopene. These active ingredients manipulate various biochemical pathways like Cell Cycle, Epithelial to Mesenchymal Transition, Inflammation and MYC Signaling and others. Butternut is recommended for Myeloproliferative Neoplasms when ongoing cancer treatment is Dasatinib. This is because Butternut modifies those biochemical pathways which have been scientifically reported to sensitize the effect of Dasatinib.

Some of the active ingredients or bioactives in European Chestnut are Quercetin, Apigenin, Ellagic Acid, Myricetin, Isoliquiritigenin. These active ingredients manipulate various biochemical pathways like Epithelial to Mesenchymal Transition and Stem Cell Signaling and others. European Chestnut is not recommended for Myeloproliferative Neoplasms when ongoing cancer treatment is Dasatinib because it modifies those biochemical pathways which make the cancer treatment resistant or less responsive.

BUTTERNUT IS RECOMMENDED OVER EUROPEAN CHESTNUT FOR Myeloproliferative Neoplasms AND TREATMENT Dasatinib.

For Individuals with Genetic Risk of Cancer

The question asked by individuals who have genetic risk of Myeloproliferative Neoplasms 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 YELLOW BELL PEPPER or KOHLRABI?

Vegetable Yellow Bell Pepper contains many active ingredients or bioactives such as Curcumin, Salicylic Acid, Formononetin, Quercetin, Isoliquiritigenin. These active ingredients manipulate various biochemical pathways like TGFB Signaling, Post Translation Modification, PI3K-AKT-MTOR Signaling and MYC Signaling and others. Yellow Bell Pepper is recommended for risk of Myeloproliferative Neoplasms when associated genetic risk is CALR. This is because Yellow Bell Pepper increases those biochemical pathways which counteract the signature drivers of it.

Some of the active ingredients or bioactives in vegetable Kohlrabi are Curcumin, Salicylic Acid, Formononetin, Quercetin, Isoliquiritigenin. These active ingredients manipulate various biochemical pathways like TGFB Signaling and WNT Beta Catenin Signaling and others. Kohlrabi is not recommended when risk of Myeloproliferative Neoplasms when associated genetic risk is CALR because it increases the signature pathways of it.

VEGETABLE YELLOW BELL PEPPER IS RECOMMENDED OVER KOHLRABI FOR CALR GENETIC RISK OF CANCER.

Choose Fruit BLACK MULBERRY or SQUASHBERRY?

Fruit Black Mulberry contains many active ingredients or bioactives such as Curcumin, Salicylic Acid, Formononetin, Quercetin, Apigenin. These active ingredients manipulate various biochemical pathways like Post Translation Modification, WNT Beta Catenin Signaling and MYC Signaling and others. Black Mulberry is recommended for risk of Myeloproliferative Neoplasms when associated genetic risk is CALR. This is because Black Mulberry increases those biochemical pathways which counteract the signature drivers of it.

Some of the active ingredients or bioactives in fruit Squashberry are Curcumin, Salicylic Acid, Formononetin, Apigenin, Myricetin. These active ingredients manipulate various biochemical pathways like Post Translation Modification, Cytokine Signaling and Chemokine Signaling and others. Squashberry is not recommended when risk of Myeloproliferative Neoplasms when associated genetic risk is CALR because it increases the signature pathways of it.

FRUIT BLACK MULBERRY IS RECOMMENDED OVER SQUASHBERRY FOR CALR GENETIC RISK OF CANCER.

Choose Nut CHIA or FLAXSEED?

Chia contains many active ingredients or bioactives such as Curcumin, Salicylic Acid, Formononetin, Apigenin, Myricetin. These active ingredients manipulate various biochemical pathways like TGFB Signaling, Histone/Protein Acetylation, WNT Beta Catenin Signaling and MYC Signaling and others. Chia is recommended for risk of Myeloproliferative Neoplasms when associated genetic risk is CALR. This is because Chia increases those biochemical pathways which counteract the signature drivers of it.

Some of the active ingredients or bioactives in Flaxseed are Curcumin, Salicylic Acid, Formononetin, Apigenin, Myricetin. These active ingredients manipulate various biochemical pathways like JAK-STAT Signaling, WNT Beta Catenin Signaling and MYC Signaling and others. Flaxseed is not recommended when risk of Myeloproliferative Neoplasms when associated genetic risk is CALR because it increases the signature pathways of it.

CHIA IS RECOMMENDED OVER FLAXSEED FOR CALR GENETIC RISK OF CANCER.

In Conclusion

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

References

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