Nutritional supplements like Folic Acid 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 Folic Acid 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 Folic Acid supplements can benefit HRAS +ve Salivary Gland Cancer patients on Methotrexate treatment. But avoid Folic Acid supplements if on Trametinib treatment for Juvenile Myelomonocytic Leukemia. Similarly, taking nutritional supplement Folic Acid can benefit healthy individuals who are at genetic risk of cancer due to mutation of gene VHL. But avoid taking nutritional supplement Folic Acid when at genetic risk of cancer due to mutation of gene MAX.
The takeaway being – your individual context will influence your decision if nutritional supplement Folic Acid 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 Folic Acid based on individual context and conditions.
So the question is should you take the supplement Folic Acid? Should you take it when at genetic risk of cancer for mutation of gene MAX? Should you take it when at genetic risk of cancer for mutation of gene VHL? Should you take it when diagnosed with Juvenile Myelomonocytic Leukemia? Should you take Folic Acid supplements when diagnosed with HRAS +ve Salivary Gland Cancer? Should you take it when on Trametinib treatment? Should you continue taking Folic Acid supplements if you change your treatment from Trametinib to Methotrexate? So a general explanation like – it is natural or it increases immunity may not be acceptable and sufficient for choosing Folic Acid.
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 Juvenile Myelomonocytic Leukemia or HRAS +ve Salivary Gland Cancer, 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 Folic Acid.
So the question is that are all genetic mutation risks and types of cancers to be considered as one when deciding the use of Folic Acid? Are the biochemical pathway implications of genetic risk for cancer due to mutation of gene MAX the same as due to mutation of gene VHL? Are the implications of taking Folic Acid supplements in Juvenile Myelomonocytic Leukemia the same as HRAS +ve Salivary Gland Cancer? Is it one and the same if you are on treatment Trametinib or on Methotrexate?
Folic Acid – A Nutritional Supplement
Folic acid is the synthetic form of the naturally occurring Vitamin B9 or Folate. It is available in the form of dietary supplements. Folic acid helps the body produce and maintain new, healthy cells – especially Red blood cells. Folate deficiency can lead to many health problems such as anemia, increased risk of heart diseases, and birth defects. Additionally, Folic acid may also help improve brain function and fertility. (Fei Ma et al, Eur J Nutr., 2019; Audrey J Gaskins et al, Obste Gynecol., 2014)
Folic Acid is an active ingredient found in various food items. Barley, Buckwheat and Bulgur contain Folic Acid at different concentration levels along with other active ingredients. The molecular pathways which are regulated by Folic Acid include PI3K-AKT-MTOR Signaling, MYC Signaling, Angiogenesis, RAS-RAF Signaling and MAPK 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 Folic Acid individually or in combination is an important decision to be made. When making decisions on the use of supplement Folic Acid for cancer – do consider all these factors and explanations. Because just as true for cancer treatments – Folic Acid use cannot be a one-size-fits-all decision for all types of cancers.
Choosing Folic Acid Supplements for Your Cancer
The reason there is no easy way to answer the question “When should I avoid Folic Acid for Cancer” is because “It Depends!”. Just like the same treatment does not work for every cancer patient, based on your individual context the Folic Acid 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 Folic Acid should be avoided or not and why.
1. Will Folic Acid Supplements benefit Cancer Patients with Juvenile Myelomonocytic Leukemia undergoing Trametinib treatment?
Juvenile Myelomonocytic Leukemia is characterized and driven by specific genetic mutations like PTPN11 and NRAS leading to biochemical pathway changes in PI3K-AKT-MTOR Signaling, RAS-RAF Signaling, JAK-STAT Signaling, MAPK Signaling and MYC Signaling. A cancer treatment like Trametinib 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, Folic Acid should be avoided for Juvenile Myelomonocytic Leukemia along with treatment Trametinib. Folic Acid impacts pathways/processes like PI3K-AKT-MTOR Signaling and RAS-RAF 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 Folic Acid Supplements benefit HRAS +ve Salivary Gland Cancer Patients undergoing Methotrexate Treatment?
HRAS +ve Salivary Gland Cancer is characterized and driven by specific genetic mutations like CREBBP and KMT2D leading to specific biochemical pathway changes. A cancer treatment like Methotrexate 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, Folic Acid supplements should be considered for HRAS +ve Salivary Gland Cancer along with treatment Methotrexate. Folic Acid supplement impacts specific pathways which either obstruct drivers of the disease and/or improve Methotrexate treatment effect.
Foods to Eat After Cancer Diagnosis!
No two cancers are the same. Go beyond the common nutrition guidelines for everyone and make personalized decisions about food and supplements with confidence.
3. Are Folic Acid Supplements Safe for Healthy Individuals with MAX 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.
MAX is one of the genes generally available in panels for cancer risk testing. MAX mutation causes biochemical pathways/processes like MYC Signaling, MAPK Signaling, Stem Cell Signaling, Angiogenesis and Cancer Epigenetics to get impacted. These pathways are direct or indirect drivers of cancer molecular endpoints. Folic Acid should be avoided when the genetic panel identifies mutation of MAX for Neuroendocrine Cancer. Folic Acid impacts pathways/processes like MYC Signaling and MAPK Signaling and creates adverse effects with MAX and related conditions.
4. Are Folic Acid Supplements Safe for Healthy Individuals with VHL Mutation Associated Genetic Risk?
VHL is one of the genes available in panels for cancer risk testing. VHL mutation causes biochemical pathways/processes like Angiogenesis, Hypoxia, Stem Cell Signaling, Post Translational Modification and Growth Factor Signaling to get impacted. These pathways are direct or indirect drivers of cancer molecular endpoints. Consider taking Folic Acid supplements when the genetic panel identifies mutation in VHL for Kidney Cancer. Folic Acid impacts pathways/processes like Angiogenesis and Hypoxia and creates a supportive effect in those with VHL mutation and related conditions.
* Other Factors are also included like BMI, Treatments, Lifestyle Habits
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 Folic Acid, is an effective tool which can be controlled by you, while facing cancer.
What food you eat and which supplements you take is a decision you make. Your decision should include consideration of the cancer gene mutations, which cancer, ongoing treatments and supplements, any allergies, lifestyle information, weight, height and habits.
The nutrition planning for cancer from addon is not based on internet searches. It automates the decision making for you based on molecular science implemented by our scientists and software engineers. Irrespective of whether you care to understand the underlying biochemical molecular pathways or not - for nutrition planning for cancer that understanding is needed.
Get started NOW with your nutrition planning by answering questions on the name of cancer, genetic mutations, ongoing treatments and supplements, any allergies, habits, lifestyle, age group and gender.
Personalized Nutrition for Cancer!
Cancer changes with time. Customize and modify your nutrition based on cancer indication, treatments, lifestyle, food preferences, allergies and other factors.
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.