Foods for Intraductal Papillary Mucinous Neoplasm!

Introduction

Foods for Intraductal Papillary Mucinous Neoplasm 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.

Intraductal papillary mucinous neoplasm (IPMN) is a type of benign (precancerous) pancreatic cyst in the pancreatic ducts, that can become malignant or cancerous. Not all of these tumor become cancerous, however, 20-30% of the IPMNs transform to pancreatic cancer. IPMNs most often develop in older men from 50-70 years of age. This neoplasm can occur in different locations, including the bile ducts and liver. Symptoms of IPMN may vary or go unnoticed, making regular screenings and check-ups important for early detection. Symptoms of IPMN include stomach pain, unintended weight loss, nausea and vomiting, back pain, jaundice, pancreatitis (inflammation of the pancreas) and possibly new-onset diabetes. Prompt treatment and monitoring are necessary given the potential for the neoplasm to progress to pancreatic cancer. Management of IPMN may involve surgical intervention to remove the affected pancreatic tissue. Prognosis and the likelihood of developing cancer vary depending on the characteristics of the neoplasm.

For Intraductal Papillary Mucinous Neoplasm 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 Intraductal Papillary Mucinous Neoplasm 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 Intraductal Papillary Mucinous Neoplasm?

For example does it matter if vegetable Giant Butterbur is consumed more compared to Chinese Broccoli? Does it make any difference if fruit Pummelo is preferred over Red Raspberry? 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 Intraductal Papillary Mucinous Neoplasm and is it the same answer for everyone with the same diagnosis or genetic risk?

Yes! Foods you eat matters for Intraductal Papillary Mucinous Neoplasm!

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 Pummelo contains active ingredients Quercetin, Curcumin, Isoliquiritigenin, Formononetin, Apigenin. And Red Raspberry contains active ingredients Quercetin, Ellagic Acid, Curcumin, Isoliquiritigenin, Formononetin and possibly others.

A common mistake made when deciding and choosing foods to eat for Intraductal Papillary Mucinous Neoplasm – 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 Intraductal Papillary Mucinous Neoplasm.

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

Skills Needed for Nutrition Personalization for Intraductal Papillary Mucinous Neoplasm?

Personalized nutrition for cancers like Intraductal Papillary Mucinous Neoplasm 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 Intraductal Papillary Mucinous Neoplasm 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 Intraductal Papillary Mucinous Neoplasm

All cancers like Intraductal Papillary Mucinous Neoplasm can be characterized by a unique set of biochemical pathways – the signature pathways of Intraductal Papillary Mucinous Neoplasm. Biochemical pathways like RAS-RAF Signaling, mRNA Splicing, Oncogenic Cancer Epigenetics, DNA Repair are part of the signature definition of Intraductal Papillary Mucinous Neoplasm. Each individual’s cancer genetics can be different and hence their specific cancer signature could be unique.

The treatments which are effective for Intraductal Papillary Mucinous Neoplasm 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 Intraductal Papillary Mucinous Neoplasm when taking cancer treatment Radiation, 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.

DNMT3A, TET2, PPM1D, ASXL1 and CHEK2 are the top ranked reported genes for Intraductal Papillary Mucinous Neoplasm. DNMT3A is reported in 33.4 % of the representative patients across all clinical trials. And TET2 is reported in 11.3 %. The combined population patient data cover ages from 5 to 95. 52.7 % of the patient data are identified as men. The Intraductal Papillary Mucinous Neoplasm 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 Intraductal Papillary Mucinous Neoplasm

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 GIANT BUTTERBUR or CHINESE BROCCOLI?

Vegetable Giant Butterbur contains many active ingredients or bioactives such as Curcumin, Myricetin, Isoliquiritigenin, Luteolin, Formononetin. These active ingredients manipulate various biochemical pathways like MAPK Signaling, DNA Repair, NFKB Signaling and Oxidative Stress and others. Giant Butterbur is recommended for Intraductal Papillary Mucinous Neoplasm when ongoing cancer treatment is Radiation. This is because Giant Butterbur modifies those biochemical pathways which have been scientifically reported to sensitize the effect of Radiation.

Some of the active ingredients or bioactives in vegetable Chinese Broccoli are Curcumin, Myricetin, Isoliquiritigenin, Luteolin, Formononetin. These active ingredients manipulate various biochemical pathways like Oxidative Stress and others. Chinese Broccoli is not recommended for Intraductal Papillary Mucinous Neoplasm when ongoing cancer treatment is Radiation because it modifies those biochemical pathways which make the cancer treatment resistant or less responsive.

VEGETABLE GIANT BUTTERBUR IS RECOMMENDED OVER CHINESE BROCCOLI FOR Intraductal Papillary Mucinous Neoplasm AND TREATMENT Radiation.

Choose Fruit RED RASPBERRY or PUMMELO?

Fruit Red Raspberry contains many active ingredients or bioactives such as Quercetin, Ellagic Acid, Curcumin, Isoliquiritigenin, Formononetin. These active ingredients manipulate various biochemical pathways like MAPK Signaling, DNA Repair, PI3K-AKT-MTOR Signaling and Oxidative Stress and others. Red Raspberry is recommended for Intraductal Papillary Mucinous Neoplasm when ongoing cancer treatment is Radiation. This is because Red Raspberry modifies those biochemical pathways which have been scientifically reported to sensitize the effect of Radiation.

Some of the active ingredients or bioactives in fruit Pummelo are Quercetin, Curcumin, Isoliquiritigenin, Formononetin, Apigenin. These active ingredients manipulate various biochemical pathways like DNA Repair and Oxidative Stress and others. Pummelo is not recommended for Intraductal Papillary Mucinous Neoplasm when ongoing cancer treatment is Radiation because it modifies those biochemical pathways which make the cancer treatment resistant or less responsive.

FRUIT RED RASPBERRY IS RECOMMENDED OVER PUMMELO FOR Intraductal Papillary Mucinous Neoplasm AND TREATMENT Radiation.

Choose Nut BUTTERNUT or EUROPEAN CHESTNUT?

Butternut contains many active ingredients or bioactives such as Curcumin, Myricetin, Isoliquiritigenin, Luteolin, Formononetin. These active ingredients manipulate various biochemical pathways like MAPK Signaling, DNA Repair, Oncogenic Cancer Epigenetics and Focal Adhesion and others. Butternut is recommended for Intraductal Papillary Mucinous Neoplasm when ongoing cancer treatment is Radiation. This is because Butternut modifies those biochemical pathways which have been scientifically reported to sensitize the effect of Radiation.

Some of the active ingredients or bioactives in European Chestnut are Quercetin, Ellagic Acid, Curcumin, Myricetin, Isoliquiritigenin. These active ingredients manipulate various biochemical pathways like Oxidative Stress and others. European Chestnut is not recommended for Intraductal Papillary Mucinous Neoplasm when ongoing cancer treatment is Radiation because it modifies those biochemical pathways which make the cancer treatment resistant or less responsive.

BUTTERNUT IS RECOMMENDED OVER EUROPEAN CHESTNUT FOR Intraductal Papillary Mucinous Neoplasm AND TREATMENT Radiation.

For Individuals with Genetic Risk of Cancer

The question asked by individuals who have genetic risk of Intraductal Papillary Mucinous Neoplasm 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 BITTER GOURD or AGAVE?

Vegetable Bitter Gourd contains many active ingredients or bioactives such as Apigenin, Curcumin, Lupeol, Protocatechuic Acid, Daidzein. These active ingredients manipulate various biochemical pathways like MAPK Signaling, DNA Repair, RAS-RAF Signaling and PI3K-AKT-MTOR Signaling and others. Bitter Gourd is recommended for risk of Intraductal Papillary Mucinous Neoplasm when associated genetic risk is ASXL1. This is because Bitter Gourd increases those biochemical pathways which counteract the signature drivers of it.

Some of the active ingredients or bioactives in vegetable Agave are Apigenin, Curcumin, Lupeol, Protocatechuic Acid, Daidzein. These active ingredients manipulate various biochemical pathways like DNA Repair and others. Agave is not recommended when risk of Intraductal Papillary Mucinous Neoplasm when associated genetic risk is ASXL1 because it increases the signature pathways of it.

VEGETABLE BITTER GOURD IS RECOMMENDED OVER AGAVE FOR ASXL1 GENETIC RISK OF CANCER.

Choose Fruit NANCE or GRAPEFRUIT?

Fruit Nance contains many active ingredients or bioactives such as Apigenin, Curcumin, Lupeol, Protocatechuic Acid, Daidzein. These active ingredients manipulate various biochemical pathways like MAPK Signaling, DNA Repair, RAS-RAF Signaling and PI3K-AKT-MTOR Signaling and others. Nance is recommended for risk of Intraductal Papillary Mucinous Neoplasm when associated genetic risk is ASXL1. This is because Nance increases those biochemical pathways which counteract the signature drivers of it.

Some of the active ingredients or bioactives in fruit Grapefruit are Curcumin, Lycopene, Lupeol, Daidzein, Beta-sitosterol. These active ingredients manipulate various biochemical pathways like DNA Repair and others. Grapefruit is not recommended when risk of Intraductal Papillary Mucinous Neoplasm when associated genetic risk is ASXL1 because it increases the signature pathways of it.

FRUIT NANCE IS RECOMMENDED OVER GRAPEFRUIT FOR ASXL1 GENETIC RISK OF CANCER.

Choose Nut COMMON HAZELNUT or PILI NUT?

Common Hazelnut contains many active ingredients or bioactives such as Curcumin, Lycopene, Lupeol, Protocatechuic Acid, Quercetin. These active ingredients manipulate various biochemical pathways like MAPK Signaling, DNA Repair, RAS-RAF Signaling and Cell Cycle Checkpoints and others. Common Hazelnut is recommended for risk of Intraductal Papillary Mucinous Neoplasm when associated genetic risk is ASXL1. This is because Common Hazelnut increases those biochemical pathways which counteract the signature drivers of it.

Some of the active ingredients or bioactives in Pili Nut are Apigenin, Curcumin, Lycopene, Lupeol, Protocatechuic Acid. These active ingredients manipulate various biochemical pathways like DNA Repair and others. Pili Nut is not recommended when risk of Intraductal Papillary Mucinous Neoplasm when associated genetic risk is ASXL1 because it increases the signature pathways of it.

COMMON HAZELNUT IS RECOMMENDED OVER PILI NUT FOR ASXL1 GENETIC RISK OF CANCER.

In Conclusion

Foods and Supplements chosen are important decisions for cancers like Intraductal Papillary Mucinous Neoplasm. Intraductal Papillary Mucinous Neoplasm 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 Intraductal Papillary Mucinous Neoplasm, 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 Giant Butterbur 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 Intraductal Papillary Mucinous Neoplasm?”. The addon multi-disciplinary team includes cancer physicians, clinical scientists, software engineers and data scientists.

References

• Pancan Pcawg 2020
• Cancer therapy shapes the fitness landscape of clonal hematopoiesis.
• DNA repair and redox activities and inhibitors of apurinic/apyrimidinic endonuclease 1/redox effector factor 1 (APE1/Ref-1): a comparative analysis and their scope and limitations toward anticancer drug development.
• The citrus flavonoid naringenin stimulates DNA repair in prostate cancer cells.
• Lycopene differentially induces quiescence and apoptosis in androgen-responsive and -independent prostate cancer cell lines.
• https://www.ncbi.nlm.nih.gov/books/NBK507779
• https://pathology.jhu.edu/pancreas/ipmn
• https://my.clevelandclinic.org/health/diseases/23176-intraductal-papillary-mucinous-neoplasm-ipmn
• https://www.ncbi.nlm.nih.gov/books/NBK507779