Which Foods are Recommended for Urothelial Carcinoma?

Introduction

Foods for Urothelial Carcinoma 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.

Urothelial carcinoma, also known as transitional cell carcinoma, is a type of cancer that originates in the urothelial cells lining the urinary tract. Accurate coding using the ICD-10 system ensures proper documentation of urothelial carcinoma in medical records. Pathology outlines provide important insights into the characteristics and features of urothelial carcinoma, aiding in accurate diagnosis. Radiology techniques play a crucial role in visualizing and evaluating urothelial carcinoma through imaging tests. Urothelial carcinoma commonly occurs in the bladder but can also affect other parts of the urinary tract. Proper treatment for urothelial carcinoma involves a multidisciplinary approach, which may include surgery, radiation therapy, chemotherapy, or immunotherapy, depending on the stage and grade of the cancer. Understanding the causes and risk factors associated with urothelial carcinoma is important, as exposure to certain chemicals, smoking, and chronic bladder infections can increase the risk. Chemotherapy is a commonly used treatment for urothelial carcinoma, especially for advanced or metastatic cases. Recurrence is a concern in urothelial carcinoma, and regular follow-up and surveillance are necessary. Following evidence-based guidelines helps in providing comprehensive and effective management for patients with urothelial carcinoma. By staying informed about the latest advancements and adhering to appropriate treatments, the optimal care can be provided for individuals with urothelial carcinoma.

For Urothelial Carcinoma 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 Urothelial Carcinoma 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 Urothelial Carcinoma?

For example does it matter if vegetable Bitter Gourd is consumed more compared to Chicory? Does it make any difference if fruit Pummelo is preferred over Java Plum? Also if similar choices are made for nuts/seeds like Butternut over Brazil Nut and for pulses like Gram Bean over Yardlong Bean. And if what I eat matters – then how does one identify foods which are recommended for Urothelial Carcinoma and is it the same answer for everyone with the same diagnosis or genetic risk?

Yes! Foods you eat matters for Urothelial Carcinoma!

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, Lupeol, Phloretin, Formononetin. And Java Plum contains active ingredients Curcumin, Ellagic Acid, Lupeol, Phloretin, Formononetin and possibly others.

A common mistake made when deciding and choosing foods to eat for Urothelial Carcinoma – 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 Urothelial Carcinoma.

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

Skills Needed for Nutrition Personalization for Urothelial Carcinoma?

Personalized nutrition for cancers like Urothelial Carcinoma 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 Urothelial Carcinoma 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 Urothelial Carcinoma

All cancers like Urothelial Carcinoma can be characterized by a unique set of biochemical pathways – the signature pathways of Urothelial Carcinoma. Biochemical pathways like Oncogenic Cancer Epigenetics, Suppressive Histone Methylation, PI3K-AKT-MTOR Signaling, MAPK Signaling are part of the signature definition of Urothelial Carcinoma. Each individual’s cancer genetics can be different and hence their specific cancer signature could be unique.

The treatments which are effective for Urothelial Carcinoma 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 Urothelial Carcinoma when taking cancer treatment Nivolumab, 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.

KMT2D, TP53, TERT, PIK3CA and RB1 are the top ranked reported genes for Urothelial Carcinoma. KMT2D is reported in 56.7 % of the representative patients across all clinical trials. And TP53 is reported in 53.3 %. The combined population patient data cover ages from to . 69.8 % of the patient data are identified as men. The Urothelial Carcinoma 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 Urothelial Carcinoma

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 BITTER GOURD or CHICORY?

Vegetable Bitter Gourd contains many active ingredients or bioactives such as Curcumin, Lupeol, Phloretin, Formononetin, Daidzein. These active ingredients manipulate various biochemical pathways like DNA Repair, Myeloid-derived Suppressor Cells, Amino Acid Metabolism and Angiogenesis and others. Bitter Gourd is recommended for Urothelial Carcinoma when ongoing cancer treatment is Nivolumab. This is because Bitter Gourd modifies those biochemical pathways which have been scientifically reported to sensitize the effect of Nivolumab.

Some of the active ingredients or bioactives in vegetable Chicory are Quercetin, Curcumin, Lupeol, Phloretin, Formononetin. These active ingredients manipulate various biochemical pathways like Chromatin Remodeling and Oncogenic Cancer Epigenetics and others. Chicory is not recommended for Urothelial Carcinoma when ongoing cancer treatment is Nivolumab because it modifies those biochemical pathways which make the cancer treatment resistant or less responsive.

VEGETABLE BITTER GOURD IS RECOMMENDED OVER CHICORY FOR Urothelial Carcinoma AND TREATMENT Nivolumab.

Choose Fruit JAVA PLUM or PUMMELO?

Fruit Java Plum contains many active ingredients or bioactives such as Curcumin, Ellagic Acid, Lupeol, Phloretin, Formononetin. These active ingredients manipulate various biochemical pathways like DNA Repair, Myeloid-derived Suppressor Cells, Amino Acid Metabolism and Angiogenesis and others. Java Plum is recommended for Urothelial Carcinoma when ongoing cancer treatment is Nivolumab. This is because Java Plum modifies those biochemical pathways which have been scientifically reported to sensitize the effect of Nivolumab.

Some of the active ingredients or bioactives in fruit Pummelo are Quercetin, Curcumin, Lupeol, Phloretin, Formononetin. These active ingredients manipulate various biochemical pathways like Chromatin Remodeling and WNT Beta Catenin Signaling and others. Pummelo is not recommended for Urothelial Carcinoma when ongoing cancer treatment is Nivolumab because it modifies those biochemical pathways which make the cancer treatment resistant or less responsive.

FRUIT JAVA PLUM IS RECOMMENDED OVER PUMMELO FOR Urothelial Carcinoma AND TREATMENT Nivolumab.

Choose Nut BUTTERNUT or BRAZIL NUT?

Butternut contains many active ingredients or bioactives such as Curcumin, Lupeol, Phloretin, Formononetin, Daidzein. These active ingredients manipulate various biochemical pathways like DNA Repair, Myeloid-derived Suppressor Cells, Amino Acid Metabolism and Angiogenesis and others. Butternut is recommended for Urothelial Carcinoma when ongoing cancer treatment is Nivolumab. This is because Butternut modifies those biochemical pathways which have been scientifically reported to sensitize the effect of Nivolumab.

Some of the active ingredients or bioactives in Brazil Nut are Curcumin, Ellagic Acid, Lupeol, Phloretin, Formononetin. These active ingredients manipulate various biochemical pathways like Angiogenesis, WNT Beta Catenin Signaling and MYC Signaling and others. Brazil Nut is not recommended for Urothelial Carcinoma when ongoing cancer treatment is Nivolumab because it modifies those biochemical pathways which make the cancer treatment resistant or less responsive.

BUTTERNUT IS RECOMMENDED OVER BRAZIL NUT FOR Urothelial Carcinoma AND TREATMENT Nivolumab.

For Individuals with Genetic Risk of Cancer

The question asked by individuals who have genetic risk of Urothelial Carcinoma 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 GIANT BUTTERBUR or MALABAR SPINACH?

Vegetable Giant Butterbur contains many active ingredients or bioactives such as Apigenin, Curcumin, Lupeol, Formononetin, Daidzein. These active ingredients manipulate various biochemical pathways like Cell Cycle, Angiogenesis, DNA Repair and Cell Cycle Checkpoints and others. Giant Butterbur is recommended for risk of Urothelial Carcinoma when associated genetic risk is KMT2D. This is because Giant Butterbur increases those biochemical pathways which counteract the signature drivers of it.

Some of the active ingredients or bioactives in vegetable Malabar Spinach are Apigenin, Curcumin, Quercetin, Lupeol, Formononetin. These active ingredients manipulate various biochemical pathways like DNA Repair, Cell Cycle Checkpoints and Oncogenic Cancer Epigenetics and others. Malabar Spinach is not recommended when risk of Urothelial Carcinoma when associated genetic risk is KMT2D because it increases the signature pathways of it.

VEGETABLE GIANT BUTTERBUR IS RECOMMENDED OVER MALABAR SPINACH FOR KMT2D GENETIC RISK OF CANCER.

Choose Fruit NANCE or GRAPEFRUIT?

Fruit Nance contains many active ingredients or bioactives such as Apigenin, Curcumin, Lupeol, Formononetin, Daidzein. These active ingredients manipulate various biochemical pathways like Cell Cycle, Angiogenesis, DNA Repair and Cell Cycle Checkpoints and others. Nance is recommended for risk of Urothelial Carcinoma when associated genetic risk is KMT2D. 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, Lupeol, Formononetin, Daidzein, Bergapten. These active ingredients manipulate various biochemical pathways like Stem Cell Signaling and Insulin Signaling and others. Grapefruit is not recommended when risk of Urothelial Carcinoma when associated genetic risk is KMT2D because it increases the signature pathways of it.

FRUIT NANCE IS RECOMMENDED OVER GRAPEFRUIT FOR KMT2D GENETIC RISK OF CANCER.

Choose Nut COMMON WALNUT or EUROPEAN CHESTNUT?

Common Walnut contains many active ingredients or bioactives such as Curcumin, Quercetin, Lupeol, Formononetin, Ellagic Acid. These active ingredients manipulate various biochemical pathways like DNA Repair, Cell Cycle and Insulin Signaling and others. Common Walnut is recommended for risk of Urothelial Carcinoma when associated genetic risk is KMT2D. This is because Common Walnut increases those biochemical pathways which counteract the signature drivers of it.

Some of the active ingredients or bioactives in European Chestnut are Apigenin, Curcumin, Quercetin, Lupeol, Formononetin. These active ingredients manipulate various biochemical pathways like Stem Cell Signaling, Oncogenic Cancer Epigenetics and Cell Cycle Checkpoints and others. European Chestnut is not recommended when risk of Urothelial Carcinoma when associated genetic risk is KMT2D because it increases the signature pathways of it.

COMMON WALNUT IS RECOMMENDED OVER EUROPEAN CHESTNUT FOR KMT2D GENETIC RISK OF CANCER.

In Conclusion

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

References

• Msk Impact 2017
• Mutational landscape of metastatic cancer revealed from prospective clinical sequencing of 10,000 patients.
• Negative regulation of signal transducer and activator of transcription-3 signalling cascade by lupeol inhibits growth and induces apoptosis in hepatocellular carcinoma cells.
• Betulinic acid inhibits prostate cancer growth through inhibition of specificity protein transcription factors.
• New concepts in phospholipase D signaling in inflammation and cancer.
• Dietary D-glucarate effects on the biomarkers of inflammation during early post-initiation stages of benzo[a]pyrene-induced lung tumorigenesis in A/J mice.