Highlights
No two cancers are the same, nor are they treated the same, and neither should nutrition be the same for everyone. Nutrition includes foods like pulses, vegetables, fruits, nuts, oils, herbs and spices. Also nutrition includes supplements which are high concentrations of foods or high concentrations of individual ingredients found in foods. For cancers like Merkel Cell Carcinoma when undergoing chemotherapy or when you determine you have a genetic risk for developing Merkel Cell Carcinoma because of RB1 and SMARCA4 gene mutations, a very important question is “What foods should I avoid and what foods are recommended specifically for me?”. The other related question is “What nutritional supplements should I avoid?”.
There is no one answer to this question for cancers such as Merkel Cell Carcinoma which can be found through internet searches. The answer to the question is “It Depends” because the nutrition plan needs to be personalized for you. Nutrition should depend on the cancer indication, genetic information, adult or pediatric, staging, primary or secondary, advanced, metastatic, relapsed or refractory, ongoing treatments if any, nutritional supplements being taken, age and factors like gender, weight, height, lifestyle, allergies and food preferences.
In short – the process to answer questions like “Should I Avoid eating fruit Bael” or “Include fruit Bilberry in my diet” or “Should I reduce consumption of vegetable Chicory” or “Can I take Guggul and Myricetin supplements” is not as simple as internet searches. The process is very complex and answers are based on knowhow of genetics, action of treatments, active ingredients in foods and their associated biological action. Finally the answer to the nutrition question needs to be personalized for you.
RECOMMENDATION: PERSONALIZE YOUR FOODS AND SUPPLEMENTS TO MERKEL CELL CARCINOMA, TREATMENTS, GENETIC INFORMATION, AND OTHER CONDITIONS.
The overall objective of personalized nutrition for Merkel Cell Carcinoma is to minimize foods and nutritional supplements which have adverse interactions with cancer molecular drivers and ongoing treatments. And identify those foods and supplements which have a beneficial action. Whenever there are changes in treatments or diagnosis – it is important to remember that your foods and supplements need re-evaluation. And the answers to the nutrition question could be different based on the new context.
RECOMMENDATION: UPDATE YOUR NUTRITION FOR MERKEL CELL CARCINOMA, WHEN TREATMENTS, DISEASE STATUS AND OTHER CONDITIONS CHANGE.
About Merkel Cell Carcinoma
cBioPortal is one source of collection of cancer patient data from clinical trials across 350 plus cancer indications. The data from each clinical trial includes the clinical trial name and study details like number of patients, ages, gender, ethnicity, treatments, tumor site, genetic aberrations found and analysis of all the data. The cBioPortal for Cancer Genomics was originally developed at Memorial Sloan Kettering Cancer Center (MSK). The public cBioPortal site is hosted by the Center for Molecular Oncology at MSK – https://www.cbioportal.org/about.
Following key highlights are derived from clinical data for Merkel Cell Carcinoma from cBioPortal. 68.3% of males and 31.7% of females were the distribution of gender in these clinical studies. From a patient sample size of 63; the top genes with mutations and other abnormalities for Merkel Cell Carcinoma include genes TP53, RB1, SMARCA4, KMT2D and KMT2C. The occurrence frequency distribution for these genes respectively is 52.6%, 42.1%, 31.6%, 31.6% and 26.3%. These tumor genetic details of Merkel Cell Carcinoma are mapped to molecular biochemical pathway drivers of cancer thereby providing definition of characteristic features of Merkel Cell Carcinoma.
Significance of Nutrition for Merkel Cell Carcinoma
All foods and nutritional supplements consist of a collection of one or more active chemical ingredients in different proportions and quantities. The action of some active ingredients in a food can have adverse interactions while other active ingredients in the same food may be supportive from the context of Merkel Cell Carcinoma. Hence the same food has good and not-so-good actions and analysis of combined effect will be needed to come up with a personalized nutrition plan.
For example Bael includes active ingredients Beta-sitosterol, Vitamin C, Linolenic Acid, Auraptene, Oleic Acid and others. And Bilberry contains active ingredients Quercetin, Myricetin, Resveratrol, Delphinidin, Caffeic Acid and others. It is likely that some of these active ingredients of the same food could have opposing effects and hence it is recommended to identify recommended foods based on analysis of all high quantity ingredients contained in foods.
For cancers like Merkel Cell Carcinoma, activation or inhibition of selected biochemical pathways like DNA Repair, Cell Cycle, PI3K-AKT-MTOR Signaling, Cell Cycle Checkpoints plays an important role in driving cancer growth. Similarly different treatments work via different molecular actions which should never be canceled out by your foods and supplements. The foods and nutritional supplements contain different active ingredients each of which have a specific molecular action on different biochemical pathways. Hence, eating some foods and nutritional supplements would be recommended with a specific treatment of Merkel Cell Carcinoma, while eating some other foods and supplements may not be recommended.
One common mistake when finding foods to eat or not – is to consider only a few active ingredients contained in foods based on internet searches and ignore the rest. Because different active ingredients contained in foods may have opposing effects on relevant biochemical pathways – it is recommended to consider all the high quantity active ingredients that are present in significant and much larger than trace amounts in the food.

RECOMMENDATION: TO FIND RECOMMENDED AND NON-RECOMMENDED FOODS FOR MERKEL CELL CARCINOMA – CONSIDER HIGH QUANTITY ACTIVE INGREDIENTS CONTAINED IN FOODS.
Foods for Merkel Cell Carcinoma undergoing chemotherapy treatment
In Merkel Cell Carcinoma – the genes TP53, RB1, SMARCA4, KMT2D and KMT2C have high occurrences of genomic abnormalities. Not all of these genes necessarily are relevant for cancer – though they have been reported. Some of these genes directly or indirectly end up manipulating different cancer related biochemical biological pathways. Some of the pathways which are relevant drivers for Merkel Cell Carcinoma are DNA Repair, Cell Cycle, Cytokine Signaling and others. Methotrexate is one of the chemotherapies used for cancer treatment. The intent of treatment is to negate or cancel out effects of biochemical pathway drivers DNA Repair, Cell Cycle, Cytokine Signaling so as to reduce disease progression and inhibit growth. Those foods whose combined action of active ingredients support treatment action and do not enhance disease drivers are recommended foods and supplements which will be included in personalized nutrition. And similarly – those foods whose combined action of active ingredients is not supportive of treatment action but end up promoting disease drives will not be recommended in your personalized nutrition plan.
RECOMMENDATION: AVOID SUPPLEMENTS AND FOODS WHICH ARE NOT SUPPORTIVE OF CANCER TREATMENT ACTION AND RATHER ENHANCE DISEASE DRIVERS.
Eat more pulses, Scarlet Bean or Common Bean?
Pulses are an important part of many diets. The active ingredients contained in Scarlet Bean are Beta-sitosterol, Vitamin C, Stigmasterol, Linolenic Acid, Oleic Acid among others. While the active ingredients contained in Common Bean are Apigenin, Kaempferol, Delphinidin, Vitamin C, Linolenic Acid and others.
Beta-sitosterol can manipulate biochemical pathways Epithelial to Mesenchymal Transition, Adherens junction and Cell Cycle. Vitamin C has biological action on biochemical pathways Growth Factor Signaling, MYC Signaling and WNT Beta Catenin Signaling.
Apigenin can manipulate biochemical pathways Epithelial to Mesenchymal Transition and DNA Repair. Esculin has biological action on biochemical pathways DNA Repair. And so on.
When treating Merkel Cell Carcinoma with chemotherapy Methotrexate – Foods like Scarlet Bean are recommended compared to Common Bean. This is because the active ingredients Apigenin and Esculin in Common Bean interferes with treatment action by canceling out the biochemical pathways through which the chemotherapy works. While the active ingredients Beta-sitosterol and Vitamin C contained in Scarlet Bean support the treatment action by enhancing the biochemical pathway effect through which the chemotherapy works.
RECOMMENDATION: SCARLET BEAN IS RECOMMENDED OVER COMMON BEAN FOR MERKEL CELL CARCINOMA ON TREATMENT WITH CHEMOTHERAPY METHOTREXATE FOR SOME CONDITIONS.
Eat more vegetables, Arugula or Chicory?
Vegetables are an important part of many diets. The active ingredients contained in Arugula are Kaempferol, Esculin, Vitamin A, Vitamin K, Erysolin among others. While the active ingredients contained in Chicory are Quercetin, Betulinic Acid, Apigenin, Lupeol, Luteolin and others.
Kaempferol can manipulate biochemical pathways JAK-STAT Signaling, Cell Cycle and WNT Beta Catenin Signaling. Vitamin A has biological action on biochemical pathways Epithelial to Mesenchymal Transition, Adherens junction and MYC Signaling.
Apigenin can manipulate biochemical pathways Epithelial to Mesenchymal Transition and DNA Repair. Luteolin has biological action on biochemical pathways MYC Signaling and WNT Beta Catenin Signaling. And so on.
When treating Merkel Cell Carcinoma with chemotherapy Methotrexate – Foods like Arugula are recommended compared to Chicory. This is because the active ingredients Apigenin and Luteolin in Chicory interferes with treatment action by canceling out the biochemical pathways through which the chemotherapy works. While the active ingredients Kaempferol and Vitamin A contained in Arugula support the treatment action by enhancing the biochemical pathway effect through which the chemotherapy works.
RECOMMENDATION: ARUGULA IS RECOMMENDED OVER CHICORY FOR MERKEL CELL CARCINOMA ON TREATMENT WITH CHEMOTHERAPY METHOTREXATE FOR SOME CONDITIONS.
Eat more fruits, Bilberry or Bael?
Fruits are an important part of many diets. The active ingredients contained in Bilberry are Quercetin, Myricetin, Resveratrol, Delphinidin, Caffeic Acid among others. While the active ingredients contained in Bael are Beta-sitosterol, Vitamin C, Linolenic Acid, Auraptene, Oleic Acid and others.
Delphinidin can manipulate biochemical pathways Growth Factor Signaling, MYC Signaling and MAPK Signaling. Chlorogenic Acid has biological action on biochemical pathways Epithelial to Mesenchymal Transition, JAK-STAT Signaling and Notch Signaling.
Oleic Acid can manipulate biochemical pathways Epithelial to Mesenchymal Transition. Linoleic Acid has biological action on biochemical pathways Growth Factor Signaling, Angiogenesis and Epithelial to Mesenchymal Transition. And so on.
When treating Merkel Cell Carcinoma with chemotherapy Methotrexate – Foods like Bilberry are recommended compared to Bael. This is because the active ingredients Oleic Acid and Linoleic Acid in Bael interferes with treatment action by canceling out the biochemical pathways through which the chemotherapy works. While the active ingredients Delphinidin and Chlorogenic Acid contained in Bilberry support the treatment action by enhancing the biochemical pathway effect through which the chemotherapy works.
RECOMMENDATION: BILBERRY IS RECOMMENDED OVER BAEL FOR MERKEL CELL CARCINOMA ON TREATMENT WITH CHEMOTHERAPY METHOTREXATE FOR SOME CONDITIONS.
Eat more nuts, Pine Nut or Peanut?
Nuts are an important part of many diets. The active ingredients contained in Pine Nut are Beta-sitosterol, Vitamin E, Linolenic Acid, Oleic Acid, Vitamin A among others. While the active ingredients contained in Peanut are Quercetin, Beta-sitosterol, Vitamin E, Vitamin C, Stigmasterol and others.
Beta-sitosterol can manipulate biochemical pathways Epithelial to Mesenchymal Transition, Adherens junction and Cell Cycle. Vitamin K has biological action on biochemical pathways MYC Signaling, PI3K-AKT-MTOR Signaling and Cell Cycle.
Lecithin can manipulate biochemical pathways JAK-STAT Signaling, MYC Signaling and MAPK Signaling. Oleic Acid has biological action on biochemical pathways Epithelial to Mesenchymal Transition. And so on.
When treating Merkel Cell Carcinoma with chemotherapy Methotrexate – Foods like Pine Nut are recommended compared to Peanut. This is because the active ingredients Lecithin and Oleic Acid in Peanut interferes with treatment action by canceling out the biochemical pathways through which the chemotherapy works. While the active ingredients Beta-sitosterol and Vitamin K contained in Pine Nut support the treatment action by enhancing the biochemical pathway effect through which the chemotherapy works.
RECOMMENDATION: PINE NUT IS RECOMMENDED OVER PEANUT FOR MERKEL CELL CARCINOMA ON TREATMENT WITH CHEMOTHERAPY METHOTREXATE FOR SOME CONDITIONS.

Foods for Genetic Risk of Merkel Cell Carcinoma
One of the ways to assess risk of cancer is by checking for presence of genetic abnormalities in a set of genes. There is prior information on a list of genes whose mutations and other aberrations can play a role in risk to different cancers. RB1 and SMARCA4 are two genes whose abnormalities are risk factors for Merkel Cell Carcinoma. In such a cancer risk situation – while there are typically no treatments which a physician can prescribe – the various biochemical pathways which are potentially molecular drivers of Merkel Cell Carcinoma can be used as a guide for coming up with a recommended personalized nutrition plan. For Merkel Cell Carcinoma gene RB1 has causative impact on biological pathways like Cell Cycle Checkpoints, DNA Repair and Cell Cycle. And SMARCA4 has a causative impact on biological pathways like Androgen Signaling, Chromatin Remodeling and Epithelial to Mesenchymal Transition. Foods and nutritional supplements which have molecular action to cancel out biochemical pathways effects of genes like RB1 and SMARCA4 should be included in a personalized nutrition plan. And those foods and supplements which promote the effects of genes RB1 and SMARCA4 should be avoided.
Eat more pulses, Common Pea or Fava Bean?
The active ingredients contained in Common Pea are Lupeol, Daidzein, Beta-sitosterol, Oleic Acid, Vitamin C among others. While the active ingredients contained in Fava Bean are Quercetin, Daidzein, Beta-sitosterol, Oleic Acid, Vitamin C and others.
Beta-sitosterol can manipulate biochemical pathways Apoptosis, MYC Signaling and P53 Signaling. Vitamin C has biological action on biochemical pathways Cell Cycle Checkpoints, PI3K-AKT-MTOR Signaling and RAS-RAF Signaling.
Quercetin can manipulate biochemical pathways DNA Repair. Ferulic Acid has biological action on biochemical pathways DNA Repair. And so on.
For genetic risk of Merkel Cell Carcinoma due to abnormalities in genes RB1 and SMARCA4 – Foods like Common Pea are recommended compared to Fava Bean. This is because the active ingredients Quercetin and Ferulic Acid in Fava Bean further promote the effects of genes on the biochemical pathways. While the active ingredients Beta-sitosterol and Vitamin C contained in Common Pea together have a canceling effect of genes on the biochemical pathways.
RECOMMENDATION: COMMON PEA IS RECOMMENDED OVER FAVA BEAN FOR REDUCING THE GENETIC RISK OF MERKEL CELL CARCINOMA DUE TO GENES RB1 AND SMARCA4
Eat more vegetables, Cassava or Jute?
The active ingredients contained in Cassava are Beta-sitosterol, Oleic Acid, Vitamin C, Linolenic Acid, Linoleic Acid among others. While the active ingredients contained in Jute are Quercetin, Oleic Acid, Vitamin C, Linolenic Acid, Vitamin B3 and others.
Vitamin C can manipulate biochemical pathways Apoptosis, MYC Signaling and P53 Signaling. Beta-sitosterol has biological action on biochemical pathways Cell Cycle Checkpoints, PI3K-AKT-MTOR Signaling and Apoptosis.
Quercetin can manipulate biochemical pathways DNA Repair. Folic Acid has biological action on biochemical pathways Apoptosis, MYC Signaling and P53 Signaling. And so on.
For genetic risk of Merkel Cell Carcinoma due to abnormalities in genes RB1 and SMARCA4 – Foods like Cassava are recommended compared to Jute. This is because the active ingredients Quercetin and Folic Acid in Jute further promote the effects of genes on the biochemical pathways. While the active ingredients Vitamin C and Beta-sitosterol contained in Cassava together have a canceling effect of genes on the biochemical pathways.
RECOMMENDATION: CASSAVA IS RECOMMENDED OVER JUTE FOR REDUCING THE GENETIC RISK OF MERKEL CELL CARCINOMA DUE TO GENES RB1 AND SMARCA4
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.
Eat more fruits, Feijoa or Raspberry?
The active ingredients contained in Feijoa are Lycopene, Vitamin C, Casuarinin, Folic Acid among others. While the active ingredients contained in Raspberry are Ellagic Acid, Quercetin, Resveratrol, Vitamin C, Salicylic Acid and others.
Vitamin C can manipulate biochemical pathways Apoptosis, MYC Signaling and P53 Signaling. Lycopene has biological action on biochemical pathways Cell Cycle Checkpoints, PI3K-AKT-MTOR Signaling and RAS-RAF Signaling.
Ellagic Acid can manipulate biochemical pathways MYC Signaling and Cell Cycle Checkpoints. Quercetin has biological action on biochemical pathways DNA Repair. And so on.
For genetic risk of Merkel Cell Carcinoma due to abnormalities in genes RB1 and SMARCA4 – Foods like Feijoa are recommended compared to Raspberry. This is because the active ingredients Ellagic Acid and Quercetin in Raspberry further promote the effects of genes on the biochemical pathways. While the active ingredients Vitamin C and Lycopene contained in Feijoa together have a canceling effect of genes on the biochemical pathways.
RECOMMENDATION: FEIJOA IS RECOMMENDED OVER RASPBERRY FOR REDUCING THE GENETIC RISK OF MERKEL CELL CARCINOMA DUE TO GENES RB1 AND SMARCA4
Eat more nuts, Hazelnut or Chestnut?
The active ingredients contained in Hazelnut are Quercetin, Vitamin E, Oleic Acid, Linolenic Acid, Linoleic Acid among others. While the active ingredients contained in Chestnut are Ellagic Acid, Quercetin, Oleic Acid, Vitamin C, Linolenic Acid and others.
Vitamin E can manipulate biochemical pathways Apoptosis, MYC Signaling and P53 Signaling. Vitamin A has biological action on biochemical pathways Cell Cycle Checkpoints, PI3K-AKT-MTOR Signaling and MYC Signaling.
Ellagic Acid can manipulate biochemical pathways MYC Signaling and Cell Cycle Checkpoints. Gallic Acid has biological action on biochemical pathways DNA Repair. And so on.
For genetic risk of Merkel Cell Carcinoma due to abnormalities in genes RB1 and SMARCA4 – Foods like Hazelnut are recommended compared to Chestnut. This is because the active ingredients Ellagic Acid and Gallic Acid in Chestnut further promote the effects of genes on the biochemical pathways. While the active ingredients Vitamin E and Vitamin A contained in Hazelnut together have a canceling effect of genes on the biochemical pathways.
RECOMMENDATION: HAZELNUT IS RECOMMENDED OVER CHESTNUT FOR REDUCING THE GENETIC RISK OF MERKEL CELL CARCINOMA DUE TO GENES RB1 AND SMARCA4

In Summary
An important thing to remember is that cancer treatments may not be the same for everyone – and neither should your nutrition be. Nutrition which includes food and nutritional supplements is a very effective tool controlled by you.
“What should I eat?” is the most frequently asked question in the context of cancer. The answer calculation is complex and depends upon cancer type, underlying genomics, current treatments, any allergies, lifestyle information, and factors like BMI.
The addon personalized nutrition plan recommends foods and supplements which minimizes adverse nutrition interactions and encourages support to treatments.
You can get started NOW and design a personalized nutrition plan for Merkel Cell Carcinoma by answering questions on type of cancer, current treatments, supplements, allergies, age group, gender, and lifestyle information.
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.

References
- Msk Impact 2017
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- Gallic acid provokes DNA damage and suppresses DNA repair gene expression in human prostate cancer PC-3 cells.
- HyperFoods: Machine intelligent mapping of cancer-beating molecules in foods.
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.