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 Cholangiocarcinoma when undergoing chemotherapy or when you determine you have a genetic risk for developing Cholangiocarcinoma because of SMAD4 and EPHA2 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 Cholangiocarcinoma 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 Sapota” or “Include fruit Persimmon in my diet” or “Should I reduce consumption of vegetable Garland Chrysanthemum” or “Can I take Dim and Birch 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 CHOLANGIOCARCINOMA, TREATMENTS, GENETIC INFORMATION, AND OTHER CONDITIONS.
The overall objective of personalized nutrition for Cholangiocarcinoma 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 CHOLANGIOCARCINOMA, WHEN TREATMENTS, DISEASE STATUS AND OTHER CONDITIONS CHANGE.
About Cholangiocarcinoma
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 Cholangiocarcinoma from cBioPortal. The patients enrolled in the studies for Cholangiocarcinoma are in ages between 19 to 89 with an average age of 64. 55.5% of males and 44.5% of females were the distribution of gender in these clinical studies. From a patient sample size of 1030; the top genes with mutations and other abnormalities for Cholangiocarcinoma include genes KRAS, SMAD4, MUC16, EPHA2 and RYR2. The occurrence frequency distribution for these genes respectively is 8.4%, 6.7%, 4.9%, 4.0% and 3.6%. These tumor genetic details of Cholangiocarcinoma are mapped to molecular biochemical pathway drivers of cancer thereby providing definition of characteristic features of Cholangiocarcinoma.
Cholangiocarcinoma is a cancer of the bile duct, a rare but aggressive cancer. Bile duct system is a series of tubes that begin in the liver where bile is made, and ends in the small intestines. Bile is a digestive enzyme that helps break down fats and digest foods. Cholangiocarcinoma that occurs in the bile duct inside the liver is called intrahepatic and if it occurs in the duct outside the liver, it is called extrahepatic cholangiocarcinoma. Being an aggressive cancer and diagnosed in late stages, cholangiocarcinoma has a poor prognosis with a 5-year survival rate of less than 10%. (American Cancer Society). It is a rare cancer but most common in people older than age 70 years. Symptoms of cholangiocarcinoma usually manifest in later stages of the disease, and they include a jaundice (yellowing of the kin and the whites of the eyes, itchy skin, dark colored urine), unintentional weight loss and abdominal pain. Treatment options for cholangiocarcinoma include adjuvant or palliative therapy with chemotherapy, immunotherapy, or targeted therapy. Supportive nutrition (foods and natural supplements) that are complimentary to the treatment plan can help with patient well-being. (Ref: https://www.cancer.gov/types/liver/hp/bile-duct-treatment-pdq ; https://my.clevelandclinic.org/health/diseases/21524-cholangiocarcinoma)
Significance of Nutrition for Cholangiocarcinoma
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 Cholangiocarcinoma. 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 Sapota includes active ingredients Lycopene, Beta-sitosterol, Vitamin C, Linolenic Acid, Gallic Acid and others. And Persimmon contains active ingredients Quercetin, Lycopene, Betulinic Acid, Lupeol, Vitamin C 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 Cholangiocarcinoma, activation or inhibition of selected biochemical pathways like Amino Acid Metabolism, Angiogenesis, PI3K-AKT-MTOR Signaling, RAS-RAF Signaling 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 Cholangiocarcinoma, 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 CHOLANGIOCARCINOMA – CONSIDER HIGH QUANTITY ACTIVE INGREDIENTS CONTAINED IN FOODS.
Foods for Cholangiocarcinoma undergoing chemotherapy treatment
In Cholangiocarcinoma – the genes KRAS, SMAD4, MUC16, EPHA2 and RYR2 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 Cholangiocarcinoma are Amino Acid Metabolism, Angiogenesis, PI3K-AKT-MTOR Signaling and others. Fluorouracil is one of the chemotherapies used for cancer treatment. The intent of treatment is to negate or cancel out effects of biochemical pathway drivers Amino Acid Metabolism, Angiogenesis, PI3K-AKT-MTOR 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 Pigeon Pea?
Pulses are an important part of many diets. The active ingredients contained in Scarlet Bean are Beta-sitosterol, Vitamin C, Linolenic Acid, Stigmasterol, Oleic Acid among others. While the active ingredients contained in Pigeon Pea are Vitamin C, Linolenic Acid, Oleic Acid, Genistein, Vitamin A and others.
Beta-sitosterol can manipulate biochemical pathways Epithelial to Mesenchymal Transition, NFKB Signaling and Adherens junction. Vitamin C has biological action on biochemical pathways MYC Signaling, WNT Beta Catenin Signaling and P53 Signaling.
Genistein can manipulate biochemical pathways DNA Repair and Oxidative Stress. Vitamin A has biological action on biochemical pathways Focal Adhesion. And so on.
When treating Cholangiocarcinoma with chemotherapy Fluorouracil – Foods like Scarlet Bean are recommended compared to Pigeon Pea. This is because the active ingredients Genistein and Vitamin A in Pigeon Pea 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 PIGEON PEA FOR CHOLANGIOCARCINOMA ON TREATMENT WITH CHEMOTHERAPY FLUOROURACIL FOR SOME CONDITIONS.
Eat more vegetables, Kohlrabi or Garland Chrysanthemum?
Vegetables are an important part of many diets. The active ingredients contained in Kohlrabi are Beta-sitosterol, Sulforaphane, Vitamin C, Linolenic Acid, Brassinin among others. While the active ingredients contained in Garland Chrysanthemum are Vitamin C, Vitamin A, Folic Acid and others.
Vitamin C can manipulate biochemical pathways Epithelial to Mesenchymal Transition, Adherens junction and MYC Signaling. Brassinin has biological action on biochemical pathways NFKB Signaling, WNT Beta Catenin Signaling and P53 Signaling.
Vitamin A can manipulate biochemical pathways Focal Adhesion. Folic Acid has biological action on biochemical pathways MYC Signaling, P53 Signaling and Vitamin D Signaling. And so on.
When treating Cholangiocarcinoma with chemotherapy Fluorouracil – Foods like Kohlrabi are recommended compared to Garland Chrysanthemum. This is because the active ingredients Vitamin A and Folic Acid in Garland Chrysanthemum interferes with treatment action by canceling out the biochemical pathways through which the chemotherapy works. While the active ingredients Vitamin C and Brassinin contained in Kohlrabi support the treatment action by enhancing the biochemical pathway effect through which the chemotherapy works.
RECOMMENDATION: KOHLRABI IS RECOMMENDED OVER GARLAND CHRYSANTHEMUM FOR CHOLANGIOCARCINOMA ON TREATMENT WITH CHEMOTHERAPY FLUOROURACIL FOR SOME CONDITIONS.
Eat more fruits, Persimmon or Sapota?
Fruits are an important part of many diets. The active ingredients contained in Persimmon are Quercetin, Lycopene, Betulinic Acid, Lupeol, Vitamin C among others. While the active ingredients contained in Sapota are Lycopene, Beta-sitosterol, Vitamin C, Linolenic Acid, Gallic Acid and others.
Lycopene can manipulate biochemical pathways Epithelial to Mesenchymal Transition, NFKB Signaling and Adherens junction. Vitamin C has biological action on biochemical pathways MYC Signaling, WNT Beta Catenin Signaling and P53 Signaling.
Vitamin A can manipulate biochemical pathways Focal Adhesion. Citric Acid has biological action on biochemical pathways Oxidative Stress. And so on.
When treating Cholangiocarcinoma with chemotherapy Fluorouracil – Foods like Persimmon are recommended compared to Sapota. This is because the active ingredients Vitamin A and Citric Acid in Sapota interferes with treatment action by canceling out the biochemical pathways through which the chemotherapy works. While the active ingredients Lycopene and Vitamin C contained in Persimmon support the treatment action by enhancing the biochemical pathway effect through which the chemotherapy works.
RECOMMENDATION: PERSIMMON IS RECOMMENDED OVER SAPOTA FOR CHOLANGIOCARCINOMA ON TREATMENT WITH CHEMOTHERAPY FLUOROURACIL FOR SOME CONDITIONS.
Eat more nuts, Walnut or Acorn?
Nuts are an important part of many diets. The active ingredients contained in Walnut are Quercetin, Ellagic Acid, Myricetin, Betulinic Acid, D-limonene among others. While the active ingredients contained in Acorn are Quercetin, Beta-sitosterol, Vitamin C, Gallic Acid, Beta-carotene and others.
Ellagic Acid can manipulate biochemical pathways NFKB Signaling, Adherens junction and Microtubule Dynamics. Myricetin has biological action on biochemical pathways Epithelial to Mesenchymal Transition, DNA Repair and MYC Signaling.
Quercetin can manipulate biochemical pathways Oxidative Stress, Hypoxia and Nucleotide metabolism. Gallic Acid has biological action on biochemical pathways Vitamin D Signaling and Oxidative Stress. And so on.
When treating Cholangiocarcinoma with chemotherapy Fluorouracil – Foods like Walnut are recommended compared to Acorn. This is because the active ingredients Quercetin and Gallic Acid in Acorn interferes with treatment action by canceling out the biochemical pathways through which the chemotherapy works. While the active ingredients Ellagic Acid and Myricetin contained in Walnut support the treatment action by enhancing the biochemical pathway effect through which the chemotherapy works.
RECOMMENDATION: WALNUT IS RECOMMENDED OVER ACORN FOR CHOLANGIOCARCINOMA ON TREATMENT WITH CHEMOTHERAPY FLUOROURACIL FOR SOME CONDITIONS.
Foods for Genetic Risk of Cholangiocarcinoma
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. SMAD4 and EPHA2 are two genes whose abnormalities are risk factors for Cholangiocarcinoma. 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 Cholangiocarcinoma can be used as a guide for coming up with a recommended personalized nutrition plan. For Cholangiocarcinoma gene SMAD4 has causative impact on biological pathways like TGFB Signaling, Inflammation and Cell Cycle. And EPHA2 has a causative impact on biological pathways like Adherens junction and Cytoskeletal Dynamics. Foods and nutritional supplements which have molecular action to cancel out biochemical pathways effects of genes like SMAD4 and EPHA2 should be included in a personalized nutrition plan. And those foods and supplements which promote the effects of genes SMAD4 and EPHA2 should be avoided.
Eat more pulses, Common Pea or Soy Bean?
The active ingredients contained in Common Pea are Lupeol, Daidzein, Vitamin C, Linolenic Acid, Beta-sitosterol among others. While the active ingredients contained in Soy Bean are Lupeol, Vitamin E, Daidzein, Vitamin C, Quercetin 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 Oncogenic Cancer Epigenetics.
Aescin can manipulate biochemical pathways Cell Cycle Checkpoints. Lecithin has biological action on biochemical pathways MYC Signaling, MAPK Signaling and PI3K-AKT-MTOR Signaling. And so on.
For genetic risk of Cholangiocarcinoma due to abnormalities in genes SMAD4 and EPHA2 – Foods like Common Pea are recommended compared to Soy Bean. This is because the active ingredients Aescin and Lecithin in Soy Bean further promote the effects of genes on the biochemical pathways. While the active ingredients Vitamin C and Beta-sitosterol contained in Common Pea together have a canceling effect of genes on the biochemical pathways.
RECOMMENDATION: COMMON PEA IS RECOMMENDED OVER SOY BEAN FOR REDUCING THE GENETIC RISK OF CHOLANGIOCARCINOMA DUE TO GENES SMAD4 AND EPHA2
Eat more vegetables, Jicama or Bell Pepper?
The active ingredients contained in Jicama are Vitamin C, Beta-carotene, Vitamin B3, Vitamin A, Folic Acid among others. While the active ingredients contained in Bell Pepper are Vitamin E, Vitamin C, Linolenic Acid, Capsaicin, P-coumaric Acid and others.
Vitamin C can manipulate biochemical pathways Apoptosis, MYC Signaling and P53 Signaling. Beta-carotene has biological action on biochemical pathways Cell Cycle Checkpoints, PI3K-AKT-MTOR Signaling and Oncogenic Cancer Epigenetics.
Capsaicin can manipulate biochemical pathways MAPK Signaling. Folic Acid has biological action on biochemical pathways Apoptosis, MYC Signaling and P53 Signaling. And so on.
For genetic risk of Cholangiocarcinoma due to abnormalities in genes SMAD4 and EPHA2 – Foods like Jicama are recommended compared to Bell Pepper. This is because the active ingredients Capsaicin and Folic Acid in Bell Pepper further promote the effects of genes on the biochemical pathways. While the active ingredients Vitamin C and Beta-carotene contained in Jicama together have a canceling effect of genes on the biochemical pathways.
RECOMMENDATION: JICAMA IS RECOMMENDED OVER BELL PEPPER FOR REDUCING THE GENETIC RISK OF CHOLANGIOCARCINOMA DUE TO GENES SMAD4 AND EPHA2
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 Huckleberry?
The active ingredients contained in Feijoa are Lycopene, Vitamin C, Casuarinin, Folic Acid among others. While the active ingredients contained in Huckleberry are Vitamin C, Resveratrol, Quercetin, Ferulic Acid, P-coumaric 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, MAPK Signaling and PI3K-AKT-MTOR Signaling.
Resveratrol can manipulate biochemical pathways P53 Signaling. Pelargonidin has biological action on biochemical pathways MYC Signaling, Cell Cycle Checkpoints and PI3K-AKT-MTOR Signaling. And so on.
For genetic risk of Cholangiocarcinoma due to abnormalities in genes SMAD4 and EPHA2 – Foods like Feijoa are recommended compared to Huckleberry. This is because the active ingredients Resveratrol and Pelargonidin in Huckleberry 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 HUCKLEBERRY FOR REDUCING THE GENETIC RISK OF CHOLANGIOCARCINOMA DUE TO GENES SMAD4 AND EPHA2
Eat more nuts, Pecan Nut or Peanut?
The active ingredients contained in Pecan Nut are Vitamin E, Cianidanol, Linolenic Acid, Oleic Acid, Linoleic Acid among others. While the active ingredients contained in Peanut are Vitamin E, Vitamin C, Quercetin, Linolenic Acid, Beta-sitosterol and others.
Vitamin E can manipulate biochemical pathways Apoptosis, MYC Signaling and P53 Signaling. Cianidanol has biological action on biochemical pathways Cell Cycle Checkpoints, MAPK Signaling and PI3K-AKT-MTOR Signaling.
Lecithin can manipulate biochemical pathways MYC Signaling, MAPK Signaling and PI3K-AKT-MTOR Signaling. Folic Acid has biological action on biochemical pathways Apoptosis, P53 Signaling and Cell Cycle Checkpoints. And so on.
For genetic risk of Cholangiocarcinoma due to abnormalities in genes SMAD4 and EPHA2 – Foods like Pecan Nut are recommended compared to Peanut. This is because the active ingredients Lecithin and Folic Acid in Peanut further promote the effects of genes on the biochemical pathways. While the active ingredients Vitamin E and Cianidanol contained in Pecan Nut together have a canceling effect of genes on the biochemical pathways.
RECOMMENDATION: PECAN NUT IS RECOMMENDED OVER PEANUT FOR REDUCING THE GENETIC RISK OF CHOLANGIOCARCINOMA DUE TO GENES SMAD4 AND EPHA2
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 Cholangiocarcinoma 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
- Chol Tcga Pan Can Atlas 2018
- Regional differences in gallbladder cancer pathogenesis: Insights from a multi-institutional comparison of tumor mutations.
- Paederia foetida induces anticancer activity by modulating chromatin modification enzymes and altering pro-inflammatory cytokine gene expression in human prostate cancer cells.
- The synergy of Vitamin C with decitabine activates TET2 in leukemic cells and significantly improves overall survival in elderly patients with acute myeloid leukemia.
- BRCA1 and BRCA2 as molecular targets for phytochemicals indole-3-carbinol and genistein in breast and prostate cancer cells.
- Adhesion to the extracellular matrix is positively regulated by retinoic acid in HepG2 cells.
- Lycopene differentially induces quiescence and apoptosis in androgen-responsive and -independent prostate cancer cell lines.
- Brassinin Represses Invasive Potential of Lung Carcinoma Cells through Deactivation of PI3K/Akt/mTOR Signaling Cascade.
- Sequential protooncogene expression in regenerating kidney following acute renal injury.
- Indeno[1,2-b]indole derivatives as a novel class of potent human protein kinase CK2 inhibitors.
- Myricetin suppresses p21-activated kinase 1 in human breast cancer MCF-7 cells through downstream signaling of the β-catenin pathway.
- Structure-based virtual screening approach to the discovery of novel inhibitors of factor-inhibiting HIF-1: identification of new chelating groups for the active-site ferrous ion.
- Cardioprotective effect of gallic acid on cardiac troponin-T, cardiac marker enzymes, lipid peroxidation products and antioxidants in experimentally induced myocardial infarction in Wistar rats.
- The recruitment of Raf-1 to membranes is mediated by direct interaction with phosphatidic acid and is independent of association with Ras.
- Resveratrol, a remarkable inhibitor of ribonucleotide reductase.
- Pelargonidin suppresses adipogenesis in 3T3-L1 cells through inhibition of PPAR-γ signaling pathway.
- Effects of β-carotene on Expression of Selected MicroRNAs, Histone Acetylation, and DNA Methylation in Colon Cancer Stem Cells.
- Triggering of transient receptor potential vanilloid type 1 (TRPV1) by capsaicin induces Fas/CD95-mediated apoptosis of urothelial cancer cells in an ATM-dependent manner.
- Gamma-tocotrienol-induced apoptosis in human gastric cancer SGC-7901 cells is associated with a suppression in mitogen-activated protein kinase signalling.
- Molecular docking analysis of Cianidanol fromGinkgo biloba with HER2+ breast cancer target.
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.