Which Foods are Recommended for Ewing Sarcoma?

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 Ewing Sarcoma when undergoing chemotherapy or when you determine you have a genetic risk for developing Ewing Sarcoma because of STAG2 and RYR2 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 Ewing Sarcoma 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 Apricot” or “Include fruit Persimmon in my diet” or “Should I reduce consumption of vegetable Yardlong Bean” or “Can I take Guggul and D-limonene 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 EWING SARCOMA, TREATMENTS, GENETIC INFORMATION, AND OTHER CONDITIONS.

The overall objective of personalized nutrition for Ewing Sarcoma 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 EWING SARCOMA, WHEN TREATMENTS, DISEASE STATUS AND OTHER CONDITIONS CHANGE.

About Ewing Sarcoma

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 Ewing Sarcoma from cBioPortal. The patients enrolled in the studies for Ewing Sarcoma are in ages between 1 to 79 with an average age of 16. 56.2% of males and 43.8% of females were the distribution of gender in these clinical studies. From a patient sample size of 413; the top genes with mutations and other abnormalities for Ewing Sarcoma include genes STAG2, TP53, RYR2, EZH2 and HSD3B2. The occurrence frequency distribution for these genes respectively is 10.5%, 4.7%, 1.8%, 1.8% and 1.2%. These tumor genetic details of Ewing Sarcoma are mapped to molecular biochemical pathway drivers of cancer thereby providing definition of characteristic features of Ewing Sarcoma.

Ewing sarcoma is the second most common primary malignant bone tumor and an aggressive tumor mostly affecting adolescents and young adults, and about 30% cases in adults over the age of 20. There is male predominance with males being diagnosed with Ewing sarcoma in a 3 to 1 ratio over females. Ewing sarcoma family of tumors are characterized by the presence of non-random chromosomal translocations producing fusion genes that encode aberrant transcription factors. The most common locations for Ewing sarcoma are the pelvis, axial skeleton and femur, however, it may occur in almost any bone or soft tissue. Patients typically present with symptoms of pain, stiffness or swelling over the site of involvement and many patients have intermittent pain that worsens at night. There has been considerable progress in the treatment of localized Ewing sarcoma with local therapy and multiagent adjuvant chemotherapy, improving the 5-year survival rate from 20% to greater than 70% in the last 40 years. About 25% of patients with initially localized disease ultimately relapse. There is no standard therapy that exists for relapsed and refractory Ewing sarcoma, with survival rates being less than 30% in those with isolated lung metastases and less than 20% in those with bone and bone marrow involvement. The right nutrition (foods and supplements) aligned to the treatment context can help improve survival and quality of life in the patients with Ewing sarcoma. (Ref: https://www.ncbi.nlm.nih.gov/books/NBK559183/)

Significance of Nutrition for Ewing Sarcoma

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 Ewing Sarcoma. 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 Apricot includes active ingredients Quercetin, Modified Citrus Pectin, Beta-sitosterol, Oleic Acid, Salicylic Acid and others. And Persimmon contains active ingredients Lycopene, Quercetin, Lupeol, Betulinic Acid, Fisetin 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 Ewing Sarcoma, activation or inhibition of selected biochemical pathways like Cell Cycle, Cytoskeletal Dynamics, 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 Ewing Sarcoma, 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 EWING SARCOMA – CONSIDER HIGH QUANTITY ACTIVE INGREDIENTS CONTAINED IN FOODS.

Foods for Ewing Sarcoma undergoing chemotherapy treatment

In Ewing Sarcoma – the genes STAG2, TP53, RYR2, EZH2 and HSD3B2 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 Ewing Sarcoma are Cell Cycle, Cytoskeletal Dynamics, Adherens junction and others. Vincristine is one of the chemotherapies used for cancer treatment. The intent of treatment is to negate or cancel out effects of biochemical pathway drivers Cell Cycle, Cytoskeletal Dynamics, Adherens junction 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, Common Pea or Common Bean?

Pulses are an important part of many diets. The active ingredients contained in Common Pea are Lupeol, Beta-sitosterol, Daidzein, Oleic Acid, Genistein among others. While the active ingredients contained in Common Bean are Apigenin, Esculin, Oleic Acid, Ferulic Acid, Genistein and others.

Beta-sitosterol can manipulate biochemical pathways Epithelial to Mesenchymal Transition, NFKB Signaling and Apoptosis. Vitamin C has biological action on biochemical pathways Carbohydrate Metabolism, Adherens junction and Cell Cycle.

Apigenin can manipulate biochemical pathways Epithelial to Mesenchymal Transition and PI3K-AKT-MTOR Signaling. P-coumaric Acid has biological action on biochemical pathways Carbohydrate Metabolism. And so on.

When treating Ewing Sarcoma with chemotherapy Vincristine – Foods like Common Pea are recommended compared to Common Bean. This is because the active ingredients Apigenin and P-coumaric Acid 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 Common Pea support the treatment action by enhancing the biochemical pathway effect through which the chemotherapy works.

RECOMMENDATION: COMMON PEA IS RECOMMENDED OVER COMMON BEAN FOR EWING SARCOMA ON TREATMENT WITH CHEMOTHERAPY VINCRISTINE FOR SOME CONDITIONS.

Eat more vegetables, Kohlrabi or Yardlong Bean?

Vegetables are an important part of many diets. The active ingredients contained in Kohlrabi are Beta-sitosterol, Oleic Acid, Brassinin, Indole-3-carbinol, Vitamin C among others. While the active ingredients contained in Yardlong Bean are Oleic Acid, Vitamin C, Linolenic Acid, Vitamin A, Linoleic Acid and others.

Brassinin can manipulate biochemical pathways Epithelial to Mesenchymal Transition, NFKB Signaling and Apoptosis. Vitamin C has biological action on biochemical pathways Carbohydrate Metabolism, Adherens junction and Cell Cycle.

Oleic Acid can manipulate biochemical pathways Epithelial to Mesenchymal Transition and Cytoskeletal Dynamics. Linoleic Acid has biological action on biochemical pathways Epithelial to Mesenchymal Transition. And so on.

When treating Ewing Sarcoma with chemotherapy Vincristine – Foods like Kohlrabi are recommended compared to Yardlong Bean. This is because the active ingredients Oleic Acid and Linoleic Acid in Yardlong Bean interferes with treatment action by canceling out the biochemical pathways through which the chemotherapy works. While the active ingredients Brassinin and Vitamin C contained in Kohlrabi support the treatment action by enhancing the biochemical pathway effect through which the chemotherapy works.

RECOMMENDATION: KOHLRABI IS RECOMMENDED OVER YARDLONG BEAN FOR EWING SARCOMA ON TREATMENT WITH CHEMOTHERAPY VINCRISTINE FOR SOME CONDITIONS.

Eat more fruits, Persimmon or Apricot?

Fruits are an important part of many diets. The active ingredients contained in Persimmon are Lycopene, Quercetin, Lupeol, Betulinic Acid, Fisetin among others. While the active ingredients contained in Apricot are Quercetin, Modified Citrus Pectin, Beta-sitosterol, Oleic Acid, Salicylic Acid and others.

Lycopene can manipulate biochemical pathways Epithelial to Mesenchymal Transition, NFKB Signaling and Apoptosis. Vitamin C has biological action on biochemical pathways Carbohydrate Metabolism, Adherens junction and Cell Cycle.

Rutin can manipulate biochemical pathways WNT Beta Catenin Signaling. Oleic Acid has biological action on biochemical pathways Epithelial to Mesenchymal Transition and Cytoskeletal Dynamics. And so on.

When treating Ewing Sarcoma with chemotherapy Vincristine – Foods like Persimmon are recommended compared to Apricot. This is because the active ingredients Rutin and Oleic Acid in Apricot 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 APRICOT FOR EWING SARCOMA ON TREATMENT WITH CHEMOTHERAPY VINCRISTINE FOR SOME CONDITIONS.

Eat more nuts, Hazelnut or Brazil Nut?

Nuts are an important part of many diets. The active ingredients contained in Hazelnut are Quercetin, Vitamin E, Oleic Acid, Linolenic Acid, Vitamin A among others. While the active ingredients contained in Brazil Nut are Vitamin E, Oleic Acid, Linolenic Acid, Lecithin, Folic Acid and others.

Quercetin can manipulate biochemical pathways Epithelial to Mesenchymal Transition, Carbohydrate Metabolism and Apoptosis. Vitamin E has biological action on biochemical pathways NFKB Signaling, Cell Cycle and Cell Survival.

Lecithin can manipulate biochemical pathways MYC Signaling, NFKB Signaling and MAPK Signaling. Oleic Acid has biological action on biochemical pathways Epithelial to Mesenchymal Transition and Cytoskeletal Dynamics. And so on.

When treating Ewing Sarcoma with chemotherapy Vincristine – Foods like Hazelnut are recommended compared to Brazil Nut. This is because the active ingredients Lecithin and Oleic Acid in Brazil Nut interferes with treatment action by canceling out the biochemical pathways through which the chemotherapy works. While the active ingredients Quercetin and Vitamin E contained in Hazelnut support the treatment action by enhancing the biochemical pathway effect through which the chemotherapy works.

RECOMMENDATION: HAZELNUT IS RECOMMENDED OVER BRAZIL NUT FOR EWING SARCOMA ON TREATMENT WITH CHEMOTHERAPY VINCRISTINE FOR SOME CONDITIONS.

Foods for Genetic Risk of Ewing Sarcoma

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. STAG2 and RYR2 are two genes whose abnormalities are risk factors for Ewing Sarcoma. 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 Ewing Sarcoma can be used as a guide for coming up with a recommended personalized nutrition plan. For Ewing Sarcoma gene STAG2 has causative impact on biological pathways like Cell Cycle, Cell Cycle and Post Translation Modification. And RYR2 has a causative impact on biological pathways like G-protein-coupled Receptor Signaling and G-protein-coupled Receptor Signaling. Foods and nutritional supplements which have molecular action to cancel out biochemical pathways effects of genes like STAG2 and RYR2 should be included in a personalized nutrition plan. And those foods and supplements which promote the effects of genes STAG2 and RYR2 should be avoided.

Eat more pulses, Mung Bean or Soy Bean?

The active ingredients contained in Mung Bean are Quercetin, Linolenic Acid, Oleic Acid, Vitamin C, Vitexin among others. While the active ingredients contained in Soy Bean are Lupeol, Quercetin, Daidzein, Vitamin E, Beta-sitosterol and others.

Quercetin can manipulate biochemical pathways Small Molecule Transport, Apoptosis and MYC Signaling. Vitamin C has biological action on biochemical pathways P53 Signaling, Cell Cycle Checkpoints and PI3K-AKT-MTOR Signaling.

Aescin can manipulate biochemical pathways Cell Cycle Checkpoints. Lecithin has biological action on biochemical pathways MYC Signaling and PI3K-AKT-MTOR Signaling. And so on.

For genetic risk of Ewing Sarcoma due to abnormalities in genes STAG2 and RYR2 – Foods like Mung Bean 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 Quercetin and Vitamin C contained in Mung Bean together have a canceling effect of genes on the biochemical pathways.

RECOMMENDATION: MUNG BEAN IS RECOMMENDED OVER SOY BEAN FOR REDUCING THE GENETIC RISK OF EWING SARCOMA DUE TO GENES STAG2 AND RYR2

Eat more vegetables, Arugula or Parsnip?

The active ingredients contained in Arugula are Esculin, Kaempferol, Vitamin A, Vitamin K, Erysolin among others. While the active ingredients contained in Parsnip are Quercetin, Psoralen, Imperatorin, Linolenic Acid, Oleic Acid and others.

Kaempferol can manipulate biochemical pathways RAS-RAF Signaling, Cell Cycle Checkpoints and PI3K-AKT-MTOR Signaling. Vitamin A has biological action on biochemical pathways MYC Signaling, Apoptosis and Cell Cycle Checkpoints.

Imperatorin can manipulate biochemical pathways Small Molecule Transport. Folic Acid has biological action on biochemical pathways Apoptosis, MYC Signaling and P53 Signaling. And so on.

For genetic risk of Ewing Sarcoma due to abnormalities in genes STAG2 and RYR2 – Foods like Arugula are recommended compared to Parsnip. This is because the active ingredients Imperatorin and Folic Acid in Parsnip further promote the effects of genes on the biochemical pathways. While the active ingredients Kaempferol and Vitamin A contained in Arugula together have a canceling effect of genes on the biochemical pathways.

RECOMMENDATION: ARUGULA IS RECOMMENDED OVER PARSNIP FOR REDUCING THE GENETIC RISK OF EWING SARCOMA DUE TO GENES STAG2 AND RYR2

Eat more fruits, Orange or Raspberry?

The active ingredients contained in Orange are D-limonene, Linalool, Modified Citrus Pectin, Linolenic Acid, Hesperidin among others. While the active ingredients contained in Raspberry are Ellagic Acid, Resveratrol, Quercetin, Vitamin C, Gallic Acid and others.

D-limonene can manipulate biochemical pathways Small Molecule Transport, Apoptosis and MYC Signaling. Vitamin C has biological action on biochemical pathways P53 Signaling, Cell Cycle Checkpoints and PI3K-AKT-MTOR Signaling.

Ellagic Acid can manipulate biochemical pathways MYC Signaling and Cell Cycle Checkpoints. Resveratrol has biological action on biochemical pathways P53 Signaling. And so on.

For genetic risk of Ewing Sarcoma due to abnormalities in genes STAG2 and RYR2 – Foods like Orange are recommended compared to Raspberry. This is because the active ingredients Ellagic Acid and Resveratrol in Raspberry further promote the effects of genes on the biochemical pathways. While the active ingredients D-limonene and Vitamin C contained in Orange together have a canceling effect of genes on the biochemical pathways.

RECOMMENDATION: ORANGE IS RECOMMENDED OVER RASPBERRY FOR REDUCING THE GENETIC RISK OF EWING SARCOMA DUE TO GENES STAG2 AND RYR2

Eat more nuts, Almond or Peanut?

The active ingredients contained in Almond are Quercetin, Vitamin E, Beta-sitosterol, Linolenic Acid, Oleic Acid among others. While the active ingredients contained in Peanut are Quercetin, Vitamin E, Beta-sitosterol, Linolenic Acid, Oleic Acid and others.

Beta-sitosterol can manipulate biochemical pathways Apoptosis, MYC Signaling and P53 Signaling. Quercetin has biological action on biochemical pathways Small Molecule Transport, Cell Cycle Checkpoints and PI3K-AKT-MTOR Signaling.

Lecithin can manipulate biochemical pathways MYC 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 Ewing Sarcoma due to abnormalities in genes STAG2 and RYR2 – Foods like Almond 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 Beta-sitosterol and Quercetin contained in Almond together have a canceling effect of genes on the biochemical pathways.

RECOMMENDATION: ALMOND IS RECOMMENDED OVER PEANUT FOR REDUCING THE GENETIC RISK OF EWING SARCOMA DUE TO GENES STAG2 AND RYR2

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 Ewing Sarcoma 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

• Pan Origimed 2020
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