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 Multiple Myeloma when undergoing chemotherapy or when you determine you have a genetic risk for developing Multiple Myeloma because of NRAS and BRAF 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 Multiple Myeloma 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 Passion Fruit” or “Include fruit Partridgeberry in my diet” or “Should I reduce consumption of vegetable Yam” or “Can I take Ellagic Acid and Dim 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 MULTIPLE MYELOMA, TREATMENTS, GENETIC INFORMATION, AND OTHER CONDITIONS.
The overall objective of personalized nutrition for Multiple Myeloma 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 MULTIPLE MYELOMA, WHEN TREATMENTS, DISEASE STATUS AND OTHER CONDITIONS CHANGE.
About Multiple Myeloma
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 Multiple Myeloma from cBioPortal. The patients enrolled in the studies for Multiple Myeloma are in ages between 24 to 82 with an average age of 61. 66.2% of males and 33.8% of females were the distribution of gender in these clinical studies. From a patient sample size of 212; the top genes with mutations and other abnormalities for Multiple Myeloma include genes KRAS, NRAS, TP53, BRAF and MUC16. The occurrence frequency distribution for these genes respectively is 22.0%, 18.0%, 7.3%, 6.3% and 6.3%. These tumor genetic details of Multiple Myeloma are mapped to molecular biochemical pathway drivers of cancer thereby providing definition of characteristic features of Multiple Myeloma.
Multiple myeloma is a blood cancer of plasma cells found in the bone marrow, the spongy tissue inside our bones, that normally creates the different parts of our blood. Plasma cells are a key part of the body’s immune system. They produce antibodies that help the body fight infection. Myeloma begins when healthy plasma cells change and grow out of control. This may result in multiple bone lesions that increase the risk of bone fractures, thus called multiple myeloma. Abnormal plasma cells that divide rapidly can crowd out or suppress the growth of other cells in the bone marrow, including the red blood cells, white blood cells and platelets. This not only lowers the body’s immunity, but also can cause anemia from a shortage of red blood cells, excessive bleeding with minor cuts and wounds due to a shortage of platelets, and decreased ability to fight infections, from a shortage of the white blood cells. Myeloma cells are unable to produce functioning antibodies but instead make an M protein that can build up in the blood and urine, potentially damaging the kidneys and other organs, besides reducing immunity. A healthy person who is found to have a small amount of M protein is said to have monoclonal gammopathy of undetermined significance (MGUS), the precursor to multiple myeloma.
Estimated new cases of multiple myeloma in 2022 is over 30,000, about 1.8% of all new cancer cases. The 5-year survival rate for patients with multiple myeloma is about 58% (Ref: seer.cancer.gov). Treatment for multiple myeloma includes treatment to control the disease as well as supportive care to improve quality of life, such as by relieving symptoms and maintaining good nutrition with the right foods and natural supplements. The treatment plan includes induction therapy for rapid control of the cancer; consolidation therapy with more chemotherapy or a bone marrow/stem cell transplant and maintenance therapy over a prolonged period to prevent cancer recurrence. The treatments include chemotherapy, targeted therapy, immunomodulatory drugs, steroids, bone-modifying drugs, and immunotherapy. The right foods and natural supplements aligned with the treatment can further help improve patient well-being. (Ref: https://www.cancer.net/cancer-types/multiple-myeloma/introduction; https://www.cancer.org/cancer/multiple-myeloma/about/key-statistics.html)
Significance of Nutrition for Multiple Myeloma
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 Multiple Myeloma. 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 Passion Fruit includes active ingredients Vitamin C, Oleic Acid, Linolenic Acid, Linoleic Acid, Vitamin A and others. And Partridgeberry contains active ingredients Resveratrol, Beta-sitosterol, Stigmasterol 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 Multiple Myeloma, activation or inhibition of selected biochemical pathways like Growth Factor Signaling, Extracellular Matrix Remodelling, RAS-RAF Signaling, MAPK 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 Multiple Myeloma, 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 MULTIPLE MYELOMA – CONSIDER HIGH QUANTITY ACTIVE INGREDIENTS CONTAINED IN FOODS.
Foods for Multiple Myeloma undergoing chemotherapy treatment
In Multiple Myeloma – the genes KRAS, NRAS, TP53, BRAF and MUC16 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 Multiple Myeloma are Growth Factor Signaling, Extracellular Matrix Remodelling, Angiogenesis and others. Bortezomib is one of the chemotherapies used for cancer treatment. The intent of treatment is to negate or cancel out effects of biochemical pathway drivers Growth Factor Signaling, Extracellular Matrix Remodelling, Angiogenesis 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, Black-eyed Pea or Pigeon Pea?
Pulses are an important part of many diets. The active ingredients contained in Black-eyed Pea are Vitamin C, Daidzein, Oleic Acid, Linolenic Acid, Beta-carotene among others. While the active ingredients contained in Pigeon Pea are Vitamin C, Oleic Acid, Linolenic Acid, Genistein, Linoleic Acid and others.
Vitamin C can manipulate biochemical pathways WNT Beta Catenin Signaling, Angiogenesis and Hypoxia. Daidzein has biological action on biochemical pathways PI3K-AKT-MTOR Signaling, Oxidative Stress and Endoplasmic Reticulum Stress.
Genistein can manipulate biochemical pathways Oxidative Stress. Vitamin A has biological action on biochemical pathways Extracellular Matrix Remodelling. And so on.
When treating Multiple Myeloma with chemotherapy Bortezomib – Foods like Black-eyed Pea 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 Vitamin C and Daidzein contained in Black-eyed Pea support the treatment action by enhancing the biochemical pathway effect through which the chemotherapy works.
RECOMMENDATION: BLACK-EYED PEA IS RECOMMENDED OVER PIGEON PEA FOR MULTIPLE MYELOMA ON TREATMENT WITH CHEMOTHERAPY BORTEZOMIB FOR SOME CONDITIONS.
Eat more vegetables, Giant Butterbur or Yam?
Vegetables are an important part of many diets. The active ingredients contained in Giant Butterbur are Vitamin C, Melatonin, Beta-sitosterol, Kaempferol, Vitamin A among others. While the active ingredients contained in Yam are Vitamin C, Beta-sitosterol, Oleic Acid, Linolenic Acid, Dioscin and others.
Vitamin C can manipulate biochemical pathways WNT Beta Catenin Signaling, Angiogenesis and Hypoxia. Melatonin has biological action on biochemical pathways PI3K-AKT-MTOR Signaling, Growth Factor Signaling and Oxidative Stress.
Citric Acid can manipulate biochemical pathways Oxidative Stress. Dioscin has biological action on biochemical pathways Notch Signaling. And so on.
When treating Multiple Myeloma with chemotherapy Bortezomib – Foods like Giant Butterbur are recommended compared to Yam. This is because the active ingredients Citric Acid and Dioscin in Yam interferes with treatment action by canceling out the biochemical pathways through which the chemotherapy works. While the active ingredients Vitamin C and Melatonin contained in Giant Butterbur support the treatment action by enhancing the biochemical pathway effect through which the chemotherapy works.
RECOMMENDATION: GIANT BUTTERBUR IS RECOMMENDED OVER YAM FOR MULTIPLE MYELOMA ON TREATMENT WITH CHEMOTHERAPY BORTEZOMIB FOR SOME CONDITIONS.
Eat more fruits, Partridgeberry or Passion Fruit?
Fruits are an important part of many diets. The active ingredients contained in Partridgeberry are Resveratrol, Beta-sitosterol, Stigmasterol among others. While the active ingredients contained in Passion Fruit are Vitamin C, Oleic Acid, Linolenic Acid, Linoleic Acid, Vitamin A and others.
Resveratrol can manipulate biochemical pathways Hypoxia, Angiogenesis and Endoplasmic Reticulum Stress. Beta-sitosterol has biological action on biochemical pathways WNT Beta Catenin Signaling, PI3K-AKT-MTOR Signaling and Oxidative Stress.
Vitamin A can manipulate biochemical pathways Extracellular Matrix Remodelling. Citric Acid has biological action on biochemical pathways Oxidative Stress. And so on.
When treating Multiple Myeloma with chemotherapy Bortezomib – Foods like Partridgeberry are recommended compared to Passion Fruit. This is because the active ingredients Vitamin A and Citric Acid in Passion Fruit interferes with treatment action by canceling out the biochemical pathways through which the chemotherapy works. While the active ingredients Resveratrol and Beta-sitosterol contained in Partridgeberry support the treatment action by enhancing the biochemical pathway effect through which the chemotherapy works.
RECOMMENDATION: PARTRIDGEBERRY IS RECOMMENDED OVER PASSION FRUIT FOR MULTIPLE MYELOMA ON TREATMENT WITH CHEMOTHERAPY BORTEZOMIB FOR SOME CONDITIONS.
Eat more nuts, Chestnut or Macadamia Nut?
Nuts are an important part of many diets. The active ingredients contained in Chestnut are Quercetin, Ellagic Acid, Vitamin C, Oleic Acid, Betulin among others. While the active ingredients contained in Macadamia Nut are Beta-sitosterol, Lauric Acid, Palmitic Acid, Myristic Acid, Folic Acid and others.
Ellagic Acid can manipulate biochemical pathways WNT Beta Catenin Signaling, Angiogenesis and Extracellular Matrix Remodelling. Betulin has biological action on biochemical pathways Hypoxia, Oxidative Stress and PI3K-AKT-MTOR Signaling.
Lauric Acid can manipulate biochemical pathways PI3K-AKT-MTOR Signaling. Palmitic Acid has biological action on biochemical pathways WNT Beta Catenin Signaling, Angiogenesis and Extracellular Matrix Remodelling. And so on.
When treating Multiple Myeloma with chemotherapy Bortezomib – Foods like Chestnut are recommended compared to Macadamia Nut. This is because the active ingredients Lauric Acid and Palmitic Acid in Macadamia Nut interferes with treatment action by canceling out the biochemical pathways through which the chemotherapy works. While the active ingredients Ellagic Acid and Betulin contained in Chestnut support the treatment action by enhancing the biochemical pathway effect through which the chemotherapy works.
RECOMMENDATION: CHESTNUT IS RECOMMENDED OVER MACADAMIA NUT FOR MULTIPLE MYELOMA ON TREATMENT WITH CHEMOTHERAPY BORTEZOMIB FOR SOME CONDITIONS.
Foods for Genetic Risk of Multiple Myeloma
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. NRAS and BRAF are two genes whose abnormalities are risk factors for Multiple Myeloma. 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 Multiple Myeloma can be used as a guide for coming up with a recommended personalized nutrition plan. For Multiple Myeloma gene NRAS has causative impact on biological pathways like G-protein-coupled Receptor Signaling, Growth Factor Signaling and RAS-RAF Signaling. And BRAF has a causative impact on biological pathways like RAS-RAF Signaling, MAPK Signaling and Antigen Presentation. Foods and nutritional supplements which have molecular action to cancel out biochemical pathways effects of genes like NRAS and BRAF should be included in a personalized nutrition plan. And those foods and supplements which promote the effects of genes NRAS and BRAF should be avoided.
Eat more pulses, Mung Bean or Adzuki Bean?
The active ingredients contained in Mung Bean are Quercetin, Oleic Acid, Linolenic Acid, Vitamin C, Vitexin among others. While the active ingredients contained in Adzuki Bean are Isoliquiritigenin, Glucaric Acid, Genistein, Folic Acid and others.
Quercetin can manipulate biochemical pathways MAPK Signaling, Cell Cycle Checkpoints and RAS-RAF Signaling. Vitamin C has biological action on biochemical pathways P53 Signaling, MYC Signaling and PI3K-AKT-MTOR Signaling.
Folic Acid can manipulate biochemical pathways MAPK Signaling, Cell Cycle Checkpoints and RAS-RAF Signaling. And so on.
For genetic risk of Multiple Myeloma due to abnormalities in genes NRAS and BRAF – Foods like Mung Bean are recommended compared to Adzuki Bean. This is because the active ingredients Folic Acid in Adzuki 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 ADZUKI BEAN FOR REDUCING THE GENETIC RISK OF MULTIPLE MYELOMA DUE TO GENES NRAS AND BRAF
Eat more vegetables, Cassava or Celery?
The active ingredients contained in Cassava are Beta-sitosterol, Oleic Acid, Linolenic Acid, Vitamin C, Linoleic Acid among others. While the active ingredients contained in Celery are Apigenin, Quercetin, Oleic Acid, Linolenic Acid, Vitamin C and others.
Vitamin C can manipulate biochemical pathways MAPK Signaling, Cell Cycle Checkpoints and RAS-RAF Signaling. Beta-sitosterol has biological action on biochemical pathways P53 Signaling, MYC Signaling and PI3K-AKT-MTOR Signaling.
Luteolin can manipulate biochemical pathways MYC Signaling. Chrysin has biological action on biochemical pathways MYC Signaling. And so on.
For genetic risk of Multiple Myeloma due to abnormalities in genes NRAS and BRAF – Foods like Cassava are recommended compared to Celery. This is because the active ingredients Luteolin and Chrysin in Celery 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 CELERY FOR REDUCING THE GENETIC RISK OF MULTIPLE MYELOMA DUE TO GENES NRAS AND BRAF
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, Orange or Strawberry?
The active ingredients contained in Orange are D-limonene, Linalool, Modified Citrus Pectin, Oleic Acid, Linolenic Acid among others. While the active ingredients contained in Strawberry are Ellagic Acid, Lupeol, Cianidanol, Beta-sitosterol, Oleic Acid and others.
D-limonene can manipulate biochemical pathways MAPK Signaling, Cell Cycle Checkpoints and RAS-RAF Signaling. Vitamin C has biological action on biochemical pathways P53 Signaling, MYC Signaling and PI3K-AKT-MTOR Signaling.
Fisetin can manipulate biochemical pathways MYC Signaling. Pelargonidin has biological action on biochemical pathways Cell Cycle Checkpoints, PI3K-AKT-MTOR Signaling and MYC Signaling. And so on.
For genetic risk of Multiple Myeloma due to abnormalities in genes NRAS and BRAF – Foods like Orange are recommended compared to Strawberry. This is because the active ingredients Fisetin and Pelargonidin in Strawberry 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 STRAWBERRY FOR REDUCING THE GENETIC RISK OF MULTIPLE MYELOMA DUE TO GENES NRAS AND BRAF
Eat more nuts, Almond or Cashew Nut?
The active ingredients contained in Almond are Quercetin, Vitamin E, Beta-sitosterol, Oleic Acid, Linolenic Acid among others. While the active ingredients contained in Cashew Nut are Palmitic Acid, Beta-sitosterol, Vitamin C, Gallic Acid, Butyric Acid and others.
Beta-sitosterol can manipulate biochemical pathways Cell Cycle Checkpoints, P53 Signaling and MYC Signaling. Quercetin has biological action on biochemical pathways MAPK Signaling, RAS-RAF Signaling and PI3K-AKT-MTOR Signaling.
Palmitic Acid can manipulate biochemical pathways MAPK Signaling. Lauric Acid has biological action on biochemical pathways MYC Signaling, PI3K-AKT-MTOR Signaling and MAPK Signaling. And so on.
For genetic risk of Multiple Myeloma due to abnormalities in genes NRAS and BRAF – Foods like Almond are recommended compared to Cashew Nut. This is because the active ingredients Palmitic Acid and Lauric Acid in Cashew Nut 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 CASHEW NUT FOR REDUCING THE GENETIC RISK OF MULTIPLE MYELOMA DUE TO GENES NRAS AND BRAF
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 Multiple Myeloma 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
- Widespread genetic heterogeneity in multiple myeloma: implications for targeted therapy.
- Vitamin C selectively kills KRAS and BRAF mutant colorectal cancer cells by targeting GAPDH.
- Daidzein effect on hormone refractory prostate cancer in vitro and in vivo compared to genistein and soy extract: potentiation of radiotherapy.
- Adhesion to the extracellular matrix is positively regulated by retinoic acid in HepG2 cells.
- Resveratrol induces autophagy by directly inhibiting mTOR through ATP competition.
- β-Sitosterol targets Trx/Trx1 reductase to induce apoptosis in A549 cells via ROS mediated mitochondrial dysregulation and p53 activation.
- Melatonin Attenuates Her-2, p38 MAPK, p-AKT, and mTOR Levels in Ovarian Carcinoma of Ethanol-Preferring Rats.
- Effect of dioscin on promoting liver regeneration via activating Notch1/Jagged1 signal pathway.
- Indeno[1,2-b]indole derivatives as a novel class of potent human protein kinase CK2 inhibitors.
- Trends in congenital heart disease in Dallas County births. 1971-1984.
- Taurine improves low-level inorganic arsenic-induced insulin resistance by activating PPARγ-mTORC2 signalling and inhibiting hepatic autophagy.
- Protein kinase and HDAC inhibitors from the endophytic fungus Epicoccum nigrum.
- Sequential protooncogene expression in regenerating kidney following acute renal injury.
- D-Limonene modulates inflammation, oxidative stress and Ras-ERK pathway to inhibit murine skin tumorigenesis.
- Crystal structure of a human cyclin-dependent kinase 6 complex with a flavonol inhibitor, fisetin.
- Pelargonidin suppresses adipogenesis in 3T3-L1 cells through inhibition of PPAR-γ signaling pathway.
- Clinical pharmacodynamics of antihistamines.
- Resveratrol, pterostilbene, and piceatannol in vaccinium berries.
- HyperFoods: Machine intelligent mapping of cancer-beating molecules in foods.
- Fisetin: a dietary antioxidant for health promotion.
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.