Foods for Epithelioid Hemangioendothelioma!

Introduction

Foods for Epithelioid Hemangioendothelioma should be personalized for each individual and also must adapt when cancer treatment or tumor genetic change. The personalization and adaptation must consider all the active ingredients or bioactives contained in different foods with respect to cancer tissue biology, genetics, treatments, lifestyle conditions and diet preferences. Hence while nutrition is one of the very important decisions for a cancer patient and individual at risk of cancer to make – how to choose foods to eat is not an easy task.

Epithelioid hemangioendothelioma is a rare and aggressive vascular tumor which most commonly occurs in older adults between 60-80 years of age. It forms in the cells that line the inside of blood vessels. It appears more frequently in females than males and seems to be more prevalent in young adults. Most common locations of epithelioid hemangioendothelioma are lungs, liver, and bones. Epithelioid hemangioendothelioma tumors have an aggressive clinical course with a tendency for both local recurrence and regional lymph node metastasis. In some cases, epithelioid hemangioendothelioma can be slow growing with mild to no symptoms for years. Surgery is considered the primary treatment for epithelioid hemangioendothelioma, especially in the soft tissue and skin. Other treatment strategies can include targeted therapy, radiation therapy, chemotherapy, and watchful waiting. In addition, supportive care with the optimal nutrition (foods and natural supplements) can enhance and improve patients’ well-being.

For Epithelioid Hemangioendothelioma does it matter what vegetables, fruits, nuts, seeds one eats?

A very common nutrition question asked by cancer patients and individuals at-genetic risk of cancer is – for cancers like Epithelioid Hemangioendothelioma does it matter what foods I eat and which I do not? Or if I follow a plant-based diet is that enough for cancer like Epithelioid Hemangioendothelioma?

For example does it matter if vegetable Cauliflower is consumed more compared to Horned Melon? Does it make any difference if fruit Pummelo is preferred over Pomegranate? Also if similar choices are made for nuts/seeds like Common Hazelnut over European Chestnut and for pulses like Moth Bean over Catjang Pea. And if what I eat matters – then how does one identify foods which are recommended for Epithelioid Hemangioendothelioma and is it the same answer for everyone with the same diagnosis or genetic risk?

Yes! Foods you eat matters for Epithelioid Hemangioendothelioma!

Food recommendations may not be the same for everyone and can be different even for the same diagnosis and genetic risk.

All foods (vegetables, fruits, nuts, seeds, pulses, oils etc.) and nutritional supplements are made up of more than one active molecular ingredient or bio-actives in different proportions and quantities. Each active ingredient has a unique mechanism of action – which can be activation or inhibition of different biochemical pathways. Simply stated foods and supplements which are recommended are those which do not cause an increase of molecular drivers of cancer but reduce them. Else those foods should not be recommended. Foods contain multiple active ingredients – hence when evaluating foods and supplements you need to consider the impact of all active ingredients cumulatively rather than individually.

For example Pummelo contains active ingredients Catechol, Quercetin, Cinnamaldehyde, Caffeine, Curcumin. And Pomegranate contains active ingredients Catechol, Myricetin, Quercetin, Ellagic Acid, Cinnamaldehyde and possibly others.

A common mistake made when deciding and choosing foods to eat for Epithelioid Hemangioendothelioma – is to evaluate only selected active ingredients contained in foods and ignore the rest. Because different active ingredients contained in foods may have opposing effects on cancer drivers – you cannot cherry pick active ingredients in foods and supplements for making a nutrition decision for Epithelioid Hemangioendothelioma.

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

Skills Needed for Nutrition Personalization for Epithelioid Hemangioendothelioma?

Personalized nutrition for cancers like Epithelioid Hemangioendothelioma consists of recommended foods / supplements; not recommended foods / supplements with example recipes which prioritize use of recommended foods. An example of personalized nutrition can be seen at this link.

Deciding which foods are recommended or not is extremely complicated, requiring expertise in Epithelioid Hemangioendothelioma biology, food science, genetics, biochemistry along with good understanding of how cancer treatments work and associated vulnerabilities by which the treatments could stop being effective.

MINIMUM KNOWLEDGE EXPERTISE NEEDED FOR NUTRITION PERSONALIZATION FOR CANCER ARE: CANCER BIOLOGY, FOOD SCIENCE, CANCER TREATMENTS AND GENETICS.

Characteristics of cancers like Epithelioid Hemangioendothelioma

All cancers like Epithelioid Hemangioendothelioma can be characterized by a unique set of biochemical pathways – the signature pathways of Epithelioid Hemangioendothelioma. Biochemical pathways like MAPK Signaling, DNA Repair, PI3K-AKT-MTOR Signaling, TGFB Signaling are part of the signature definition of Epithelioid Hemangioendothelioma. Each individual’s cancer genetics can be different and hence their specific cancer signature could be unique.

The treatments which are effective for Epithelioid Hemangioendothelioma need to be cognizant of the associated signature biochemical pathways for each cancer patient and individual at genetic risk. Therefore different treatments with different mechanisms of actions are effective for different patients. Similarly and for the same reasons foods and supplements need to be personalized for each individual. Hence some foods and supplements are recommended for Epithelioid Hemangioendothelioma when taking cancer treatment Dactinomycin, and some foods and supplements are not recommended.

Sources like cBioPortal and many others provide population representative patient anonymized data from clinical trials for all cancer indications. This data consists of clinical trial study details like sample size / number of patients, age groups, gender, ethnicity, treatments, tumor site and any genetic mutations.

ATRX, CREBBP, ERBB4, MED12 and SDHAF2 are the top ranked reported genes for Epithelioid Hemangioendothelioma. ATRX is reported in 13.3 % of the representative patients across all clinical trials. And CREBBP is reported in 6.7 %. The combined population patient data cover ages from to . 42.9 % of the patient data are identified as men. The Epithelioid Hemangioendothelioma biology along with reported genetics together define the population represented signature biochemical pathways for this cancer. If the individual cancer tumor genetics or genes contributing to the risk are also known then that should also be used for nutrition personalization.

NUTRITION CHOICES SHOULD MATCH WITH EACH INDIVIDUAL’S CANCER SIGNATURE.

Food and Supplements for Epithelioid Hemangioendothelioma

For Cancer Patients

Cancer patients on treatment or on palliative care need to make decisions on food and supplements – for the needed dietary calories, for managing any treatment side effects and also for improved cancer management. All plant-based foods are not equal and choosing and prioritizing foods which are personalized and customized to ongoing cancer treatment is important and complicated. Here are some examples providing guidelines for making nutrition decisions.

Choose Vegetable CAULIFLOWER or HORNED MELON?

Vegetable Cauliflower contains many active ingredients or bioactives such as Catechol, Cinnamaldehyde, Curcumin, Daidzein, Lupeol. These active ingredients manipulate various biochemical pathways like PI3K-AKT-MTOR Signaling and MAPK Signaling and others. Cauliflower is recommended for Epithelioid Hemangioendothelioma when ongoing cancer treatment is Dactinomycin. This is because Cauliflower modifies those biochemical pathways which have been scientifically reported to sensitize the effect of Dactinomycin.

Some of the active ingredients or bioactives in vegetable Horned Melon are Catechol, Myricetin, Cinnamaldehyde, Caffeine, Curcumin. These active ingredients manipulate various biochemical pathways like PI3K-AKT-MTOR Signaling and others. Horned Melon is not recommended for Epithelioid Hemangioendothelioma when ongoing cancer treatment is Dactinomycin because it modifies those biochemical pathways which make the cancer treatment resistant or less responsive.

VEGETABLE CAULIFLOWER IS RECOMMENDED OVER HORNED MELON FOR Epithelioid Hemangioendothelioma AND TREATMENT Dactinomycin.

Choose Fruit POMEGRANATE or PUMMELO?

Fruit Pomegranate contains many active ingredients or bioactives such as Catechol, Myricetin, Quercetin, Ellagic Acid, Cinnamaldehyde. These active ingredients manipulate various biochemical pathways like PI3K-AKT-MTOR Signaling, DNA Repair and MAPK Signaling and others. Pomegranate is recommended for Epithelioid Hemangioendothelioma when ongoing cancer treatment is Dactinomycin. This is because Pomegranate modifies those biochemical pathways which have been scientifically reported to sensitize the effect of Dactinomycin.

Some of the active ingredients or bioactives in fruit Pummelo are Catechol, Quercetin, Cinnamaldehyde, Caffeine, Curcumin. These active ingredients manipulate various biochemical pathways like PI3K-AKT-MTOR Signaling and DNA Repair and others. Pummelo is not recommended for Epithelioid Hemangioendothelioma when ongoing cancer treatment is Dactinomycin because it modifies those biochemical pathways which make the cancer treatment resistant or less responsive.

FRUIT POMEGRANATE IS RECOMMENDED OVER PUMMELO FOR Epithelioid Hemangioendothelioma AND TREATMENT Dactinomycin.

Choose Nut COMMON HAZELNUT or EUROPEAN CHESTNUT?

Common Hazelnut contains many active ingredients or bioactives such as Catechol, Myricetin, Quercetin, Cinnamaldehyde, Caffeine. These active ingredients manipulate various biochemical pathways like PI3K-AKT-MTOR Signaling, DNA Repair and MAPK Signaling and others. Common Hazelnut is recommended for Epithelioid Hemangioendothelioma when ongoing cancer treatment is Dactinomycin. This is because Common Hazelnut modifies those biochemical pathways which have been scientifically reported to sensitize the effect of Dactinomycin.

Some of the active ingredients or bioactives in European Chestnut are Catechol, Myricetin, Quercetin, Ellagic Acid, Cinnamaldehyde. These active ingredients manipulate various biochemical pathways like PI3K-AKT-MTOR Signaling and others. European Chestnut is not recommended for Epithelioid Hemangioendothelioma when ongoing cancer treatment is Dactinomycin because it modifies those biochemical pathways which make the cancer treatment resistant or less responsive.

COMMON HAZELNUT IS RECOMMENDED OVER EUROPEAN CHESTNUT FOR Epithelioid Hemangioendothelioma AND TREATMENT Dactinomycin.

For Individuals with Genetic Risk of Cancer

The question asked by individuals who have genetic risk of Epithelioid Hemangioendothelioma or familial history is “What Should I Eat Differently from Before?” and how they should choose foods and supplements to manage risks of the disease. Since for cancer risk there is nothing actionable in terms of treatment – decisions of foods and supplements become important and one of the very few actionable things which can be done. All plant-based foods are not equal and based on identified genetics and pathway signature – the choices of food and supplements should be personalized.

Choose Vegetable GIANT BUTTERBUR or CARDOON?

Vegetable Giant Butterbur contains many active ingredients or bioactives such as Curcumin, Apigenin, Lupeol, Formononetin, Lycopene. These active ingredients manipulate various biochemical pathways like TGFB Signaling, PI3K-AKT-MTOR Signaling, Oncogenic Cancer Epigenetics and P53 Signaling and others. Giant Butterbur is recommended for risk of Epithelioid Hemangioendothelioma when associated genetic risk is ATRX. This is because Giant Butterbur increases those biochemical pathways which counteract the signature drivers of it.

Some of the active ingredients or bioactives in vegetable Cardoon are Curcumin, Apigenin, Lupeol, Formononetin, Lycopene. These active ingredients manipulate various biochemical pathways like WNT Beta Catenin Signaling, TGFB Signaling and Oncogenic Cancer Epigenetics and others. Cardoon is not recommended when risk of Epithelioid Hemangioendothelioma when associated genetic risk is ATRX because it increases the signature pathways of it.

VEGETABLE GIANT BUTTERBUR IS RECOMMENDED OVER CARDOON FOR ATRX GENETIC RISK OF CANCER.

Choose Fruit NANCE or ALASKA BLUEBERRY?

Fruit Nance contains many active ingredients or bioactives such as Curcumin, Apigenin, Lupeol, Formononetin, Daidzein. These active ingredients manipulate various biochemical pathways like PI3K-AKT-MTOR Signaling, Hypoxia and P53 Signaling and others. Nance is recommended for risk of Epithelioid Hemangioendothelioma when associated genetic risk is ATRX. This is because Nance increases those biochemical pathways which counteract the signature drivers of it.

Some of the active ingredients or bioactives in fruit Alaska Blueberry are Curcumin, Apigenin, Lupeol, Formononetin, Daidzein. These active ingredients manipulate various biochemical pathways like WNT Beta Catenin Signaling, TGFB Signaling and Oncogenic Cancer Epigenetics and others. Alaska Blueberry is not recommended when risk of Epithelioid Hemangioendothelioma when associated genetic risk is ATRX because it increases the signature pathways of it.

FRUIT NANCE IS RECOMMENDED OVER ALASKA BLUEBERRY FOR ATRX GENETIC RISK OF CANCER.

Choose Nut BUTTERNUT or CHESTNUT?

Butternut contains many active ingredients or bioactives such as Curcumin, Apigenin, Lupeol, Formononetin, Lycopene. These active ingredients manipulate various biochemical pathways like Growth Factor Signaling, PI3K-AKT-MTOR Signaling, Oncogenic Cancer Epigenetics and P53 Signaling and others. Butternut is recommended for risk of Epithelioid Hemangioendothelioma when associated genetic risk is ATRX. This is because Butternut increases those biochemical pathways which counteract the signature drivers of it.

Some of the active ingredients or bioactives in Chestnut are Curcumin, Apigenin, Ellagic Acid, Lupeol, Formononetin. These active ingredients manipulate various biochemical pathways like WNT Beta Catenin Signaling and PI3K-AKT-MTOR Signaling and others. Chestnut is not recommended when risk of Epithelioid Hemangioendothelioma when associated genetic risk is ATRX because it increases the signature pathways of it.

BUTTERNUT IS RECOMMENDED OVER CHESTNUT FOR ATRX GENETIC RISK OF CANCER.

In Conclusion

Foods and Supplements chosen are important decisions for cancers like Epithelioid Hemangioendothelioma. Epithelioid Hemangioendothelioma patients and individuals with genetic-risk always have this question: “What foods and nutritional supplements are recommended for me and which are not?” There is a common belief which is a misconception that all plant-based foods could be beneficial or not but would not be harmful. Certain foods and supplements can interfere with cancer treatments or promote molecular pathway drivers of cancer.

There are different types of cancer indications like Epithelioid Hemangioendothelioma, each with different tumor genetics with further genomic variations across each individual. Further every cancer treatment and chemotherapy has a unique mechanism of action. Each food like Cauliflower contains various bioactives in different quantities, which have an impact on different and distinct sets of biochemical pathways. The definition of personalized nutrition is individualized food recommendations for the cancer indication, treatments, genetics, lifestyle and other factors. Nutrition personalization decisions for cancer require knowledge of cancer biology, food science and an understanding of different chemotherapy treatments. Finally when there are treatment changes or new genomics is identified – the nutrition personalization needs re-evaluation.

The addon nutrition personalization solution makes the decision making easy and removes all the guesswork in answering the question, “What foods should I choose or not choose for Epithelioid Hemangioendothelioma?”. The addon multi-disciplinary team includes cancer physicians, clinical scientists, software engineers and data scientists.

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• (ref: Liu Z and He S, J Oncol., 2022, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9507694/; https://fightehe.org/ehe-epithelioid-hemangioendothelioma/; https://my.clevelandclinic.org/health/diseases/23121-epithelioid-hemangioendothelioma )