Foods for Fibrolamellar Carcinoma!

Introduction

Foods for Fibrolamellar Carcinoma 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.

Fibrolamellar hepatocellular carcinoma, commonly known as fibrolamellar carcinoma, is a rare type of liver cancer. This aggressive form of cancer requires prompt diagnosis and effective treatment for improved prognosis. Radiology techniques, such as MRI scans, play a crucial role in detecting fibrolamellar carcinoma and assessing its stage. Pathology outlines are essential for understanding the characteristics of this cancer, aiding in accurate diagnosis. Survival rates for fibrolamellar carcinoma vary, but with timely intervention, patients have better chances of overcoming this challenging disease. Treatment options, including surgical excision, chemotherapy, and radiation therapy, are available for managing fibrolamellar hepatocellular carcinoma. As stage 4 fibrolamellar carcinoma indicates advanced disease, aggressive treatment measures may be required. While the exact causes of this cancer remain unknown, organizations like the Fibrolamellar Carcinoma Foundation provide valuable support to patients and promote awareness. Proper pathology and diagnosis are important for determining appropriate treatment pathways for fibrolamellar carcinoma. The collaborative efforts of healthcare professionals and researchers in understanding this cancer and developing effective management strategies continue to progress.

For Fibrolamellar Carcinoma 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 Fibrolamellar Carcinoma 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 Fibrolamellar Carcinoma?

For example does it matter if vegetable Cabbage is consumed more compared to Kohlrabi? Does it make any difference if fruit Pummelo is preferred over Red Raspberry? Also if similar choices are made for nuts/seeds like Black Walnut over Brazil Nut and for pulses like Alfalfa over Soy Bean. And if what I eat matters – then how does one identify foods which are recommended for Fibrolamellar Carcinoma and is it the same answer for everyone with the same diagnosis or genetic risk?

Yes! Foods you eat matters for Fibrolamellar Carcinoma!

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 Lycopene, Protocatechuic Acid, Quercetin, Curcumin, Lupeol. And Red Raspberry contains active ingredients Ellagic Acid, Protocatechuic Acid, Quercetin, Curcumin, Lupeol and possibly others.

A common mistake made when deciding and choosing foods to eat for Fibrolamellar Carcinoma – 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 Fibrolamellar Carcinoma.

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

Skills Needed for Nutrition Personalization for Fibrolamellar Carcinoma?

Personalized nutrition for cancers like Fibrolamellar Carcinoma 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 Fibrolamellar Carcinoma 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 Fibrolamellar Carcinoma

All cancers like Fibrolamellar Carcinoma can be characterized by a unique set of biochemical pathways – the signature pathways of Fibrolamellar Carcinoma. Biochemical pathways like RAS-RAF Signaling, Focal Adhesion, MAPK Signaling, DNA Repair are part of the signature definition of Fibrolamellar Carcinoma. Each individual’s cancer genetics can be different and hence their specific cancer signature could be unique.

The treatments which are effective for Fibrolamellar Carcinoma 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 Fibrolamellar Carcinoma when taking cancer treatment Radiation, 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.

TERT, EIF4A2, EPHA5, NOTCH1 and RASA1 are the top ranked reported genes for Fibrolamellar Carcinoma. TERT is reported in 25.0 % of the representative patients across all clinical trials. And EIF4A2 is reported in 12.5 %. The combined population patient data cover ages from 14 to 25. 48.1 % of the patient data are identified as men. The Fibrolamellar Carcinoma 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 Fibrolamellar Carcinoma

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 CABBAGE or KOHLRABI?

Vegetable Cabbage contains many active ingredients or bioactives such as Lycopene, Protocatechuic Acid, Quercetin, Glucaric Acid, Curcumin. These active ingredients manipulate various biochemical pathways like MAPK Signaling, MYC Signaling and PI3K-AKT-MTOR Signaling and others. Cabbage is recommended for Fibrolamellar Carcinoma when ongoing cancer treatment is Radiation. This is because Cabbage modifies those biochemical pathways which have been scientifically reported to sensitize the effect of Radiation.

Some of the active ingredients or bioactives in vegetable Kohlrabi are Protocatechuic Acid, Quercetin, Curcumin, Luteolin, Lupeol. These active ingredients manipulate various biochemical pathways like DNA Repair, MYC Signaling and PI3K-AKT-MTOR Signaling and others. Kohlrabi is not recommended for Fibrolamellar Carcinoma when ongoing cancer treatment is Radiation because it modifies those biochemical pathways which make the cancer treatment resistant or less responsive.

VEGETABLE CABBAGE IS RECOMMENDED OVER KOHLRABI FOR Fibrolamellar Carcinoma AND TREATMENT Radiation.

Choose Fruit RED RASPBERRY or PUMMELO?

Fruit Red Raspberry contains many active ingredients or bioactives such as Ellagic Acid, Protocatechuic Acid, Quercetin, Curcumin, Lupeol. These active ingredients manipulate various biochemical pathways like MAPK Signaling, RAS-RAF Signaling, Focal Adhesion and MYC Signaling and others. Red Raspberry is recommended for Fibrolamellar Carcinoma when ongoing cancer treatment is Radiation. This is because Red Raspberry modifies those biochemical pathways which have been scientifically reported to sensitize the effect of Radiation.

Some of the active ingredients or bioactives in fruit Pummelo are Lycopene, Protocatechuic Acid, Quercetin, Curcumin, Lupeol. These active ingredients manipulate various biochemical pathways like DNA Repair and others. Pummelo is not recommended for Fibrolamellar Carcinoma when ongoing cancer treatment is Radiation because it modifies those biochemical pathways which make the cancer treatment resistant or less responsive.

FRUIT RED RASPBERRY IS RECOMMENDED OVER PUMMELO FOR Fibrolamellar Carcinoma AND TREATMENT Radiation.

Choose Nut BLACK WALNUT or BRAZIL NUT?

Black Walnut contains many active ingredients or bioactives such as Ellagic Acid, Protocatechuic Acid, Quercetin, Curcumin, Myricetin. These active ingredients manipulate various biochemical pathways like MAPK Signaling, MYC Signaling and PI3K-AKT-MTOR Signaling and others. Black Walnut is recommended for Fibrolamellar Carcinoma when ongoing cancer treatment is Radiation. This is because Black Walnut modifies those biochemical pathways which have been scientifically reported to sensitize the effect of Radiation.

Some of the active ingredients or bioactives in Brazil Nut are Ellagic Acid, Protocatechuic Acid, Curcumin, Lupeol, Daidzein. These active ingredients manipulate various biochemical pathways like MAPK Signaling, DNA Repair and PI3K-AKT-MTOR Signaling and others. Brazil Nut is not recommended for Fibrolamellar Carcinoma when ongoing cancer treatment is Radiation because it modifies those biochemical pathways which make the cancer treatment resistant or less responsive.

BLACK WALNUT IS RECOMMENDED OVER BRAZIL NUT FOR Fibrolamellar Carcinoma AND TREATMENT Radiation.

For Individuals with Genetic Risk of Cancer

The question asked by individuals who have genetic risk of Fibrolamellar Carcinoma 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 TURNIP?

Vegetable Giant Butterbur contains many active ingredients or bioactives such as Curcumin, Apigenin, Myricetin, Lycopene, Formononetin. These active ingredients manipulate various biochemical pathways like MAPK Signaling, RAS-RAF Signaling, EPHRIN Signaling and PI3K-AKT-MTOR Signaling and others. Giant Butterbur is recommended for risk of Fibrolamellar Carcinoma when associated genetic risk is EIF4A2. 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 Turnip are Curcumin, Ellagic Acid, Quercetin, Formononetin, Lupeol. These active ingredients manipulate various biochemical pathways like MAPK Signaling, Notch Signaling and PI3K-AKT-MTOR Signaling and others. Turnip is not recommended when risk of Fibrolamellar Carcinoma when associated genetic risk is EIF4A2 because it increases the signature pathways of it.

VEGETABLE GIANT BUTTERBUR IS RECOMMENDED OVER TURNIP FOR EIF4A2 GENETIC RISK OF CANCER.

Choose Fruit BILBERRY or JUJUBE?

Fruit Bilberry contains many active ingredients or bioactives such as Curcumin, Apigenin, Quercetin, Myricetin, Lycopene. These active ingredients manipulate various biochemical pathways like MAPK Signaling, Cell Cycle Checkpoints, Hypoxia and PI3K-AKT-MTOR Signaling and others. Bilberry is recommended for risk of Fibrolamellar Carcinoma when associated genetic risk is EIF4A2. This is because Bilberry increases those biochemical pathways which counteract the signature drivers of it.

Some of the active ingredients or bioactives in fruit Jujube are Curcumin, Apigenin, Quercetin, Myricetin, Lycopene. These active ingredients manipulate various biochemical pathways like MAPK Signaling, Cell Cycle Checkpoints and Growth Factor Signaling and others. Jujube is not recommended when risk of Fibrolamellar Carcinoma when associated genetic risk is EIF4A2 because it increases the signature pathways of it.

FRUIT BILBERRY IS RECOMMENDED OVER JUJUBE FOR EIF4A2 GENETIC RISK OF CANCER.

Choose Nut BUTTERNUT or PUMPKIN SEEDS?

Butternut contains many active ingredients or bioactives such as Curcumin, Apigenin, Myricetin, Lycopene, Formononetin. These active ingredients manipulate various biochemical pathways like MAPK Signaling, PI3K-AKT-MTOR Signaling, RAS-RAF Signaling and EPHRIN Signaling and others. Butternut is recommended for risk of Fibrolamellar Carcinoma when associated genetic risk is EIF4A2. This is because Butternut increases those biochemical pathways which counteract the signature drivers of it.

Some of the active ingredients or bioactives in Pumpkin Seeds are Beta-sitosterol, Linolenic Acid, Oleic Acid, Stigmasterol, Gamma-linolenic Acid. These active ingredients manipulate various biochemical pathways like MAPK Signaling, JAK-STAT Signaling and PI3K-AKT-MTOR Signaling and others. Pumpkin Seeds is not recommended when risk of Fibrolamellar Carcinoma when associated genetic risk is EIF4A2 because it increases the signature pathways of it.

BUTTERNUT IS RECOMMENDED OVER PUMPKIN SEEDS FOR EIF4A2 GENETIC RISK OF CANCER.

In Conclusion

Foods and Supplements chosen are important decisions for cancers like Fibrolamellar Carcinoma. Fibrolamellar Carcinoma 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 Fibrolamellar Carcinoma, 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 Cabbage 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 Fibrolamellar Carcinoma?”. The addon multi-disciplinary team includes cancer physicians, clinical scientists, software engineers and data scientists.

References

• Msk Impact 2017
• Pan-cancer analysis of whole genomes.
• Preventive effects of butyric acid, nicotinamide, calcium glucarate alone or in combination during the 7, 12-dimethylbenz (a) anthracene induced mouse skin tumorigenesis via modulation of K-Ras-PI3K-AKTpathway and associated micro RNAs.
• Research progress on the anticancer effects of vitamin K2.
• Functional lipidomics: Palmitic acid impairs hepatocellular carcinoma development by modulating membrane fluidity and glucose metabolism.
• Growth stimulation of human pulmonary adenocarcinoma cells and small airway epithelial cells by beta-carotene via activation of cAMP, PKA, CREB and ERK1/2.
• Lycopene differentially induces quiescence and apoptosis in androgen-responsive and -independent prostate cancer cell lines.
• Resveratrol modulates tumor cell proliferation and protein translation via SIRT1-dependent AMPK activation.