Foods for Oropharyngeal Cancer!

Introduction

Foods for Oropharyngeal Cancer 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.

Oropharyngeal cancer refers to the development of malignant tumors in the oropharynx, which includes the back of the throat, tonsils, and base of the tongue. Human papillomavirus (HPV) is a significant risk factor for oropharyngeal cancer, particularly in younger individuals. Tobacco use and Alcohol consumption are also significant risk factors for oropharyngeal cancer. Early symptoms may include persistent sore throat, difficulty swallowing, difficulty opening your mouth or moving your tongue, unexplained weight loss, voice changes, ear pain, or a lump in the neck. The survival rate for oropharyngeal cancer varies depending on the stage, overall health, and response to treatment. While curability depends on several factors, advancements in treatment modalities have improved the chances of successful outcomes. Treatment options may involve a combination of surgery, radiation therapy, chemotherapy, or targeted therapy, depending on the stage and characteristics of the tumor. Guidelines provide healthcare providers with evidence-based recommendations for managing oropharyngeal cancer. Although oropharyngeal cancer is relatively rare, its prevalence has been increasing in recent years. Adopting a healthy diet can support overall well-being during treatment and recovery. Seeking medical attention for any concerning symptoms and understanding the significance of early detection can potentially save lives.

For Oropharyngeal Cancer 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 Oropharyngeal Cancer 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 Oropharyngeal Cancer?

For example does it matter if vegetable Wild Leek is consumed more compared to Yellow Bell Pepper? Does it make any difference if fruit Muscadine Grape is preferred over Nance? Also if similar choices are made for nuts/seeds like Common Hazelnut over Chestnut and for pulses like Black-eyed Pea over Pigeon Pea. And if what I eat matters – then how does one identify foods which are recommended for Oropharyngeal Cancer and is it the same answer for everyone with the same diagnosis or genetic risk?

Yes! Foods you eat matters for Oropharyngeal Cancer!

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 Muscadine Grape contains active ingredients Curcumin, Lupeol, Phloretin, Daidzein, Ellagic Acid. And Nance contains active ingredients Curcumin, Lupeol, Phloretin, Daidzein, Apigenin and possibly others.

A common mistake made when deciding and choosing foods to eat for Oropharyngeal Cancer – 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 Oropharyngeal Cancer.

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

Skills Needed for Nutrition Personalization for Oropharyngeal Cancer?

Personalized nutrition for cancers like Oropharyngeal Cancer 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 Oropharyngeal Cancer 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 Oropharyngeal Cancer

All cancers like Oropharyngeal Cancer can be characterized by a unique set of biochemical pathways – the signature pathways of Oropharyngeal Cancer. Biochemical pathways like Cell Cycle, Apoptosis, PI3K-AKT-MTOR Signaling, Cell Cycle Checkpoints are part of the signature definition of Oropharyngeal Cancer. Each individual’s cancer genetics can be different and hence their specific cancer signature could be unique.

The treatments which are effective for Oropharyngeal Cancer 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 Oropharyngeal Cancer when taking cancer treatment Cisplatin, 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.

TP53, PIK3CA, KMT2D, TOP2A and EP300 are the top ranked reported genes for Oropharyngeal Cancer. TP53 is reported in 26.3 % of the representative patients across all clinical trials. And PIK3CA is reported in 20.6 %. The combined population patient data cover ages from to . % of the patient data are identified as men. The Oropharyngeal Cancer 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 Oropharyngeal Cancer

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 WILD LEEK or YELLOW BELL PEPPER?

Vegetable Wild Leek contains many active ingredients or bioactives such as Curcumin, Lupeol, Phloretin, Daidzein, Apigenin. These active ingredients manipulate various biochemical pathways like Cell Cycle, Epithelial to Mesenchymal Transition, Amino Acid Metabolism and P53 Signaling and others. Wild Leek is recommended for Oropharyngeal Cancer when ongoing cancer treatment is Cisplatin. This is because Wild Leek modifies those biochemical pathways which have been scientifically reported to sensitize the effect of Cisplatin.

Some of the active ingredients or bioactives in vegetable Yellow Bell Pepper are Curcumin, Quercetin, Lupeol, Phloretin, Lycopene. These active ingredients manipulate various biochemical pathways like DNA Repair and MAPK Signaling and others. Yellow Bell Pepper is not recommended for Oropharyngeal Cancer when ongoing cancer treatment is Cisplatin because it modifies those biochemical pathways which make the cancer treatment resistant or less responsive.

VEGETABLE WILD LEEK IS RECOMMENDED OVER YELLOW BELL PEPPER FOR Oropharyngeal Cancer AND TREATMENT Cisplatin.

Choose Fruit NANCE or MUSCADINE GRAPE?

Fruit Nance contains many active ingredients or bioactives such as Curcumin, Lupeol, Phloretin, Daidzein, Apigenin. These active ingredients manipulate various biochemical pathways like Cell Cycle, Epithelial to Mesenchymal Transition, Amino Acid Metabolism and P53 Signaling and others. Nance is recommended for Oropharyngeal Cancer when ongoing cancer treatment is Cisplatin. This is because Nance modifies those biochemical pathways which have been scientifically reported to sensitize the effect of Cisplatin.

Some of the active ingredients or bioactives in fruit Muscadine Grape are Curcumin, Lupeol, Phloretin, Daidzein, Ellagic Acid. These active ingredients manipulate various biochemical pathways like DNA Repair, Epithelial to Mesenchymal Transition and WNT Beta Catenin Signaling and others. Muscadine Grape is not recommended for Oropharyngeal Cancer when ongoing cancer treatment is Cisplatin because it modifies those biochemical pathways which make the cancer treatment resistant or less responsive.

FRUIT NANCE IS RECOMMENDED OVER MUSCADINE GRAPE FOR Oropharyngeal Cancer AND TREATMENT Cisplatin.

Choose Nut COMMON HAZELNUT or CHESTNUT?

Common Hazelnut contains many active ingredients or bioactives such as Curcumin, Quercetin, Lupeol, Phloretin, Lycopene. These active ingredients manipulate various biochemical pathways like DNA Repair, Cell Cycle, Amino Acid Metabolism and Epithelial to Mesenchymal Transition and others. Common Hazelnut is recommended for Oropharyngeal Cancer when ongoing cancer treatment is Cisplatin. This is because Common Hazelnut modifies those biochemical pathways which have been scientifically reported to sensitize the effect of Cisplatin.

Some of the active ingredients or bioactives in Chestnut are Curcumin, Lupeol, Phloretin, Lycopene, Daidzein. These active ingredients manipulate various biochemical pathways like Epithelial to Mesenchymal Transition, WNT Beta Catenin Signaling and Oxidative Stress and others. Chestnut is not recommended for Oropharyngeal Cancer when ongoing cancer treatment is Cisplatin because it modifies those biochemical pathways which make the cancer treatment resistant or less responsive.

COMMON HAZELNUT IS RECOMMENDED OVER CHESTNUT FOR Oropharyngeal Cancer AND TREATMENT Cisplatin.

For Individuals with Genetic Risk of Cancer

The question asked by individuals who have genetic risk of Oropharyngeal Cancer 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 GREEN BELL PEPPER or MALABAR SPINACH?

Vegetable Green Bell Pepper contains many active ingredients or bioactives such as Curcumin, Quercetin, Resveratrol, Linalool, Lupeol. These active ingredients manipulate various biochemical pathways like Cell Cycle, Angiogenesis, P53 Signaling and Cell Cycle Checkpoints and others. Green Bell Pepper is recommended for risk of Oropharyngeal Cancer when associated genetic risk is EP300. This is because Green Bell Pepper increases those biochemical pathways which counteract the signature drivers of it.

Some of the active ingredients or bioactives in vegetable Malabar Spinach are Curcumin, Apigenin, Quercetin, Lupeol, Formononetin. These active ingredients manipulate various biochemical pathways like TGFB Signaling, Insulin Signaling and Sirtuin Signaling and others. Malabar Spinach is not recommended when risk of Oropharyngeal Cancer when associated genetic risk is EP300 because it increases the signature pathways of it.

VEGETABLE GREEN BELL PEPPER IS RECOMMENDED OVER MALABAR SPINACH FOR EP300 GENETIC RISK OF CANCER.

Choose Fruit WATERMELON or PUMMELO?

Fruit Watermelon contains many active ingredients or bioactives such as Curcumin, Lupeol, Formononetin, Isoliquiritigenin, Lycopene. These active ingredients manipulate various biochemical pathways like Cell Cycle, P53 Signaling and Insulin Signaling and others. Watermelon is recommended for risk of Oropharyngeal Cancer when associated genetic risk is EP300. This is because Watermelon increases those biochemical pathways which counteract the signature drivers of it.

Some of the active ingredients or bioactives in fruit Pummelo are Curcumin, Apigenin, Quercetin, Lupeol, Formononetin. These active ingredients manipulate various biochemical pathways like TGFB Signaling, Insulin Signaling and Cell Cycle Checkpoints and others. Pummelo is not recommended when risk of Oropharyngeal Cancer when associated genetic risk is EP300 because it increases the signature pathways of it.

FRUIT WATERMELON IS RECOMMENDED OVER PUMMELO FOR EP300 GENETIC RISK OF CANCER.

Choose Nut BUTTERNUT or EUROPEAN CHESTNUT?

Butternut contains many active ingredients or bioactives such as Curcumin, Apigenin, Lupeol, Formononetin, Isoliquiritigenin. These active ingredients manipulate various biochemical pathways like Cell Cycle, P53 Signaling and Insulin Signaling and others. Butternut is recommended for risk of Oropharyngeal Cancer when associated genetic risk is EP300. This is because Butternut increases those biochemical pathways which counteract the signature drivers of it.

Some of the active ingredients or bioactives in European Chestnut are Curcumin, Apigenin, Quercetin, Ellagic Acid, Lupeol. These active ingredients manipulate various biochemical pathways like TGFB Signaling, Insulin Signaling and Sirtuin Signaling and others. European Chestnut is not recommended when risk of Oropharyngeal Cancer when associated genetic risk is EP300 because it increases the signature pathways of it.

BUTTERNUT IS RECOMMENDED OVER EUROPEAN CHESTNUT FOR EP300 GENETIC RISK OF CANCER.

In Conclusion

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

References

• Daidzein exerts anti-tumor activity against bladder cancer cells via inhibition of FGFR3 pathway.
• Negative regulation of signal transducer and activator of transcription-3 signalling cascade by lupeol inhibits growth and induces apoptosis in hepatocellular carcinoma cells.
• Apoptotic markers in a prostate cancer cell line: effect of ellagic acid.
• Retinol decreases beta-catenin protein levels in retinoic acid-resistant colon cancer cell lines.
• 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.
• Effects and significance of formononetin on expression levels of HIF-1α and VEGF in mouse cervical cancer tissue.
• Isorhamnetin Induces Cell Cycle Arrest and Apoptosis Via Reactive Oxygen Species-Mediated AMP-Activated Protein Kinase Signaling Pathway Activation in Human Bladder Cancer Cells.
• https://my.clevelandclinic.org/health/diseases/12180-oropharyngeal-cancer
• https://www.cancercenter.com/cancer-types/head-and-neck-cancer/types/oropharyngeal-cancer