Foods for Choriocarcinoma!

Introduction

Foods for Choriocarcinoma 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.

Choriocarcinoma is a rare and aggressive form of cancer that arises from abnormal placental cells in the uterus or ovary. Although it most commonly occurs in the uterus following a molar pregnancy, choriocarcinoma can also affect males, typically originating in the testicles. Choriocarcinoma can spread quickly to other parts of the body including lungs, uterine muscle layer, lymph nodes, liver or kidneys, brain and blood vessels. There are two types of choriocarcinoma: gestinational and non-gestational. Gestational choriocarcinoma is more common and it refers to cancer developing while a person is pregrant. The non-gestational type affects all sexes. Symptoms may include abnormal vaginal bleeding, elevated levels of human chorionic gonadotropin (hCG) hormone, and enlarged ovaries or testicles. Early diagnosis and appropriate management are essential for optimal outcomes. Treatment options for choriocarcinoma may involve surgery, chemotherapy, and radiation therapy, depending on the stage and location of the tumor. Ultrasound imaging and monitoring hCG levels play crucial roles in diagnosis and monitoring response to treatment. Prognosis can vary depending on factors such as the extent of metastasis and hCG levels. Clinical management of choriocarcinoma involves a multidisciplinary approach with close coordination between oncologists, gynecologists, and other healthcare professionals.

For Choriocarcinoma 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 Choriocarcinoma 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 Choriocarcinoma?

For example does it matter if vegetable Cauliflower is consumed more compared to Mustard Spinach? Does it make any difference if fruit Muscadine Grape is preferred over Black Mulberry? Also if similar choices are made for nuts/seeds like Butternut over European Chestnut and for pulses like Gram Bean over Common Bean. And if what I eat matters – then how does one identify foods which are recommended for Choriocarcinoma and is it the same answer for everyone with the same diagnosis or genetic risk?

Yes! Foods you eat matters for Choriocarcinoma!

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, Isoliquiritigenin, Phloretin, Lupeol, Delphinidin. And Black Mulberry contains active ingredients Curcumin, Quercetin, Isoliquiritigenin, Phloretin, Lupeol and possibly others.

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

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

Skills Needed for Nutrition Personalization for Choriocarcinoma?

Personalized nutrition for cancers like Choriocarcinoma 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 Choriocarcinoma 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 Choriocarcinoma

All cancers like Choriocarcinoma can be characterized by a unique set of biochemical pathways – the signature pathways of Choriocarcinoma. Biochemical pathways like Epithelial to Mesenchymal Transition, Growth Factor Signaling, Oncogenic Cancer Epigenetics, PI3K-AKT-MTOR Signaling are part of the signature definition of Choriocarcinoma. Each individual’s cancer genetics can be different and hence their specific cancer signature could be unique.

The treatments which are effective for Choriocarcinoma 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 Choriocarcinoma when taking cancer treatment Methotrexate, 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.

DNMT3A, PPM1D, TP53, PALB2 and MRE11 are the top ranked reported genes for Choriocarcinoma. DNMT3A is reported in 27.5 % of the representative patients across all clinical trials. And PPM1D is reported in 15.0 %. The combined population patient data cover ages from 1 to 70. 87.7 % of the patient data are identified as men. The Choriocarcinoma 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 Choriocarcinoma

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 MUSTARD SPINACH?

Vegetable Cauliflower contains many active ingredients or bioactives such as Curcumin, Isoliquiritigenin, Phloretin, Lupeol, Delphinidin. These active ingredients manipulate various biochemical pathways like PI3K-AKT-MTOR Signaling, RAS-RAF Signaling, Epithelial to Mesenchymal Transition and Growth Factor Signaling and others. Cauliflower is recommended for Choriocarcinoma when ongoing cancer treatment is Methotrexate. This is because Cauliflower modifies those biochemical pathways which have been scientifically reported to sensitize the effect of Methotrexate.

Some of the active ingredients or bioactives in vegetable Mustard Spinach are Lycopene, Curcumin, Isoliquiritigenin, Phloretin, Lupeol. These active ingredients manipulate various biochemical pathways like WNT Beta Catenin Signaling and Epithelial to Mesenchymal Transition and others. Mustard Spinach is not recommended for Choriocarcinoma when ongoing cancer treatment is Methotrexate because it modifies those biochemical pathways which make the cancer treatment resistant or less responsive.

VEGETABLE CAULIFLOWER IS RECOMMENDED OVER MUSTARD SPINACH FOR Choriocarcinoma AND TREATMENT Methotrexate.

Choose Fruit BLACK MULBERRY or MUSCADINE GRAPE?

Fruit Black Mulberry contains many active ingredients or bioactives such as Curcumin, Quercetin, Isoliquiritigenin, Phloretin, Lupeol. These active ingredients manipulate various biochemical pathways like PI3K-AKT-MTOR Signaling and Epithelial to Mesenchymal Transition and others. Black Mulberry is recommended for Choriocarcinoma when ongoing cancer treatment is Methotrexate. This is because Black Mulberry modifies those biochemical pathways which have been scientifically reported to sensitize the effect of Methotrexate.

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

FRUIT BLACK MULBERRY IS RECOMMENDED OVER MUSCADINE GRAPE FOR Choriocarcinoma AND TREATMENT Methotrexate.

Choose Nut BUTTERNUT or EUROPEAN CHESTNUT?

Butternut contains many active ingredients or bioactives such as Lycopene, Curcumin, Isoliquiritigenin, Juglone, Phloretin. These active ingredients manipulate various biochemical pathways like WNT Beta Catenin Signaling, PI3K-AKT-MTOR Signaling, Epithelial to Mesenchymal Transition and Growth Factor Signaling and others. Butternut is recommended for Choriocarcinoma when ongoing cancer treatment is Methotrexate. This is because Butternut modifies those biochemical pathways which have been scientifically reported to sensitize the effect of Methotrexate.

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

BUTTERNUT IS RECOMMENDED OVER EUROPEAN CHESTNUT FOR Choriocarcinoma AND TREATMENT Methotrexate.

For Individuals with Genetic Risk of Cancer

The question asked by individuals who have genetic risk of Choriocarcinoma 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 TOWEL GOURD?

Vegetable Giant Butterbur contains many active ingredients or bioactives such as Apigenin, Curcumin, Formononetin, Lupeol, Daidzein. These active ingredients manipulate various biochemical pathways like Angiogenesis, JAK-STAT Signaling, PI3K-AKT-MTOR Signaling and P53 Signaling and others. Giant Butterbur is recommended for risk of Choriocarcinoma when associated genetic risk is DNMT3A. 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 Towel Gourd are Apigenin, Curcumin, Formononetin, Lupeol, Daidzein. These active ingredients manipulate various biochemical pathways like Oxidative Stress, Stem Cell Signaling, DNA Repair and MAPK Signaling and others. Towel Gourd is not recommended when risk of Choriocarcinoma when associated genetic risk is DNMT3A because it increases the signature pathways of it.

VEGETABLE GIANT BUTTERBUR IS RECOMMENDED OVER TOWEL GOURD FOR DNMT3A GENETIC RISK OF CANCER.

Choose Fruit NANCE or ABIYUCH?

Fruit Nance contains many active ingredients or bioactives such as Apigenin, Curcumin, Formononetin, Lupeol, Daidzein. These active ingredients manipulate various biochemical pathways like Angiogenesis, JAK-STAT Signaling, PI3K-AKT-MTOR Signaling and P53 Signaling and others. Nance is recommended for risk of Choriocarcinoma when associated genetic risk is DNMT3A. This is because Nance increases those biochemical pathways which counteract the signature drivers of it.

Some of the active ingredients or bioactives in fruit Abiyuch are Apigenin, Curcumin, Formononetin, Lupeol, Daidzein. These active ingredients manipulate various biochemical pathways like Oxidative Stress, DNA Repair, Stem Cell Signaling and Oncogenic Cancer Epigenetics and others. Abiyuch is not recommended when risk of Choriocarcinoma when associated genetic risk is DNMT3A because it increases the signature pathways of it.

FRUIT NANCE IS RECOMMENDED OVER ABIYUCH FOR DNMT3A GENETIC RISK OF CANCER.

Choose Nut COMMON HAZELNUT or CHESTNUT?

Common Hazelnut contains many active ingredients or bioactives such as Curcumin, Formononetin, Lupeol, Daidzein, Quercetin. These active ingredients manipulate various biochemical pathways like Oxidative Stress, Angiogenesis, JAK-STAT Signaling and PI3K-AKT-MTOR Signaling and others. Common Hazelnut is recommended for risk of Choriocarcinoma when associated genetic risk is DNMT3A. This is because Common Hazelnut increases those biochemical pathways which counteract the signature drivers of it.

Some of the active ingredients or bioactives in Chestnut are Apigenin, Curcumin, Ellagic Acid, Formononetin, Lupeol. These active ingredients manipulate various biochemical pathways like Oxidative Stress, Stem Cell Signaling and DNA Repair and others. Chestnut is not recommended when risk of Choriocarcinoma when associated genetic risk is DNMT3A because it increases the signature pathways of it.

COMMON HAZELNUT IS RECOMMENDED OVER CHESTNUT FOR DNMT3A GENETIC RISK OF CANCER.

In Conclusion

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

References

• Msk Ch 2020
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• Lycopene differentially induces quiescence and apoptosis in androgen-responsive and -independent prostate cancer cell lines.
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• Gallic acid provokes DNA damage and suppresses DNA repair gene expression in human prostate cancer PC-3 cells.
• https://my.clevelandclinic.org/health/diseases/24863-choriocarcinoma
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