Foods for Ampullary Carcinoma?

Introduction

Foods for Ampullary 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.

Ampullary carcinoma, a rare malignancy occurring at the junction of the bile duct and pancreatic duct, is distinct in its presentation and prognosis. The ICD-10 classification for ampullary carcinoma aids in its standardized reporting and treatment tracking. Pathology outlines of this cancer are critical for diagnosis, often highlighting unique histological features. Staging, which can be determined through radiology, including CT scans, is essential for assessing the tumor’s extent and planning treatment, with staging radiology playing a pivotal role. The survival rate and prognosis of ampullary carcinoma vary, depending on the stage at diagnosis and response to treatment. Common symptoms include jaundice, abdominal pain, and weight loss. Treatment typically involves surgical resection, potentially followed by adjuvant chemotherapy, especially in cases where the tumor is advanced or there is a high risk of recurrence. The CAP (College of American Pathologists) protocol provides guidelines for the pathological assessment of ampullary carcinoma. A comparison with cholangiocarcinoma, another biliary tract cancer, is important for accurate diagnosis, as the treatment approach and prognosis can differ significantly between these two conditions. Overall, the management of ampullary carcinoma requires a comprehensive and multidisciplinary approach, combining surgical and chemotherapeutic strategies to improve outcomes for patients.

For Ampullary 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 Ampullary 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 Ampullary Carcinoma?

For example does it matter if vegetable Giant Butterbur is consumed more compared to Swede? Does it make any difference if fruit Pummelo is preferred over Red Raspberry? Also if similar choices are made for nuts/seeds like Butternut over European Chestnut and for pulses like Broad Bean over Soy Bean. And if what I eat matters – then how does one identify foods which are recommended for Ampullary Carcinoma and is it the same answer for everyone with the same diagnosis or genetic risk?

Yes! Foods you eat matters for Ampullary 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 Quercetin, Curcumin, Phloretin, Naringenin, Naringin. And Red Raspberry contains active ingredients Quercetin, Ellagic Acid, Curcumin, Phloretin, Formononetin and possibly others.

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

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

Skills Needed for Nutrition Personalization for Ampullary Carcinoma?

Personalized nutrition for cancers like Ampullary 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 Ampullary 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 Ampullary Carcinoma

All cancers like Ampullary Carcinoma can be characterized by a unique set of biochemical pathways – the signature pathways of Ampullary Carcinoma. Biochemical pathways like Nucleotide metabolism, Amino Acid Metabolism, PI3K-AKT-MTOR Signaling, MAPK Signaling are part of the signature definition of Ampullary Carcinoma. Each individual’s cancer genetics can be different and hence their specific cancer signature could be unique.

The treatments which are effective for Ampullary 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 Ampullary Carcinoma when taking cancer treatment Gemcitabine, 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, KRAS, APC, SMAD4 and PIK3CA are the top ranked reported genes for Ampullary Carcinoma. TP53 is reported in 56.2 % of the representative patients across all clinical trials. And KRAS is reported in 48.9 %. The combined population patient data cover ages from 32 to 87. 62.3 % of the patient data are identified as men. The Ampullary 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 Ampullary 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 GIANT BUTTERBUR or SWEDE?

Vegetable Giant Butterbur contains many active ingredients or bioactives such as Curcumin, Myricetin, Phloretin, Formononetin, Lycopene. These active ingredients manipulate various biochemical pathways like Metastasis, PI3K-AKT-MTOR Signaling, NFKB Signaling and Epithelial to Mesenchymal Transition and others. Giant Butterbur is recommended for Ampullary Carcinoma when ongoing cancer treatment is Gemcitabine. This is because Giant Butterbur modifies those biochemical pathways which have been scientifically reported to sensitize the effect of Gemcitabine.

Some of the active ingredients or bioactives in vegetable Swede are Curcumin, Phloretin, Formononetin, Lupeol, Caffeic Acid. These active ingredients manipulate various biochemical pathways like Oxidative Stress, TGFB Signaling and Endoplasmic Reticulum Stress and others. Swede is not recommended for Ampullary Carcinoma when ongoing cancer treatment is Gemcitabine because it modifies those biochemical pathways which make the cancer treatment resistant or less responsive.

VEGETABLE GIANT BUTTERBUR IS RECOMMENDED OVER SWEDE FOR Ampullary Carcinoma AND TREATMENT Gemcitabine.

Choose Fruit RED RASPBERRY or PUMMELO?

Fruit Red Raspberry contains many active ingredients or bioactives such as Quercetin, Ellagic Acid, Curcumin, Phloretin, Formononetin. These active ingredients manipulate various biochemical pathways like Metastasis, PI3K-AKT-MTOR Signaling, NFKB Signaling and Epithelial to Mesenchymal Transition and others. Red Raspberry is recommended for Ampullary Carcinoma when ongoing cancer treatment is Gemcitabine. This is because Red Raspberry modifies those biochemical pathways which have been scientifically reported to sensitize the effect of Gemcitabine.

Some of the active ingredients or bioactives in fruit Pummelo are Quercetin, Curcumin, Phloretin, Naringenin, Naringin. These active ingredients manipulate various biochemical pathways like Oxidative Stress and Endoplasmic Reticulum Stress and others. Pummelo is not recommended for Ampullary Carcinoma when ongoing cancer treatment is Gemcitabine because it modifies those biochemical pathways which make the cancer treatment resistant or less responsive.

FRUIT RED RASPBERRY IS RECOMMENDED OVER PUMMELO FOR Ampullary Carcinoma AND TREATMENT Gemcitabine.

Choose Nut BUTTERNUT or EUROPEAN CHESTNUT?

Butternut contains many active ingredients or bioactives such as Curcumin, Myricetin, Phloretin, Formononetin, Lycopene. These active ingredients manipulate various biochemical pathways like Metastasis, NFKB Signaling, Cell Cycle and Epithelial to Mesenchymal Transition and others. Butternut is recommended for Ampullary Carcinoma when ongoing cancer treatment is Gemcitabine. This is because Butternut modifies those biochemical pathways which have been scientifically reported to sensitize the effect of Gemcitabine.

Some of the active ingredients or bioactives in European Chestnut are Quercetin, Ellagic Acid, Curcumin, Myricetin, Phloretin. These active ingredients manipulate various biochemical pathways like Oxidative Stress and TGFB Signaling and others. European Chestnut is not recommended for Ampullary Carcinoma when ongoing cancer treatment is Gemcitabine because it modifies those biochemical pathways which make the cancer treatment resistant or less responsive.

BUTTERNUT IS RECOMMENDED OVER EUROPEAN CHESTNUT FOR Ampullary Carcinoma AND TREATMENT Gemcitabine.

For Individuals with Genetic Risk of Cancer

The question asked by individuals who have genetic risk of Ampullary 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 WILD LEEK or TURNIP?

Vegetable Wild Leek contains many active ingredients or bioactives such as Curcumin, Apigenin, Lupeol, Daidzein, Formononetin. These active ingredients manipulate various biochemical pathways like TGFB Signaling, Oxidative Stress, Cell Cycle and PI3K-AKT-MTOR Signaling and others. Wild Leek is recommended for risk of Ampullary Carcinoma when associated genetic risk is APC. This is because Wild Leek increases those biochemical pathways which counteract the signature drivers of it.

Some of the active ingredients or bioactives in vegetable Turnip are Ellagic Acid, Curcumin, Quercetin, Lupeol, Daidzein. These active ingredients manipulate various biochemical pathways like Oxidative Stress and others. Turnip is not recommended when risk of Ampullary Carcinoma when associated genetic risk is APC because it increases the signature pathways of it.

VEGETABLE WILD LEEK IS RECOMMENDED OVER TURNIP FOR APC GENETIC RISK OF CANCER.

Choose Fruit NANCE or JUJUBE?

Fruit Nance contains many active ingredients or bioactives such as Curcumin, Apigenin, Myricetin, Lupeol, Daidzein. These active ingredients manipulate various biochemical pathways like TGFB Signaling, RAS-RAF Signaling, Cell Cycle and PI3K-AKT-MTOR Signaling and others. Nance is recommended for risk of Ampullary Carcinoma when associated genetic risk is APC. This is because Nance increases those biochemical pathways which counteract the signature drivers of it.

Some of the active ingredients or bioactives in fruit Jujube are Curcumin, Quercetin, Apigenin, Myricetin, Lupeol. These active ingredients manipulate various biochemical pathways like Oxidative Stress, Angiogenesis and PI3K-AKT-MTOR Signaling and others. Jujube is not recommended when risk of Ampullary Carcinoma when associated genetic risk is APC because it increases the signature pathways of it.

FRUIT NANCE IS RECOMMENDED OVER JUJUBE FOR APC GENETIC RISK OF CANCER.

Choose Nut COMMON HAZELNUT or CHESTNUT?

Common Hazelnut contains many active ingredients or bioactives such as Curcumin, Quercetin, Myricetin, Lupeol, Daidzein. These active ingredients manipulate various biochemical pathways like Angiogenesis, RAS-RAF Signaling, Cell Cycle and PI3K-AKT-MTOR Signaling and others. Common Hazelnut is recommended for risk of Ampullary Carcinoma when associated genetic risk is APC. 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 Ellagic Acid, Curcumin, Apigenin, Myricetin, Lupeol. These active ingredients manipulate various biochemical pathways like Oxidative Stress, Stem Cell Signaling and TGFB Signaling and others. Chestnut is not recommended when risk of Ampullary Carcinoma when associated genetic risk is APC because it increases the signature pathways of it.

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

In Conclusion

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

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