Which Foods are Recommended for Polycythemia Vera?

Highlights

No two cancers are the same, nor are they treated the same, and neither should nutrition be the same for everyone. Nutrition includes foods like pulses, vegetables, fruits, nuts, oils, herbs and spices. Also nutrition includes supplements which are high concentrations of foods or high concentrations of individual ingredients found in foods. For cancers like Polycythemia Vera when undergoing chemotherapy or when you determine you have a genetic risk for developing Polycythemia Vera because of JAK2 and SH2B3 gene mutations, a very important question is “What foods should I avoid and what foods are recommended specifically for me?”. The other related question is “What nutritional supplements should I avoid?”.

There is no one answer to this question for cancers such as Polycythemia Vera which can be found through internet searches. The answer to the question is “It Depends” because the nutrition plan needs to be personalized for you. Nutrition should depend on the cancer indication, genetic information, adult or pediatric, staging, primary or secondary, advanced, metastatic, relapsed or refractory, ongoing treatments if any, nutritional supplements being taken, age and factors like gender, weight, height, lifestyle, allergies and food preferences.

In short – the process to answer questions like “Should I Avoid eating fruit Fig” or “Include fruit Watermelon in my diet” or “Should I reduce consumption of vegetable Spinach” or “Can I take Dim and Andrographis supplements” is not as simple as internet searches. The process is very complex and answers are based on knowhow of genetics, action of treatments, active ingredients in foods and their associated biological action. Finally the answer to the nutrition question needs to be personalized for you.

RECOMMENDATION: PERSONALIZE YOUR FOODS AND SUPPLEMENTS TO POLYCYTHEMIA VERA, TREATMENTS, GENETIC INFORMATION, AND OTHER CONDITIONS.

The overall objective of personalized nutrition for Polycythemia Vera is to minimize foods and nutritional supplements which have adverse interactions with cancer molecular drivers and ongoing treatments. And identify those foods and supplements which have a beneficial action. Whenever there are changes in treatments or diagnosis – it is important to remember that your foods and supplements need re-evaluation. And the answers to the nutrition question could be different based on the new context.

RECOMMENDATION: UPDATE YOUR NUTRITION FOR POLYCYTHEMIA VERA, WHEN TREATMENTS, DISEASE STATUS AND OTHER CONDITIONS CHANGE.

About Polycythemia Vera

cBioPortal is one source of collection of cancer patient data from clinical trials across 350 plus cancer indications. The data from each clinical trial includes the clinical trial name and study details like number of patients, ages, gender, ethnicity, treatments, tumor site, genetic aberrations found and analysis of all the data. The cBioPortal for Cancer Genomics was originally developed at Memorial Sloan Kettering Cancer Center (MSK). The public cBioPortal site is hosted by the Center for Molecular Oncology at MSK – https://www.cbioportal.org/about.

Following key highlights are derived from clinical data for Polycythemia Vera from cBioPortal. From a patient sample size of 52; the top genes with mutations and other abnormalities for Polycythemia Vera include genes JAK2, TET2, DNMT3A, SH2B3 and ARID2. The occurrence frequency distribution for these genes respectively is 76.5%, 21.6%, 9.8%, 3.9% and 2.0%. These tumor genetic details of Polycythemia Vera are mapped to molecular biochemical pathway drivers of cancer thereby providing definition of characteristic features of Polycythemia Vera.

Polycythemia vera is a rare, chronic, blood cell disorder, classified as a myeloproliferative neoplasm or MPN. Polycythemia vera is caused by the dramatic overproduction of red blood cells (RBCs) in the bone marrow, along with excessive production of white blood cells and platelets too. It affects slightly more men than women and it occurs most often in individuals more than 60 years old. Individuals with polycythemia vera have an abnormally high number of circulating RBCs in their blood, causing the blood to thicken and increase in volume (a condition called hyperviscosity). Thickened blood may not flow through the smaller blood vessels (capillaries) properly. A range of symptoms can occur in individuals with polycythemia vera including nonspecific symptoms such as headaches, fatigue, weakness, dizziness, itchy skin; an enlarged spleen (splenomegaly); a variety of gastrointestinal problems; and a high risk of blood clot formation, which may prevent blood flow to vital organs. More than 90% of the individuals with polycythemia vera have a mutation in the JAK2 gene. The treatment of polycythemia vera is aimed at reducing the levels of red blood cells and preventing the complications especially of blood clot formation (thrombosis). Treatment options include phlebotomy (drawing out blood at regular intervals) to reduce the volume of circulating RBCs so that blood can flow properly. Patients are also treated with myelosuppressive drugs like hydroxyurea and busulfan, that suppress the formation of blood cells in the bone marrow. There are additional treatments such as low-dose aspirin and a newly approved drug targeted to the JAK2 enzyme that is found to be effective. Additionally, supportive care with the right nutrition (foods and natural supplements) that have inherent bioactives to modulate the disease causing pathways can help improve patient well-being. (Ref: https://www.lls.org/sites/default/files/file_assets/FS13_PolycythemiaVera_FactSheet_final5.1.15.pdf;
https://rarediseases.org/rare-diseases/polycythemia-vera/)

Significance of Nutrition for Polycythemia Vera

All foods and nutritional supplements consist of a collection of one or more active chemical ingredients in different proportions and quantities. The action of some active ingredients in a food can have adverse interactions while other active ingredients in the same food may be supportive from the context of Polycythemia Vera. Hence the same food has good and not-so-good actions and analysis of combined effect will be needed to come up with a personalized nutrition plan.

For example Fig includes active ingredients Bergapten, Vitamin C, Lupeol, Psoralen, Beta-sitosterol and others. And Watermelon contains active ingredients Cucurbitacin E, Lycopene, Vitamin C, Linolenic Acid, Oleic Acid and others. It is likely that some of these active ingredients of the same food could have opposing effects and hence it is recommended to identify recommended foods based on analysis of all high quantity ingredients contained in foods.

For cancers like Polycythemia Vera, activation or inhibition of selected biochemical pathways like RAS-RAF Signaling, Cytokine Signaling, JAK-STAT Signaling, Hematopoiesis plays an important role in driving cancer growth. Similarly different treatments work via different molecular actions which should never be canceled out by your foods and supplements. The foods and nutritional supplements contain different active ingredients each of which have a specific molecular action on different biochemical pathways. Hence, eating some foods and nutritional supplements would be recommended with a specific treatment of Polycythemia Vera, while eating some other foods and supplements may not be recommended.

One common mistake when finding foods to eat or not – is to consider only a few active ingredients contained in foods based on internet searches and ignore the rest. Because different active ingredients contained in foods may have opposing effects on relevant biochemical pathways – it is recommended to consider all the high quantity active ingredients that are present in significant and much larger than trace amounts in the food.

RECOMMENDATION: TO FIND RECOMMENDED AND NON-RECOMMENDED FOODS FOR POLYCYTHEMIA VERA – CONSIDER HIGH QUANTITY ACTIVE INGREDIENTS CONTAINED IN FOODS.

Foods for Polycythemia Vera undergoing chemotherapy treatment

In Polycythemia Vera – the genes JAK2, TET2, DNMT3A, SH2B3 and ARID2 have high occurrences of genomic abnormalities. Not all of these genes necessarily are relevant for cancer – though they have been reported. Some of these genes directly or indirectly end up manipulating different cancer related biochemical biological pathways. Some of the pathways which are relevant drivers for Polycythemia Vera are RAS-RAF Signaling, Cytokine Signaling, JAK-STAT Signaling and others. Ruxolitinib is one of the chemotherapies used for cancer treatment. The intent of treatment is to negate or cancel out effects of biochemical pathway drivers RAS-RAF Signaling, Cytokine Signaling, JAK-STAT Signaling so as to reduce disease progression and inhibit growth. Those foods whose combined action of active ingredients support treatment action and do not enhance disease drivers are recommended foods and supplements which will be included in personalized nutrition. And similarly – those foods whose combined action of active ingredients is not supportive of treatment action but end up promoting disease drives will not be recommended in your personalized nutrition plan.

RECOMMENDATION: AVOID SUPPLEMENTS AND FOODS WHICH ARE NOT SUPPORTIVE OF CANCER TREATMENT ACTION AND RATHER ENHANCE DISEASE DRIVERS.

Eat more pulses, Mung Bean or Lentils?

Pulses are an important part of many diets. The active ingredients contained in Mung Bean are Stigmasterol, Quercetin, Vitamin C, Linolenic Acid, Vitexin among others. While the active ingredients contained in Lentils are Vitamin C, Esculin, Ellagic Acid, Linolenic Acid, Isoliquiritigenin and others.

Stigmasterol can manipulate biochemical pathways MYC Signaling, Cytokine Signaling and JAK-STAT Signaling. Quercetin has biological action on biochemical pathways DNA Repair, MAPK Signaling and Oncogenic Cancer Epigenetics.

Ellagic Acid can manipulate biochemical pathways MYC Signaling. Genistein has biological action on biochemical pathways DNA Repair. And so on.

When treating Polycythemia Vera with chemotherapy Ruxolitinib – Foods like Mung Bean are recommended compared to Lentils. This is because the active ingredients Ellagic Acid and Genistein in Lentils interferes with treatment action by canceling out the biochemical pathways through which the chemotherapy works. While the active ingredients Stigmasterol and Quercetin contained in Mung Bean support the treatment action by enhancing the biochemical pathway effect through which the chemotherapy works.

RECOMMENDATION: MUNG BEAN IS RECOMMENDED OVER LENTILS FOR POLYCYTHEMIA VERA ON TREATMENT WITH CHEMOTHERAPY RUXOLITINIB FOR SOME CONDITIONS.

Eat more vegetables, Bitter Melon or Spinach?

Vegetables are an important part of many diets. The active ingredients contained in Bitter Melon are Cucurbitacin I, Cucurbitacin E, Vitamin C, Linolenic Acid, Ferulic Acid among others. While the active ingredients contained in Spinach are Quercetin, Apigenin, Vitamin C, Linolenic Acid, Kaempferol and others.

Vitamin C can manipulate biochemical pathways MYC Signaling, MAPK Signaling and Oncogenic Cancer Epigenetics. Cucurbitacin I has biological action on biochemical pathways Cytokine Signaling, JAK-STAT Signaling and RAS-RAF Signaling.

Apigenin can manipulate biochemical pathways DNA Repair. Folic Acid has biological action on biochemical pathways MYC Signaling, JAK-STAT Signaling and MAPK Signaling. And so on.

When treating Polycythemia Vera with chemotherapy Ruxolitinib – Foods like Bitter Melon are recommended compared to Spinach. This is because the active ingredients Apigenin and Folic Acid in Spinach interferes with treatment action by canceling out the biochemical pathways through which the chemotherapy works. While the active ingredients Vitamin C and Cucurbitacin I contained in Bitter Melon support the treatment action by enhancing the biochemical pathway effect through which the chemotherapy works.

RECOMMENDATION: BITTER MELON IS RECOMMENDED OVER SPINACH FOR POLYCYTHEMIA VERA ON TREATMENT WITH CHEMOTHERAPY RUXOLITINIB FOR SOME CONDITIONS.

Eat more fruits, Watermelon or Fig?

Fruits are an important part of many diets. The active ingredients contained in Watermelon are Cucurbitacin E, Lycopene, Vitamin C, Linolenic Acid, Oleic Acid among others. While the active ingredients contained in Fig are Bergapten, Vitamin C, Lupeol, Psoralen, Beta-sitosterol and others.

Lycopene can manipulate biochemical pathways JAK-STAT Signaling, MYC Signaling and MAPK Signaling. Cucurbitacin E has biological action on biochemical pathways Cytokine Signaling, MYC Signaling and JAK-STAT Signaling.

Palmitic Acid can manipulate biochemical pathways Oncogenic Cancer Epigenetics and MAPK Signaling. Lauric Acid has biological action on biochemical pathways MYC Signaling and MAPK Signaling. And so on.

When treating Polycythemia Vera with chemotherapy Ruxolitinib – Foods like Watermelon are recommended compared to Fig. This is because the active ingredients Palmitic Acid and Lauric Acid in Fig interferes with treatment action by canceling out the biochemical pathways through which the chemotherapy works. While the active ingredients Lycopene and Cucurbitacin E contained in Watermelon support the treatment action by enhancing the biochemical pathway effect through which the chemotherapy works.

RECOMMENDATION: WATERMELON IS RECOMMENDED OVER FIG FOR POLYCYTHEMIA VERA ON TREATMENT WITH CHEMOTHERAPY RUXOLITINIB FOR SOME CONDITIONS.

Eat more nuts, Almond or Chestnut?

Nuts are an important part of many diets. The active ingredients contained in Almond are Stigmasterol, Quercetin, Vitamin E, Linolenic Acid, Salicylic Acid among others. While the active ingredients contained in Chestnut are Quercetin, Vitamin C, Ellagic Acid, Linolenic Acid, Oleic Acid and others.

Beta-sitosterol can manipulate biochemical pathways MYC Signaling, Oncogenic Cancer Epigenetics and Hypoxia. Stigmasterol has biological action on biochemical pathways Cytokine Signaling, JAK-STAT Signaling and MAPK Signaling.

Ellagic Acid can manipulate biochemical pathways MYC Signaling. Gallic Acid has biological action on biochemical pathways DNA Repair. And so on.

When treating Polycythemia Vera with chemotherapy Ruxolitinib – Foods like Almond are recommended compared to Chestnut. This is because the active ingredients Ellagic Acid and Gallic Acid in Chestnut interferes with treatment action by canceling out the biochemical pathways through which the chemotherapy works. While the active ingredients Beta-sitosterol and Stigmasterol contained in Almond support the treatment action by enhancing the biochemical pathway effect through which the chemotherapy works.

RECOMMENDATION: ALMOND IS RECOMMENDED OVER CHESTNUT FOR POLYCYTHEMIA VERA ON TREATMENT WITH CHEMOTHERAPY RUXOLITINIB FOR SOME CONDITIONS.

Foods for Genetic Risk of Polycythemia Vera

One of the ways to assess risk of cancer is by checking for presence of genetic abnormalities in a set of genes. There is prior information on a list of genes whose mutations and other aberrations can play a role in risk to different cancers. JAK2 and SH2B3 are two genes whose abnormalities are risk factors for Polycythemia Vera. In such a cancer risk situation – while there are typically no treatments which a physician can prescribe – the various biochemical pathways which are potentially molecular drivers of Polycythemia Vera can be used as a guide for coming up with a recommended personalized nutrition plan. For Polycythemia Vera gene JAK2 has causative impact on biological pathways like AGE-RAGE Signaling, Chemokine Signaling and Hematopoiesis. And SH2B3 has a causative impact on biological pathways like Hematopoiesis, Growth Factor Signaling and Growth Factor Signaling. Foods and nutritional supplements which have molecular action to cancel out biochemical pathways effects of genes like JAK2 and SH2B3 should be included in a personalized nutrition plan. And those foods and supplements which promote the effects of genes JAK2 and SH2B3 should be avoided.

Eat more pulses, Scarlet Bean or Common Bean?

The active ingredients contained in Scarlet Bean are Stigmasterol, Vitamin C, Oleic Acid, Beta-sitosterol, Linolenic Acid among others. While the active ingredients contained in Common Bean are Apigenin, Kaempferol, Esculin, Vitamin C, Oleic Acid and others.

Stigmasterol can manipulate biochemical pathways MYC Signaling, Cytokine Signaling and JAK-STAT Signaling. Vitamin C has biological action on biochemical pathways RAS-RAF Signaling, Oncogenic Cancer Epigenetics and PI3K-AKT-MTOR Signaling.

Pelargonidin can manipulate biochemical pathways MYC Signaling and PI3K-AKT-MTOR Signaling. Folic Acid has biological action on biochemical pathways RAS-RAF Signaling, JAK-STAT Signaling and MYC Signaling. And so on.

For genetic risk of Polycythemia Vera due to abnormalities in genes JAK2 and SH2B3 – Foods like Scarlet Bean are recommended compared to Common Bean. This is because the active ingredients Pelargonidin and Folic Acid in Common Bean further promote the effects of genes on the biochemical pathways. While the active ingredients Stigmasterol and Vitamin C contained in Scarlet Bean together have a canceling effect of genes on the biochemical pathways.

RECOMMENDATION: SCARLET BEAN IS RECOMMENDED OVER COMMON BEAN FOR REDUCING THE GENETIC RISK OF POLYCYTHEMIA VERA DUE TO GENES JAK2 AND SH2B3

Eat more vegetables, Cluster Bean or Carob?

The active ingredients contained in Cluster Bean are Stigmasterol, Vitamin C, Beta-sitosterol, Oleic Acid, Linolenic Acid among others. While the active ingredients contained in Carob are Quercetin, Myricetin, Phloroglucinol, Gallic Acid, Palmitic Acid and others.

Stigmasterol can manipulate biochemical pathways MYC Signaling, Cytokine Signaling and JAK-STAT Signaling. Vitamin C has biological action on biochemical pathways RAS-RAF Signaling, Oncogenic Cancer Epigenetics and PI3K-AKT-MTOR Signaling.

Palmitic Acid can manipulate biochemical pathways Oncogenic Cancer Epigenetics. Myricetin has biological action on biochemical pathways Oncogenic Cancer Epigenetics. And so on.

For genetic risk of Polycythemia Vera due to abnormalities in genes JAK2 and SH2B3 – Foods like Cluster Bean are recommended compared to Carob. This is because the active ingredients Palmitic Acid and Myricetin in Carob further promote the effects of genes on the biochemical pathways. While the active ingredients Stigmasterol and Vitamin C contained in Cluster Bean together have a canceling effect of genes on the biochemical pathways.

RECOMMENDATION: CLUSTER BEAN IS RECOMMENDED OVER CAROB FOR REDUCING THE GENETIC RISK OF POLYCYTHEMIA VERA DUE TO GENES JAK2 AND SH2B3

Eat more fruits, Apricot or Plum?

The active ingredients contained in Apricot are Quercetin, Modified Citrus Pectin, Stigmasterol, Glucaric Acid, Vitamin C among others. While the active ingredients contained in Plum are Quercetin, Betulinic Acid, Glucaric Acid, Vitamin C, Beta-sitosterol and others.

Glucaric Acid can manipulate biochemical pathways MYC Signaling, RAS-RAF Signaling and PI3K-AKT-MTOR Signaling. Rutin has biological action on biochemical pathways Cytokine Signaling, JAK-STAT Signaling and MYC Signaling.

Palmitic Acid can manipulate biochemical pathways Oncogenic Cancer Epigenetics. Lauric Acid has biological action on biochemical pathways MYC Signaling and PI3K-AKT-MTOR Signaling. And so on.

For genetic risk of Polycythemia Vera due to abnormalities in genes JAK2 and SH2B3 – Foods like Apricot are recommended compared to Plum. This is because the active ingredients Palmitic Acid and Lauric Acid in Plum further promote the effects of genes on the biochemical pathways. While the active ingredients Glucaric Acid and Rutin contained in Apricot together have a canceling effect of genes on the biochemical pathways.

RECOMMENDATION: APRICOT IS RECOMMENDED OVER PLUM FOR REDUCING THE GENETIC RISK OF POLYCYTHEMIA VERA DUE TO GENES JAK2 AND SH2B3

Eat more nuts, Walnut or Acorn?

The active ingredients contained in Walnut are Quercetin, Betulinic Acid, D-limonene, Myricetin, Stigmasterol among others. While the active ingredients contained in Acorn are Quercetin, Vitamin C, Beta-sitosterol, Beta-carotene, Gallic Acid and others.

D-limonene can manipulate biochemical pathways MYC Signaling, RAS-RAF Signaling and PI3K-AKT-MTOR Signaling. Vitamin C has biological action on biochemical pathways Oncogenic Cancer Epigenetics, MYC Signaling and RAS-RAF Signaling.

Vitamin B2 can manipulate biochemical pathways Oncogenic Cancer Epigenetics. Folic Acid has biological action on biochemical pathways MYC Signaling, RAS-RAF Signaling and JAK-STAT Signaling. And so on.

For genetic risk of Polycythemia Vera due to abnormalities in genes JAK2 and SH2B3 – Foods like Walnut are recommended compared to Acorn. This is because the active ingredients Vitamin B2 and Folic Acid in Acorn further promote the effects of genes on the biochemical pathways. While the active ingredients D-limonene and Vitamin C contained in Walnut together have a canceling effect of genes on the biochemical pathways.

RECOMMENDATION: WALNUT IS RECOMMENDED OVER ACORN FOR REDUCING THE GENETIC RISK OF POLYCYTHEMIA VERA DUE TO GENES JAK2 AND SH2B3

In Summary

An important thing to remember is that cancer treatments may not be the same for everyone – and neither should your nutrition be. Nutrition which includes food and nutritional supplements is a very effective tool controlled by you.

“What should I eat?” is the most frequently asked question in the context of cancer. The answer calculation is complex and depends upon cancer type, underlying genomics, current treatments, any allergies, lifestyle information, and factors like BMI.

The addon personalized nutrition plan recommends foods and supplements which minimizes adverse nutrition interactions and encourages support to treatments.

You can get started NOW and design a personalized nutrition plan for Polycythemia Vera by answering questions on type of cancer, current treatments, supplements, allergies, age group, gender, and lifestyle information.

What food you eat and which supplements you take is a decision you make. Your decision should include consideration of the cancer gene mutations, which cancer, ongoing treatments and supplements, any allergies, lifestyle information, weight, height and habits.

The nutrition planning for cancer from addon is not based on internet searches. It automates the decision making for you based on molecular science implemented by our scientists and software engineers. Irrespective of whether you care to understand the underlying biochemical molecular pathways or not - for nutrition planning for cancer that understanding is needed.

Get started NOW with your nutrition planning by answering questions on the name of cancer, genetic mutations, ongoing treatments and supplements, any allergies, habits, lifestyle, age group and gender.

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