For Which Cancer Types Should I Avoid Sage Supplement?

Highlights

Nutritional supplements and extracts like Sage have benefits and are used by cancer patients and those at-genetic risk of cancer. There is limited or hardly any clinical data available for use of nutritional supplements and foods in cancer patients. Generating clinical evidence of efficacy for cancer through a randomized clinical trial is further infeasible due to variations in genetics and cancer chemotherapy treatments across cancer patients. Hence a different and new approach is needed to find out for which cancers you should not take Sage supplement and why should not take them?

Is it okay to take Sage extracts or supplements for all cancer indications and any chemotherapy treatment? A common belief but a myth is that everything natural can only be of benefit and do no harm. For example, the use of grapefruit with certain medications is not recommended. Another example is the use of spinach with some blood thinning medications can cause adverse interactions and hence to be avoided. For cancer, nutrition including plant-based foods and supplements can influence outcomes and hence an extremely important decision which needs to be made. Hence NIH-National Cancer Institute has a website for nutrition for cancer care for patients which are generalized recommendations and not personalized for cancer indication and treatments.

A frequently asked question by cancer patients and those at-risk is “What Foods and Nutritional Supplements could be beneficial over others for me?”. “Who should not take an extract or supplement and why?”. Generic guidelines like eating only plant-based-foods or avoiding all sugar or adopting a keto diet is a good start but not actionable and personalized enough.

To find answers to questions on extracts and nutritional supplements and foods requires knowledge of contained active ingredients; genetic mutation prevalence for cancer indication; understanding of underlying cancer biology; chemotherapy treatments and mechanism of actions of active ingredients.

Taking Sage extracts or nutritional supplements may benefit Primary Inflammatory Myofibroblastic Tumor patients on Fluorouracil treatment over Flaxseed nutritional supplements. But Sage supplements or Sage extracts offer less benefit if on Radiation treatment for Primary Adamantinoma compared to Pineapple. Similarly, taking nutritional supplements Sage may benefit healthy individuals who are at genetic risk of cancer due to mutation of gene NRAS over Beta-carotene. But avoid nutritional supplements Sage when at genetic risk of cancer due to mutation of gene VHL.

The takeaway being – cancer, genomics, treatments and other personalized factors will influence decision making to questions like: Are extracts or nutritional supplements Sage beneficial and should not be taken? Why should Sage be not taken? Who should not take Sage? What are side effects of Sage with Radiation chemotherapy? What are the benefits of Sage for cancer? Can Sage help fight cancer and so on.

Whenever there are changes in chemotherapy treatments or cancer tissue genetics – the nutrition may change and hence needs to be re-evaluated. Do consider factors like cancer indication, ongoing chemotherapy treatments and nutritional supplements, age, gender, weight, height, lifestyle and genetics for personalization of nutrition.

Brief Overview

Use of nutritional supplements – vitamins, herbs, minerals, probiotics, and other specialty categories are increasing. Supplements are high concentrations of active ingredients which are also found in different foods. Difference between supplements and foods being that foods contain more than one active ingredient at much lower concentrations. Every active ingredient in an extract or nutritional supplement or food has a unique mechanism of action which can influence nutrition decisions.

These are some example questions which nutrition planning should help answer for you. Should you take supplements Sage? Should you take it when at genetic risk of cancer for mutation of gene NRAS? Should you take it when at genetic risk of cancer for mutation of gene VHL? Should you take it when diagnosed with Primary Adamantinoma? Should you take it when diagnosed with Primary Inflammatory Myofibroblastic Tumor? Should you take it when on Fluorouracil treatment? Should you continue taking it if you change your treatment from Fluorouracil to Radiation? So a general explanation like – it is organic and plant-based or it increases immunity is not sufficient information for making a decision of use of Sage extracts and nutritional supplements.

Cancer

Genetic variations across cancer patients can be different and hence no two cancers are alike. The improved availability of “personalized to genetics” chemotherapy treatments and cancer disease monitoring via blood and saliva have been significant factors to improve outcomes. The earlier the lifestyle and treatment intervention – the better the influence on outcome. Genetic testing has the potential to assess cancer risk and susceptibility early. But for at-risk individuals besides regular monitoring in most cases there are no therapeutic treatment intervention options available. After diagnosis with cancer such as Primary Inflammatory Myofibroblastic Tumor or Primary Adamantinoma, the treatments get personalized to tumor genomics and factors like staging of disease, age and gender. During cancer remission (after treatment cycle is complete) – monitoring is used for assessment of any relapse and accordingly decide on next steps. A large majority of cancer patients and those at-risk may take nutritional supplements like Sage.

So the question is that are all genetic risks and cancer indications to be considered uniformly when making decisions on the use of Sage extracts or nutritional supplements? Are the biochemical pathway implications of genetic risk for cancer due to mutation of gene NRAS the same as due to mutation of gene VHL? Are the implications of Primary Inflammatory Myofibroblastic Tumor the same as Primary Adamantinoma? Is it one and the same if you are on treatment with Radiation or Fluorouracil?

Sage – An Extract or Nutritional Supplement

Sage is a perennial herb which belongs to the mint family. It has aromatic flavour and is known for its healing properties. Sage is rich in phenolic compounds which have strong antioxidant properties which reduces free radicals. The benefits of consuming sage are:

• Helps in digestion
• Reduces headache
• Helps boost memory
• Controls cholesterol level
• Has anti-inflammatory properties
• Possesses anticancer effect (Dalila F N Pedro et al, Phytother Res., 2016 ; Maho Yanagimichi et al, Biochem Biophys Rep., 2020)

Sage supplements contain many active ingredients including Vitamin K, Vitamin B3, Ursolic Acid, Rosmarinic Acid and Oleic Acid at different concentration levels. The molecular pathways which are regulated by Sage include PI3K-AKT-MTOR Signaling, Epithelial to Mesenchymal Transition, Angiogenesis and MYC Signaling. These biochemical pathways directly or indirectly regulate specific cancer molecular endpoints like growth, spread and death of cancer cells. Because of this biological regulation – for cancer nutrition, the right choice of supplements like Sage individually or in combination is an important decision to be made. When making decisions on the use of supplement Sage over other nutritional supplements – do consider all these factors.

Who Should not take Sage Supplements and Why?

There is no easy way to answer the question “For which cancers should I not chooseSage nutritional supplements”. Just like the same chemotherapy treatment does not work across patients, for similar reasons Sage in comparison with other nutritional supplements may be beneficial or not. Along with which cancer and associated genetics – the ongoing treatments, lifestyle habits, height, weight and food allergies are all factors in deciding if Sage should be avoided or not and why.

1. Will Sage Supplements benefit Primary Adamantinoma patients undergoing Radiation treatment?

Primary Adamantinoma is characterized and driven by specific genetic mutations like ARHGAP45, PI4KB and SDSL leading to biochemical pathway changes in Epithelial to Mesenchymal Transition and Inositol Phosphate Signaling. A cancer treatment like Radiation works through a specific pathway mechanism of action. The goal is to have a good overlap between the treatment and cancer driving pathways for a personalized approach which is effective. In such a condition any food or nutritional supplement which has a contrary effect to the treatment or reduces the overlap should be avoided. As an example, Sage supplement should not be taken for Primary Adamantinoma along with treatment Radiation. Sage supplement impacts the biochemical pathway called Epithelial to Mesenchymal Transition which either promotes drivers of the disease and/or nullifies the treatment effect. Some of the factors which should be considered when choosing nutrition are type of cancer, treatments and supplements being taken currently (if any

2. Will Sage Supplements benefit Primary Inflammatory Myofibroblastic Tumor Patients undergoing Fluorouracil Treatment?

Primary Inflammatory Myofibroblastic Tumor is characterized and driven by specific genetic mutations like ARID2, FLT4 and IGF1R leading to biochemical pathway changes in Chromatin Remodeling, Angiogenesis, Growth Factor Signaling and PI3K-AKT-MTOR Signaling. A cancer treatment like Fluorouracil works through specific pathway mechanisms. The goal is to have a good overlap between the treatment and cancer driving pathways for a personalized approach. In such a condition any food or nutritional supplement which supports treatment action or improves the overlap should be considered. As an example, Sage supplements should be considered for Primary Inflammatory Myofibroblastic Tumor along with the treatment Fluorouracil. Sage supplement impacts pathways/processes like PI3K-AKT-MTOR Signaling which either obstruct drivers of Primary Inflammatory Myofibroblastic Tumor and/or improve Fluorouracil treatment effect.

3. What about Sage Supplements for Healthy Individuals with VHL Mutation associated Genetic Risk?

Different companies offer panels of genes to be tested for assessing genetic risk to different cancers. These panels cover genes associated with cancers of the breast, ovary, uterus, prostate, and gastrointestinal system and others. Genetic testing of these genes may confirm a diagnosis and help guide treatment and management decisions. Identification of a disease-causing variant may also guide testing and diagnosis of at-risk relatives. VHL is one of the genes generally available in panels for cancer risk testing.

VHL mutation causes biochemical pathways/processes like Angiogenesis and Hypoxia to get impacted. These pathways are direct or indirect drivers of cancer molecular endpoints. Sage should not be taken when the genetic panel identifies mutation of VHL for Kidney Cancer. Sage impacts pathways/processes like Angiogenesis and creates adverse conditions with VHL.

4. What about Sage Supplements for Healthy Individuals with NRAS Mutation associated Genetic Risk?

NRAS is one of the genes available in panels for cancer risk testing. NRAS mutation causes biochemical pathways/processes like MYC Signaling, MAPK Signaling and RAS-RAF Signaling to get impacted. These pathways are direct or indirect drivers of cancer molecular endpoints. Sage supplements may be considered when the genetic panel identifies mutations in NRAS for Acute Lymphoid Leukemia. Sage impacts pathways/processes like MYC Signaling and creates a canceling effect in those individuals with NRAS mutation.

* Other Factors are also included like BMI, Treatments, Lifestyle Habits

In Conclusion

It is important to remember that cancer chemotherapy treatments and nutrition are never the same for everyone. Food and nutritional supplements like Sage are chosen by you and can influence outcomes.

“What should I eat?” is a commonly asked question by cancer patients and those at-risk. The answer to this question depends on cancer indication, underlying genetics, current chemotherapy treatments, food allergies, lifestyle information, and food preferences.

The addon.life approach to nutrition personalization uses knowledge of active ingredients contained in foods and nutritional supplements, cancer biology, chemotherapy treatment action and genetic mutation prevalence across cancer indications. addon.life team of clinicians, clinical scientists and engineers are experts in cancer biology focusing only on nutrition personalization for cancer patients and those at-risk.

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.

References

• Pan-cancer analysis of whole genomes.
• Oleic acid induces apoptosis and autophagy in the treatment of Tongue Squamous cell carcinomas.
• Oleic acid-induced ANGPTL4 enhances head and neck squamous cell carcinoma anoikis resistance and metastasis via up-regulation of fibronectin.
• Mutational landscape of metastatic cancer revealed from prospective clinical sequencing of 10,000 patients.
• Radio resistance in breast cancer cells is mediated through TGF-β signalling, hybrid epithelial-mesenchymal phenotype and cancer stem cells.
• cBioPortal for Cancer Genomics
• cBioPortal for Cancer Genomics
• Over-activation of AKT signaling leading to 5-Fluorouracil resistance in SNU-C5/5-FU cells.