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What Foods are Recommended for Cancer?
is a very common question. Personalized Nutrition Plans are foods and supplements which are personalized to a cancer indication, genes, any treatments and lifestyle conditions.

Foods for Richter Syndrome!

Jul 29, 2023

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Introduction

Foods for Richter Syndrome 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.

Richter syndrome, a rare and serious complication of chronic lymphocytic leukemia (CLL), involves the transformation of CLL into a more aggressive form of lymphoma. This condition’s life expectancy and prognosis are generally poor, as it marks a significant escalation in the severity of the disease. Treatment for Richter syndrome is challenging and often involves a combination of chemotherapy and targeted therapies, depending on the patient’s overall health and the specifics of their condition. Pathology outlines of Richter syndrome provide essential insights into its cellular characteristics and help guide therapeutic decisions. Resources such as Richter syndrome Wiki offer accessible information for patients and caregivers, while its occurrence in animals, like dogs, highlights the broader relevance of this disease across species. The pronunciation of ‘Richter syndrome’ can be a point of confusion for some, emphasizing the importance of patient education in understanding this complex condition. For medical coding purposes, the ICD-10 code for Richter syndrome in remission is crucial for treatment tracking and insurance claims. Radiology plays a significant role in diagnosing Richter syndrome, with imaging techniques like CT scans being used to assess the extent of disease progression. Richter syndrome’s definition encompasses its nature as a transformation from a typically slower-progressing CLL to a more aggressive lymphoma, and this transition is also detailed in resources like Radiopaedia. Overall, the management of Richter syndrome requires a comprehensive and informed approach to address its aggressive nature effectively.



For Richter Syndrome 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 Richter Syndrome 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 Richter Syndrome?

For example does it matter if vegetable Cluster Bean is consumed more compared to Mexican Groundcherry? Does it make any difference if fruit Fox Grape is preferred over Apricot? Also if similar choices are made for nuts/seeds like Almond over Chestnut and for pulses like Moth Bean over Common Bean. And if what I eat matters – then how does one identify foods which are recommended for Richter Syndrome and is it the same answer for everyone with the same diagnosis or genetic risk?

Yes! Foods you eat matters for Richter Syndrome!

Food recommendations may not be the same for everyone and can be different even for the same diagnosis and genetic risk.

All cancers like Richter Syndrome can be characterized by a unique set of biochemical pathways - the signature pathways of Richter Syndrome. Biochemical pathways like Amino Acid Metabolism, Cell Cycle Checkpoints, PI3K-AKT-MTOR Signaling, Cell Cycle are part of the signature definition of Richter Syndrome.

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 Fox Grape contains active ingredients Curcumin, Apigenin, Beta-sitosterol, Phloretin, Lupeol. And Apricot contains active ingredients Curcumin, Beta-sitosterol, Phloretin, Lupeol, Daidzein and possibly others.

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

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

Skills Needed for Nutrition Personalization for Richter Syndrome?

Personalized nutrition for cancers like Richter Syndrome 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 Richter Syndrome 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.

Foods to Eat After Cancer Diagnosis!

No two cancers are the same. Go beyond the common nutrition guidelines for everyone and make personalized decisions about food and supplements with confidence.

Characteristics of cancers like Richter Syndrome

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

The treatments which are effective for Richter Syndrome 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 Richter Syndrome when taking cancer treatment Doxorubicin, 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.

MYC, NOTCH1, BDKRB1, BRAF and CDKN2A are the top ranked reported genes for Richter Syndrome. MYC is reported in 57.1 % of the representative patients across all clinical trials. And NOTCH1 is reported in 35.7 %. The combined population patient data cover ages from to . % of the patient data are identified as men. The Richter Syndrome 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.

Foods for Richter Syndrome!

Food and Supplements for Richter Syndrome

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 CLUSTER BEAN or MEXICAN GROUNDCHERRY?

Vegetable Cluster Bean contains many active ingredients or bioactives such as Beta-sitosterol, Stigmasterol, Vitamin C, Linolenic Acid, Linoleic Acid. These active ingredients manipulate various biochemical pathways like DNA Repair, P53 Signaling, MAPK Signaling and MYC Signaling and others. Cluster Bean is recommended for Richter Syndrome when ongoing cancer treatment is Doxorubicin. This is because Cluster Bean modifies those biochemical pathways which have been scientifically reported to sensitize the effect of Doxorubicin.

Some of the active ingredients or bioactives in vegetable Mexican Groundcherry are Curcumin, Apigenin, Beta-sitosterol, Phloretin, Lupeol. These active ingredients manipulate various biochemical pathways like DNA Repair and Oncogenic Cancer Epigenetics and others. Mexican Groundcherry is not recommended for Richter Syndrome when ongoing cancer treatment is Doxorubicin because it modifies those biochemical pathways which make the cancer treatment resistant or less responsive.

VEGETABLE CLUSTER BEAN IS RECOMMENDED OVER MEXICAN GROUNDCHERRY FOR Richter Syndrome AND TREATMENT Doxorubicin.

Choose Fruit APRICOT or FOX GRAPE?

Fruit Apricot contains many active ingredients or bioactives such as Curcumin, Beta-sitosterol, Phloretin, Lupeol, Daidzein. These active ingredients manipulate various biochemical pathways like DNA Repair, Apoptosis, MAPK Signaling and NFKB Signaling and others. Apricot is recommended for Richter Syndrome when ongoing cancer treatment is Doxorubicin. This is because Apricot modifies those biochemical pathways which have been scientifically reported to sensitize the effect of Doxorubicin.

Some of the active ingredients or bioactives in fruit Fox Grape are Curcumin, Apigenin, Beta-sitosterol, Phloretin, Lupeol. These active ingredients manipulate various biochemical pathways like DNA Repair, Amino Acid Metabolism and Cell Cycle Checkpoints and others. Fox Grape is not recommended for Richter Syndrome when ongoing cancer treatment is Doxorubicin because it modifies those biochemical pathways which make the cancer treatment resistant or less responsive.

FRUIT APRICOT IS RECOMMENDED OVER FOX GRAPE FOR Richter Syndrome AND TREATMENT Doxorubicin.

Choose Nut ALMOND or CHESTNUT?

Almond contains many active ingredients or bioactives such as Curcumin, Beta-sitosterol, Phloretin, Lupeol, Daidzein. These active ingredients manipulate various biochemical pathways like DNA Repair, P53 Signaling, MAPK Signaling and MYC Signaling and others. Almond is recommended for Richter Syndrome when ongoing cancer treatment is Doxorubicin. This is because Almond modifies those biochemical pathways which have been scientifically reported to sensitize the effect of Doxorubicin.

Some of the active ingredients or bioactives in Chestnut are Curcumin, Apigenin, Beta-sitosterol, Phloretin, Lupeol. These active ingredients manipulate various biochemical pathways like DNA Repair, Amino Acid Metabolism and Cell Cycle Checkpoints and others. Chestnut is not recommended for Richter Syndrome when ongoing cancer treatment is Doxorubicin because it modifies those biochemical pathways which make the cancer treatment resistant or less responsive.

ALMOND IS RECOMMENDED OVER CHESTNUT FOR Richter Syndrome AND TREATMENT Doxorubicin.

For Individuals with Genetic Risk of Cancer

The question asked by individuals who have genetic risk of Richter Syndrome 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 SWEDE?

Vegetable Giant Butterbur contains many active ingredients or bioactives such as Apigenin, Curcumin, Lupeol, Lycopene, Daidzein. These active ingredients manipulate various biochemical pathways like Cell Cycle, Stem Cell Signaling, P53 Signaling and MAPK Signaling and others. Giant Butterbur is recommended for risk of Richter Syndrome when associated genetic risk is BDKRB1. 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 Swede are Apigenin, Curcumin, Lupeol, Daidzein, Beta-sitosterol. These active ingredients manipulate various biochemical pathways like Cell Cycle, Stem Cell Signaling and PI3K-AKT-MTOR Signaling and others. Swede is not recommended when risk of Richter Syndrome when associated genetic risk is BDKRB1 because it increases the signature pathways of it.

VEGETABLE GIANT BUTTERBUR IS RECOMMENDED OVER SWEDE FOR BDKRB1 GENETIC RISK OF CANCER.

Choose Fruit NANCE or PUMMELO?

Fruit Nance contains many active ingredients or bioactives such as Apigenin, Curcumin, Lupeol, Daidzein, Beta-sitosterol. These active ingredients manipulate various biochemical pathways like Cell Cycle, Stem Cell Signaling, P53 Signaling and MAPK Signaling and others. Nance is recommended for risk of Richter Syndrome when associated genetic risk is BDKRB1. This is because Nance increases those biochemical pathways which counteract the signature drivers of it.

Some of the active ingredients or bioactives in fruit Pummelo are Apigenin, Curcumin, Lupeol, Lycopene, Daidzein. These active ingredients manipulate various biochemical pathways like Stem Cell Signaling, Amino Acid Metabolism and Cell Cycle Checkpoints and others. Pummelo is not recommended when risk of Richter Syndrome when associated genetic risk is BDKRB1 because it increases the signature pathways of it.

FRUIT NANCE IS RECOMMENDED OVER PUMMELO FOR BDKRB1 GENETIC RISK OF CANCER.

Choose Nut BLACK WALNUT or EUROPEAN CHESTNUT?

Black Walnut contains many active ingredients or bioactives such as Apigenin, Curcumin, Ellagic Acid, Lupeol, Daidzein. These active ingredients manipulate various biochemical pathways like Cell Cycle, P53 Signaling, MAPK Signaling and Cell Cycle Checkpoints and others. Black Walnut is recommended for risk of Richter Syndrome when associated genetic risk is BDKRB1. This is because Black Walnut increases those biochemical pathways which counteract the signature drivers of it.

Some of the active ingredients or bioactives in European Chestnut are Apigenin, Curcumin, Ellagic Acid, Lupeol, Daidzein. These active ingredients manipulate various biochemical pathways like Stem Cell Signaling and others. European Chestnut is not recommended when risk of Richter Syndrome when associated genetic risk is BDKRB1 because it increases the signature pathways of it.

BLACK WALNUT IS RECOMMENDED OVER EUROPEAN CHESTNUT FOR BDKRB1 GENETIC RISK OF CANCER.


In Conclusion

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


Personalized Nutrition for Cancer!

Cancer changes with time. Customize and modify your nutrition based on cancer indication, treatments, lifestyle, food preferences, allergies and other factors.

References

Scientifically Reviewed by: Dr. Cogle

Christopher R. Cogle, M.D. is a tenured professor at the University of Florida, Chief Medical Officer of Florida Medicaid, and Director of the Florida Health Policy Leadership Academy at the Bob Graham Center for Public Service.

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