Foods for Small Bowel Neuroendocrine Tumor!

Introduction

Foods for Small Bowel Neuroendocrine Tumor 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.

Small bowel neuroendocrine tumors, a type of cancer originating from the neuroendocrine cells in the small intestine, are known for their unique characteristics and behavior. Radiology, especially CT scans, plays a pivotal role in diagnosing these tumors, often highlighted in detailed discussions on Radiopaedia. The ICD-10 code for small bowel neuroendocrine tumors aids in their classification and standardizes medical documentation. Patients may experience a range of symptoms, including abdominal pain and changes in bowel habits, which necessitate a thorough workup for accurate diagnosis. The pathology outlines of these tumors provide crucial insights into their cellular makeup, essential for determining the appropriate treatment, which often involves surgery and may include targeted therapies or chemotherapy. Staging is critical in assessing the extent of the disease and informing the prognosis, with grade 1 tumors generally having a better outlook. The CAP protocol for small bowel neuroendocrine tumors standardizes the pathological assessment, ensuring consistency in diagnosis and treatment planning. Genetic factors and hereditary components are areas of ongoing research, offering insights into the development and progression of these tumors. Understanding the genetics may also aid in identifying individuals at higher risk. Keeping up-to-date with the latest information, such as that found in medical resources like UpToDate, is crucial for healthcare professionals managing these complex tumors. The overall approach to small bowel neuroendocrine tumors requires a multifaceted strategy, encompassing accurate diagnosis, staging, and a tailored treatment plan to improve patient outcomes.

For Small Bowel Neuroendocrine Tumor 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 Small Bowel Neuroendocrine Tumor 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 Small Bowel Neuroendocrine Tumor?

For example does it matter if vegetable Parsnip is consumed more compared to Daikon Radish? Does it make any difference if fruit Pummelo is preferred over Soursop? Also if similar choices are made for nuts/seeds like Black Walnut over Chestnut and for pulses like Black-eyed Pea over Yellow Wax Bean. And if what I eat matters – then how does one identify foods which are recommended for Small Bowel Neuroendocrine Tumor and is it the same answer for everyone with the same diagnosis or genetic risk?

Yes! Foods you eat matters for Small Bowel Neuroendocrine Tumor!

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 Apigenin, Lupeol, Daidzein, Curcumin, Geraniol. And Soursop contains active ingredients Apigenin, Lupeol, Fisetin, Daidzein, Curcumin and possibly others.

A common mistake made when deciding and choosing foods to eat for Small Bowel Neuroendocrine Tumor – 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 Small Bowel Neuroendocrine Tumor.

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

Skills Needed for Nutrition Personalization for Small Bowel Neuroendocrine Tumor?

Personalized nutrition for cancers like Small Bowel Neuroendocrine Tumor 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 Small Bowel Neuroendocrine Tumor 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 Small Bowel Neuroendocrine Tumor

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

The treatments which are effective for Small Bowel Neuroendocrine Tumor 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 Small Bowel Neuroendocrine Tumor when taking cancer treatment Lanreotide, 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.

CDKN1B, NF1, TP53, TGFBR2 and RUNX1T1 are the top ranked reported genes for Small Bowel Neuroendocrine Tumor. CDKN1B is reported in 14.3 % of the representative patients across all clinical trials. And NF1 is reported in 9.5 %. The combined population patient data cover ages from to . 58.8 % of the patient data are identified as men. The Small Bowel Neuroendocrine Tumor 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 Small Bowel Neuroendocrine Tumor

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 PARSNIP or DAIKON RADISH?

Vegetable Parsnip contains many active ingredients or bioactives such as Lupeol, Daidzein, Curcumin, Geraniol, Quercetin. These active ingredients manipulate various biochemical pathways like Cell Cycle, MAPK Signaling and PI3K-AKT-MTOR Signaling and others. Parsnip is recommended for Small Bowel Neuroendocrine Tumor when ongoing cancer treatment is Lanreotide. This is because Parsnip modifies those biochemical pathways which have been scientifically reported to sensitize the effect of Lanreotide.

Some of the active ingredients or bioactives in vegetable Daikon Radish are Apigenin, Lupeol, Daidzein, Curcumin, Geraniol. These active ingredients manipulate various biochemical pathways like Cell Cycle and PI3K-AKT-MTOR Signaling and others. Daikon Radish is not recommended for Small Bowel Neuroendocrine Tumor when ongoing cancer treatment is Lanreotide because it modifies those biochemical pathways which make the cancer treatment resistant or less responsive.

VEGETABLE PARSNIP IS RECOMMENDED OVER DAIKON RADISH FOR Small Bowel Neuroendocrine Tumor AND TREATMENT Lanreotide.

Choose Fruit SOURSOP or PUMMELO?

Fruit Soursop contains many active ingredients or bioactives such as Apigenin, Lupeol, Fisetin, Daidzein, Curcumin. These active ingredients manipulate various biochemical pathways like Cell Cycle, MAPK Signaling and PI3K-AKT-MTOR Signaling and others. Soursop is recommended for Small Bowel Neuroendocrine Tumor when ongoing cancer treatment is Lanreotide. This is because Soursop modifies those biochemical pathways which have been scientifically reported to sensitize the effect of Lanreotide.

Some of the active ingredients or bioactives in fruit Pummelo are Apigenin, Lupeol, Daidzein, Curcumin, Geraniol. These active ingredients manipulate various biochemical pathways like Cell Cycle and PI3K-AKT-MTOR Signaling and others. Pummelo is not recommended for Small Bowel Neuroendocrine Tumor when ongoing cancer treatment is Lanreotide because it modifies those biochemical pathways which make the cancer treatment resistant or less responsive.

FRUIT SOURSOP IS RECOMMENDED OVER PUMMELO FOR Small Bowel Neuroendocrine Tumor AND TREATMENT Lanreotide.

Choose Nut BLACK WALNUT or CHESTNUT?

Black Walnut contains many active ingredients or bioactives such as Apigenin, Lupeol, Ellagic Acid, Daidzein, Curcumin. These active ingredients manipulate various biochemical pathways like Cell Cycle and MAPK Signaling and others. Black Walnut is recommended for Small Bowel Neuroendocrine Tumor when ongoing cancer treatment is Lanreotide. This is because Black Walnut modifies those biochemical pathways which have been scientifically reported to sensitize the effect of Lanreotide.

Some of the active ingredients or bioactives in Chestnut are Apigenin, Lupeol, Ellagic Acid, Daidzein, Curcumin. These active ingredients manipulate various biochemical pathways like Cell Cycle and PI3K-AKT-MTOR Signaling and others. Chestnut is not recommended for Small Bowel Neuroendocrine Tumor when ongoing cancer treatment is Lanreotide because it modifies those biochemical pathways which make the cancer treatment resistant or less responsive.

BLACK WALNUT IS RECOMMENDED OVER CHESTNUT FOR Small Bowel Neuroendocrine Tumor AND TREATMENT Lanreotide.

For Individuals with Genetic Risk of Cancer

The question asked by individuals who have genetic risk of Small Bowel Neuroendocrine Tumor 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 SHALLOT?

Vegetable Giant Butterbur contains many active ingredients or bioactives such as Apigenin, Curcumin, Lupeol, Daidzein, Lycopene. These active ingredients manipulate various biochemical pathways like Cell Cycle, TGFB Signaling, P53 Signaling and MYC Signaling and others. Giant Butterbur is recommended for risk of Small Bowel Neuroendocrine Tumor when associated genetic risk is CDKN1B. 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 Shallot are Apigenin, Curcumin, Lupeol, Daidzein, Beta-sitosterol. These active ingredients manipulate various biochemical pathways like TGFB Signaling and Oncogenic Cancer Epigenetics and others. Shallot is not recommended when risk of Small Bowel Neuroendocrine Tumor when associated genetic risk is CDKN1B because it increases the signature pathways of it.

VEGETABLE GIANT BUTTERBUR IS RECOMMENDED OVER SHALLOT FOR CDKN1B GENETIC RISK OF CANCER.

Choose Fruit RED RASPBERRY or FIG?

Fruit Red Raspberry contains many active ingredients or bioactives such as Curcumin, Ellagic Acid, Lupeol, Quercetin, Daidzein. These active ingredients manipulate various biochemical pathways like Cell Cycle, TGFB Signaling, MAPK Signaling and MYC Signaling and others. Red Raspberry is recommended for risk of Small Bowel Neuroendocrine Tumor when associated genetic risk is CDKN1B. This is because Red Raspberry increases those biochemical pathways which counteract the signature drivers of it.

Some of the active ingredients or bioactives in fruit Fig are Curcumin, Lupeol, Quercetin, Linalool, Daidzein. These active ingredients manipulate various biochemical pathways like TGFB Signaling, Growth Factor Signaling and PI3K-AKT-MTOR Signaling and others. Fig is not recommended when risk of Small Bowel Neuroendocrine Tumor when associated genetic risk is CDKN1B because it increases the signature pathways of it.

FRUIT RED RASPBERRY IS RECOMMENDED OVER FIG FOR CDKN1B GENETIC RISK OF CANCER.

Choose Nut COMMON HAZELNUT or EUROPEAN CHESTNUT?

Common Hazelnut contains many active ingredients or bioactives such as Curcumin, Lupeol, Quercetin, Daidzein, Lycopene. These active ingredients manipulate various biochemical pathways like Cell Cycle, TGFB Signaling, MAPK Signaling and MYC Signaling and others. Common Hazelnut is recommended for risk of Small Bowel Neuroendocrine Tumor when associated genetic risk is CDKN1B. This is because Common Hazelnut 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, Quercetin. These active ingredients manipulate various biochemical pathways like TGFB Signaling and Oncogenic Cancer Epigenetics and others. European Chestnut is not recommended when risk of Small Bowel Neuroendocrine Tumor when associated genetic risk is CDKN1B because it increases the signature pathways of it.

COMMON HAZELNUT IS RECOMMENDED OVER EUROPEAN CHESTNUT FOR CDKN1B GENETIC RISK OF CANCER.

In Conclusion

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

References

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• Paederia foetida induces anticancer activity by modulating chromatin modification enzymes and altering pro-inflammatory cytokine gene expression in human prostate cancer cells.
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