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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 Smoldering Multiple Myeloma!

Jul 31, 2023

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Introduction

Foods for Smoldering Multiple Myeloma 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.

Smoldering multiple myeloma (SMM) is a precancerous condition often considered an intermediary stage between MGUS (monoclonal gammopathy of undetermined significance) and active multiple myeloma, with distinct features and a specific ICD-10 code for accurate medical recording. Understanding the difference between smoldering myeloma and multiple myeloma is crucial, as they differ in terms of symptoms, treatment approaches, and prognosis. Smoldering multiple myeloma symptoms are generally less severe than those of full-blown myeloma but can include fatigue and other subtle signs. The diagnosis of SMM is based on specific criteria, which are outlined in various medical resources, including pathology outlines. The smoldering multiple myeloma prognosis and survival rate can vary significantly, influenced by various factors like disease progression and individual health. Treatment for SMM is typically more conservative compared to multiple myeloma, often involving careful monitoring and sometimes clinical trials for smoldering multiple myeloma, which explore new therapeutic approaches. These clinical trials are crucial for advancing our understanding and management of this condition, potentially leading to more effective treatments in the future.



For Smoldering Multiple Myeloma 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 Smoldering Multiple Myeloma 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 Smoldering Multiple Myeloma?

For example does it matter if vegetable Brussel Sprouts is consumed more compared to Cardoon? Does it make any difference if fruit Lime is preferred over Kiwi? Also if similar choices are made for nuts/seeds like Butternut over Chestnut and for pulses like Broad Bean over Moth Bean. And if what I eat matters – then how does one identify foods which are recommended for Smoldering Multiple Myeloma and is it the same answer for everyone with the same diagnosis or genetic risk?

Yes! Foods you eat matters for Smoldering Multiple Myeloma!

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

All cancers like Smoldering Multiple Myeloma can be characterized by a unique set of biochemical pathways - the signature pathways of Smoldering Multiple Myeloma. Biochemical pathways like Amino Acid Metabolism, NFKB Signaling, PI3K-AKT-MTOR Signaling, Hypoxia are part of the signature definition of Smoldering Multiple Myeloma.

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 Lime contains active ingredients Isoliquiritigenin, Curcumin, Catechol, Lycopene, Melatonin. And Kiwi contains active ingredients Kaempferol, Isoliquiritigenin, Curcumin, Catechol, Melatonin and possibly others.

A common mistake made when deciding and choosing foods to eat for Smoldering Multiple Myeloma – 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 Smoldering Multiple Myeloma.

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

Skills Needed for Nutrition Personalization for Smoldering Multiple Myeloma?

Personalized nutrition for cancers like Smoldering Multiple Myeloma 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 Smoldering Multiple Myeloma 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 Smoldering Multiple Myeloma

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

The treatments which are effective for Smoldering Multiple Myeloma 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 Smoldering Multiple Myeloma when taking cancer treatment Lenalidomide, 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.

BRCA2, IRS2, CDK8, RB1 and LCP1 are the top ranked reported genes for Smoldering Multiple Myeloma. BRCA2 is reported in 45.0 % of the representative patients across all clinical trials. And IRS2 is reported in 45.0 %. The combined population patient data cover ages from to . % of the patient data are identified as men. The Smoldering Multiple Myeloma 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 Smoldering Multiple Myeloma!

Food and Supplements for Smoldering Multiple Myeloma

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 BRUSSEL SPROUTS or CARDOON?

Vegetable Brussel Sprouts contains many active ingredients or bioactives such as Isoliquiritigenin, Curcumin, Catechol, Melatonin, Daidzein. These active ingredients manipulate various biochemical pathways like Cell Cycle, Cell Survival, P53 Signaling and Angiogenesis and others. Brussel Sprouts is recommended for Smoldering Multiple Myeloma when ongoing cancer treatment is Lenalidomide. This is because Brussel Sprouts modifies those biochemical pathways which have been scientifically reported to sensitize the effect of Lenalidomide.

Some of the active ingredients or bioactives in vegetable Cardoon are Apigenin, Kaempferol, Isoliquiritigenin, Curcumin, Catechol. These active ingredients manipulate various biochemical pathways like Oncogenic Histone Methylation, Oncogenic Cancer Epigenetics and NFKB Signaling and others. Cardoon is not recommended for Smoldering Multiple Myeloma when ongoing cancer treatment is Lenalidomide because it modifies those biochemical pathways which make the cancer treatment resistant or less responsive.

VEGETABLE BRUSSEL SPROUTS IS RECOMMENDED OVER CARDOON FOR Smoldering Multiple Myeloma AND TREATMENT Lenalidomide.

Choose Fruit KIWI or LIME?

Fruit Kiwi contains many active ingredients or bioactives such as Kaempferol, Isoliquiritigenin, Curcumin, Catechol, Melatonin. These active ingredients manipulate various biochemical pathways like Cell Cycle, Hypoxia and P53 Signaling and others. Kiwi is recommended for Smoldering Multiple Myeloma when ongoing cancer treatment is Lenalidomide. This is because Kiwi modifies those biochemical pathways which have been scientifically reported to sensitize the effect of Lenalidomide.

Some of the active ingredients or bioactives in fruit Lime are Isoliquiritigenin, Curcumin, Catechol, Lycopene, Melatonin. These active ingredients manipulate various biochemical pathways like WNT Beta Catenin Signaling, Microtubule Dynamics and NFKB Signaling and others. Lime is not recommended for Smoldering Multiple Myeloma when ongoing cancer treatment is Lenalidomide because it modifies those biochemical pathways which make the cancer treatment resistant or less responsive.

FRUIT KIWI IS RECOMMENDED OVER LIME FOR Smoldering Multiple Myeloma AND TREATMENT Lenalidomide.

Choose Nut BUTTERNUT or CHESTNUT?

Butternut contains many active ingredients or bioactives such as Apigenin, Kaempferol, Isoliquiritigenin, Curcumin, Catechol. These active ingredients manipulate various biochemical pathways like DNA Repair, Cell Cycle, Angiogenesis and Microtubule Dynamics and others. Butternut is recommended for Smoldering Multiple Myeloma when ongoing cancer treatment is Lenalidomide. This is because Butternut modifies those biochemical pathways which have been scientifically reported to sensitize the effect of Lenalidomide.

Some of the active ingredients or bioactives in Chestnut are Apigenin, Kaempferol, Isoliquiritigenin, Curcumin, Catechol. These active ingredients manipulate various biochemical pathways like DNA Repair and WNT Beta Catenin Signaling and others. Chestnut is not recommended for Smoldering Multiple Myeloma when ongoing cancer treatment is Lenalidomide because it modifies those biochemical pathways which make the cancer treatment resistant or less responsive.

BUTTERNUT IS RECOMMENDED OVER CHESTNUT FOR Smoldering Multiple Myeloma AND TREATMENT Lenalidomide.

For Individuals with Genetic Risk of Cancer

The question asked by individuals who have genetic risk of Smoldering Multiple Myeloma 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 ORANGE BELL PEPPER or CAROB?

Vegetable Orange Bell Pepper contains many active ingredients or bioactives such as Apigenin, Curcumin, Lupeol, Daidzein, Formononetin. These active ingredients manipulate various biochemical pathways like DNA Repair, Cell Cycle, Cell Cycle Checkpoints and MYC Signaling and others. Orange Bell Pepper is recommended for risk of Smoldering Multiple Myeloma when associated genetic risk is BRCA2. This is because Orange Bell Pepper increases those biochemical pathways which counteract the signature drivers of it.

Some of the active ingredients or bioactives in vegetable Carob are Apigenin, Curcumin, Lupeol, Daidzein, Quercetin. These active ingredients manipulate various biochemical pathways like DNA Repair and Growth Factor Signaling and others. Carob is not recommended when risk of Smoldering Multiple Myeloma when associated genetic risk is BRCA2 because it increases the signature pathways of it.

VEGETABLE ORANGE BELL PEPPER IS RECOMMENDED OVER CAROB FOR BRCA2 GENETIC RISK OF CANCER.

Choose Fruit JAVA PLUM or GRAPEFRUIT?

Fruit Java Plum 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, DNA Repair and Angiogenesis and others. Java Plum is recommended for risk of Smoldering Multiple Myeloma when associated genetic risk is BRCA2. This is because Java Plum increases those biochemical pathways which counteract the signature drivers of it.

Some of the active ingredients or bioactives in fruit Grapefruit are Curcumin, Lupeol, Daidzein, Formononetin, Naringin. These active ingredients manipulate various biochemical pathways like DNA Repair, Stem Cell Signaling and Growth Factor Signaling and others. Grapefruit is not recommended when risk of Smoldering Multiple Myeloma when associated genetic risk is BRCA2 because it increases the signature pathways of it.

FRUIT JAVA PLUM IS RECOMMENDED OVER GRAPEFRUIT FOR BRCA2 GENETIC RISK OF CANCER.

Choose Nut COMMON HAZELNUT or EUROPEAN CHESTNUT?

Common Hazelnut contains many active ingredients or bioactives such as Curcumin, Lupeol, Daidzein, Quercetin, Formononetin. These active ingredients manipulate various biochemical pathways like DNA Repair, Cell Cycle, Angiogenesis and Stem Cell Signaling and others. Common Hazelnut is recommended for risk of Smoldering Multiple Myeloma when associated genetic risk is BRCA2. 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, Daidzein. These active ingredients manipulate various biochemical pathways like DNA Repair and Stem Cell Signaling and others. European Chestnut is not recommended when risk of Smoldering Multiple Myeloma when associated genetic risk is BRCA2 because it increases the signature pathways of it.

COMMON HAZELNUT IS RECOMMENDED OVER EUROPEAN CHESTNUT FOR BRCA2 GENETIC RISK OF CANCER.


In Conclusion

Foods and Supplements chosen are important decisions for cancers like Smoldering Multiple Myeloma. Smoldering Multiple Myeloma 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 Smoldering Multiple Myeloma, 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 Brussel Sprouts 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 Smoldering Multiple Myeloma?”. 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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