Revealed… at least in the Petri dish1. We’ll get back to that in a couple of paragraphs.
Short Intro to the Topic
Cancer patients and their healthcare providers need reliable cancer diet information. How so? A recent paper published by Champ et al.2 highlights the predicament faced by cancer patients as well their primary-care physicians to find good, reliable information on diet and cancer.
I will not go in much detail, but out of 21 National Comprehensive Cancer Network (NCCN) institutions, only four (19%) provided cancer diet guidelines. One third (7) of all NCCN sites linked to nine external websites. Only 44% of the external sites offered cancer diet guidelines to cancer patients2.
Here is where the tale gets interesting. Many recommendations made by NCCN organizations oppose one another. Foods suggested to cancer patients by some sites are on the steer clear of list of others. Additionally, externally linked websites further encouraged dietary strategies that were not only inconsistent with each other, but also with NCCN member websites2.
While most scholars agree that dietary factors play an influential role in cancer outcomes and with two-thirds of cancer patients going online for cancer diet guidance, most of the information posted online was not cancer-specific. I.e. metabolically active cancers call for a different dietary approach than localized cancers2.
“The ‘lack of consistent nutritional guidelines’ for cancer patients — and for many other patients as well — is a failing that needs to be confronted, and corrected, by us as clinicians. This is an important issue”3.
Champ et al. (2013) presented a poster illuminating the results. You can get access to the poster here.
There is a genuine need for reliable, evidence based information on diet and cancer. Over the summer, I will do a little digging on diet and cancer as it pertains to pancreatic cancer, to raise public awareness and to edu;cate myself further about the biochemistry of this ruthless cancer. What will be achieved? I am hoping to uncover various foods that show promise in the lab to target cancer cells.
What’s the Reasoning Behind This?
Pancreatic cancer patients still need to eat! Right? The quandary is that many pancreatic cancer patients die not from cancer, but from malnutrition4. Eliminating consumption of foods that could be characterized as SAD (Standard American Diet) highly processed foods, stripped of most of their nutrients; foodstuffs that are in all probability exhausting the immune system and most likely promoting the very cancer you are fighting5, and replacing these foodstuffs with nutrient dense foods that show promise in the lab, and perhaps even promise in population studies, should allow pancreatic cancer patients to do something about the hypoxic (low-oxygen) biochemical soup in which pancreatic cancer thrives.
An ideal cancer diet that changes a pancreatic cancer patient’s biochemical soup should help increase her strength, reduce (to some degree) the harmful side effects of treatments and should promote treatments’ effectiveness6,7,8.
Managing Cancer-Rather than Destroying It
None of us can dodge the bullet with our name on it! As a pancreatic cancer patient, no matter how abysmal the prognosis, there are people all around you, who beat the odds, on a daily basis, who did not necessarily “destroy” or “kill” their cancer, but people who are actively managing their cancer. Against all odds, these patients have found a way to bring into being a symbiotic relationship with cancer.
If you could find a way to “manage” pancreatic cancer, with a mind-body approach as well a nutritional approach, well then you would be way ahead of the game by controlling the disease and not cancer controlling your life!
I understand that this might not be an agreeable resolution, but sadly enough and for the time being for many pancreatic cancer patients that is the first and last option. This brings me to hope.
A Word about Hope
Dr. Allan Hamilton, author of the Scalpel and the Soul (book review forthcoming in May) reminds us to be never afraid of hope as an integral ingredient of any therapeutic approach. In other words, there is no such thing as false hope. Hope is simply the desire to prevail, to survive, and to win against overwhelming odds9.
What about Seaweed and Pancreatic Cancer?
The ensuing paragraphs get a little technical. I have provided a link to each gene, enzyme, growth factor that describes in a little more detail what it is and what researchers believe the genes, enzymes and growth factors described are responsible for.
Aravindan at al. (2013) studied the anti-tumorigenic potential of polyphenols from five distinctive brown algae in four human pancreatic cancer cells. Total anti-oxidant capacity (TAC) analysis identified high levels of TAC in dichloromethane (DCM) and ethyl acetate (EA) extractions across all seaweeds assessed1.
All DCM and EA separated polyphenols induced a dose-dependent and sustained (time-independent) inhibition of cell proliferation and viability. The polyphenols also profoundly enhanced DNA damage in all the pancreatic cancer cell lines investigated. What that means is that DNA damage in pancreatic cancer cells is a good idea. Damaging pancreatic cancer’s DNA will prevent it from duplicating1.
There was also a significant inhibition of Nuclear Factor-KappaB (NFkB) transcription in cells treated with polyphenols. Interestingly, quantitative PCR (polymerase chain reaction) analysis identified a differential yet definite regulation of
- pro-tumorigenic epidermal growth factor receptor (EGFR),
- vascular endothelial growth factor A (VEGFA),
- v-akt murine thymoma viral oncogene homolog 1 (AKT),
- telomerase reverse transcriptase (hTERT),
- v-Ki-ras2 Kirsten rat sarcoma viral oncogene homolog (kRas),
- B-cell CLL/lymphoma 2 (Bcl2),
- fibroblast growth factor 1 (acidic) (FGFα) and
- platelet-derived growth factor alpha polypeptide (PDGFα)
transcription in cells treated with DCM and EA polyphenols1.
Immunoblotting validated the inhibitory potential of seaweed polyphenols in EGFR phosphorylation, kRas, aurora kinase B (AurKb) and signal transducer and activator of transcription 3 (STAT3)1.
Together, these data imply that intermediate polarity based fractions of seaweed polyphenols may significantly potentiate tumor cell killing and may serve as potential drug deliverable for pancreatic cancer treatment, (the authors write cure, but this might be overly confident)1.
More good news from Aravindan et al.’s (2013) research is that they exposed normal cells to the same seaweed treatment. The researchers found that healthy cells were not affected at all by the seaweed treatment. To sum up Aravindan et al.’s investigation of the brown algae, Dictyota dichotoma (DD), Hormophysa triquetra (HT), Spatoglossum asperum (SA), Stoechospermum marginatum (SM) and Padina tetrastromatica (PT):
- Seaweed polyphenols harbor high levels of antioxidants. Antioxidant-rich polyphenol fractions retard pancreatic cancer cell viability (makes cancer cells less capable of surviving).
- Seaweed polyphenols inhibit pancreatic cancer cell proliferation (does not allow the cancer cell to multiply).
- Seaweed polyphenols exerts apoptotic cell death in pancreatic cells (tells the cancer cell to commit suicide, [a very good thing]).
- Seaweed polyphenols inhibit functional activation of NFkB (interrupts communications)
- Seaweed polyphenols regulate tumor progression molecules in pancreatic cancer cells (interrupts communication)
Note: While these experiments were performed in highly controlled conditions, with extracted seaweed polyphenols in vitro (a test tube) further studies will have to show viability of this process in animals and then humans (in vivo).
There is, however, evidence emerging that eating a diet rich in seaweed, which has significant sources of protein, iodine, vitamin and minerals possesses cancer protective potential1,10,11,12.
How about you? What else do you need do know? As a pancreatic cancer patient, or loved one or caretaker of a pancreatic cancer patient what do you grapple with? What do you worry about? What are your desires, hopes, dreams? Short of curing cancer, what problem(s) do you need solved? Shoot me an email or post in the comment section.
Other ways to get involved:
Here in the U.S. the Pancreatic Cancer Action Network provides a plethora of services and opportunities to get involved in advocacy. Susan St. Maur recently made me aware of an e-petition effort in the U.K. to offer more funding and awareness for pancreatic cancer to aid long overdue progress in earlier detection and, ultimately, improved survival.
1. Aravindan, S., Delma, C. R., Thirugnanasambandan, S. S., Herman, T. S. & Aravindan, N. Anti-Pancreatic Cancer Deliverables from Sea: First-Hand Evidence on the Efficacy, Molecular Targets and Mode of Action for Multifarious Polyphenols from Five Different Brown-Algae. Plos One 8, e61977 (2013).
2. Champ, C. E. et al. Dietary recommendations during and after cancer treatment: consistently inconsistent? Nutr. Cancer 65, 430–439 (2013).
3. Laino, C. Gupta Guide: Cancer Patients Poorly Served by Online Nutrition Info. Medpage Today (2013). at <http://www.medpagetoday.com/TheGuptaGuide/Oncology/38124>
4. Dalal, S. et al. Relationships Among Body Mass Index, Longitudinal Body Composition Alterations, and Survival in Patients With Locally Advanced Pancreatic Cancer Receiving Chemoradiation: A Pilot Study. J. Pain Symptom Manage. 44, 181–191 (2012).
5. Chan, J. M., Gong, Z., Holly, E. A. & Bracci, P. M. Dietary patterns and risk of pancreatic cancer in a large population-based case-control study in the San Francisco Bay Area. Nutr. Cancer 65, 157–164 (2013).
6. Block, K. I. et al. Impact of antioxidant supplementation on chemotherapeutic efficacy: A systematic review of the evidence from randomized controlled trials. Cancer Treat. Rev. 33, 407–418 (2007).
7. Block, K. I., Boyd, D. B., Gonzalez, N. & Vojdani, A. The Immune System in Cancer. Integr. Cancer Ther. 1, 294–316 (2002).
8. McCarty, M. F. Toward a Core Nutraceutical Program for Cancer Management. Integr. Cancer Ther. 5, 150–171 (2006).
9. Hamilton, A. J. The scalpel and the soul: Encounters with surgery, the supernatural, and the healing power of hope. (Jeremy P. Tarcher/Putnam, 2008).
10. Mans, D. R. A. Anti-Cancer Drug Discovery and Development in Brazil: Targeted Plant Collection as a Rational Strategy to Acquire Candidate Anti-Cancer Compounds. The Oncologist 5, 185–198 (2000).
11. Sithranga Boopathy, N. & Kathiresan, K. Anticancer Drugs from Marine Flora: An Overview. J. Oncol. 2010, 1–18 (2010).
12. Halliwell, B. Dietary polyphenols: Good, bad, or indifferent for your health? Cardiovasc. Res. 73, 341–347 (2007).