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Regulation of Properties Specific to Cancer Cells
by Nutrients and Non-nutrients
- Effects of food components on hepatoma proliferation,
metastasis and cancerous dyslipidemia -
| Kazumi Yagasaki |
| Institute of Symbiotic Science and Technology, Tokyo University of Agriculture and Technology | |
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Cancer cells have two biological properties, namely, endless proliferation and metastasis. The invasion of cancer cells is a characteristic and important step in cancer metastasis. Hosts with cancer often show cancerous dyslipidemia as one of the symptoms of cancerous cachexia. Using a rat ascites hepatoma cell line of AH109A, we have constructed the proliferation and invasion assay systems in culture, and screened food components that suppress the proliferation and/or invasion of hepatoma cells in vitro. Catechins in teas, diterpenes in coffee, isoflavones in soybean, lignans in cereal, gingerol in ginger, stilbenoids in grapes, ascorbic acid and so forth suppressed both the proliferation and invasion at the same concentration ranges, while curcumin, chlorogenic acid, caffeic acid, quinic acid, trigonelline, niacin, carotenoids, tocopherols, glycine, theanine, eicosapentaenoic acid and so on suppressed only the invasion of hepatoma cells at the same concentration ranges. If serum samples from rats orally given food components could suppress the proliferation and/or invasion in culture, then the facts would provide us with information on absorbability of food components from the gastrointestinal tract, time-dependent rise and fall of active principles in blood, and possibility of their effectiveness in vivo. For instance, serum sample from rats orally given 7-hydroxymatairesinol (HMR), a lignan, was demonstrated to inhibit the hepatoma proliferation within the first hour after the gavage of HMR and remained below the control value for 24 hours. Intracorporeal chemical entity inhibiting the hepatoma proliferation was found to be enterolactone (ENL), a mammalian lignan converted from HMR by intestinal microflora that could induce cell cycle arrest and apoptosis in AH109A. Feeding diets containing HMR or ENL strikingly suppressed the growth of solid hepatoma and improved abnormal lipoprotein profiles in the serum of hepatoma-transplanted rats. In contrast, serum sample from rats orally given resveratrol (RES), a phytoalexin present in grapes and wine, lost anti-proliferative effect but maintained anti-invasive action against AH109A. Both RES as such and RES-treated rat serum scavenged intracellular reactive oxygen species (ROS), suppressed the gene and protein expression of hepatocyte growth factor (HGF), a known cell motility factor. Feeding diets containing RES suppressed the metastasis of hepatoma cells and improved abnormal lipoprotein profiles in the serum of hepatoma-bearing rats. Amino acids such as glycine and theanine were suggested to inhibit the hepatoma invasion via glycine transporter and glutamate receptor, respectively. From these findings, food components have been suggested to be remediable as well as preventive against hepatoma via diverse modes of actions.
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Nutritional management for cancer patients
| Takashi Higashiguchi |
| Professor & Director of Department of Surgery & Palliative Medicine
Chair of Nutrition Support Team, Fujita Health University School of Medicine |
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Current cancer treatments include: 1) surgical therapy, 2) chemotherapy, 3) radiation therapy, 4) immunotherapy, and 5) palliative therapy. Among these therapies, chemo / radiation therapies, not to mention surgical therapy, all involve in vivo invasion and furthermore, cause damage to healthy tissues while destroying cancer tissues. To truly secure the safety and comfort of cancer patients, it is necessary to promote recovery of damaged healthy tissues as well as to minimize invasion of healthy tissues. In this regard, metabolic and nutritional support including supplementation of nutrients such as arginine and zinc is required to promote regeneration / recovery of damaged tissues.
As is stated in the "WHO guidelines" and "the Basic Law for Cancer Prevention", holistic approaches to palliative care have been required from ever since cancer treatment began. Therefore, practicing cancer treatment that is kind on the body using nutrition management concurrently with pain control and psychological care will realize true palliative care.
The roles of nutrition management in cancer treatment from this standpoint are: 1) alleviation of invasion to healthy tissues; 2) promotion of regeneration / recovery of damaged healthy tissues; 3) remedy of abnormal metabolism associated with cancer treatment; 4) amelioration of nutritional disorders resulting from the side effects; 5) improvement in immunocompetence through nutritional intervention; and 6) nutrition therapy for terminal cancer patients. In particular, nutritional management for alleviating invasion and promoting recovery of damaged healthy tissues will be applied to all cancer patients in the near future, which will draw attention to the science of nutrition and metabolism based on the latest knowledge and evidence.
To effectively practice nutrition management for cancer therapy in a hospital as a whole, a nutrition support team (NST) should be established, which will help improve therapeutic effects through nutritional management. Moreover, proper nutritional management by an NST can reduce the incidence of infectious diseases, particularly, of in-house infection as well as the occurrence of pressure sores and difficulty with swallowing, and can prevent psychological distresses associated with high-level invasion and adverse effects. Nutritional management thus enables a broad range of holistic medical practice.
In other words, nutritional management can serve as a useful tool for providing safety and comfort to cancer patients.
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The challenge to feed cancer patients:
from calories towards a tailor made nutritional approach
| Denis Breuillé |
| Nestlé Research Center, N&H Department, Lausanne Suisse |
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Malnutrition is common in cancer patients and is associated with reduction in survival and quality of life. In identifying malnutrition, loss of body weight is probably the most useful clinical parameter. This body weight loss affects especially the lean body mass commonly named "sarcopenia". Eighty percent of patients below the mean BMI have been found to be sarcopenic. Surprisingly, 19% of obese patients are sarcopenic. In these obese patients, loss of lean body mass is also threatening for the clinical outcome.
Malnutrition and wasting (cancer cachexia / anorexia) evolve continuously during the progression of these advanced malignancies. The understanding of the pathophysiology of cancer-associated anorexia and cachexia is progressing. The role of cytokines (Interleukin 1, TNF alpha, Interleukin 6) in the induction of anorexia and tissue catabolism is now becoming more clearly understood. Cancer patients with cachexia only take in sufficient calories to cover basal metabolism (20-25 kcal/kg/day). The calorie intake required to maintain weight appears to be in excess of 35-45 kcal/kg/day which means these patients need an additional intake of 1000 kcal per day.
Where oral intake is limited, there is initial focus on dietary counseling and oral supplements. The efficacy of these approaches is not entirely clear. Enteral and parenteral nutritional support are currently applied but the formulations used are not necessarily well designed to meet the needs of cancer patients. A multi-modal strategy is needed to turn appetite back on, to correct the imbalances between anabolism and catabolism and to deliver nutritional therapy which is appropriate and which meets the requirements of patients.
Treatment-related toxicity and nutritional deficits occurring during surgery, radiation therapy and systemic chemotherapy may be serious. Injury to the mucosa of the gastrointestinal tract and to the bone marrow is the major dose-limiting toxicity and both of these effects are known to be sensitive to nutritional modulation. Patients with primary tumors of the head and neck are particularly limited in their ability to maintain oral intake. The paper will address specific composition of various nutritional concepts with the intent to optimize body functions such as immune response and mitigate toxic side effects of therapies.
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