HUN 3800

Assignment 4
Cancer Therapy Through Plant-Based Diet
Modjeska Herndon
N00870512
November 18, 2014

Introduction
Cancer is born from abnormal cells that grow out of control and
continue to invade other tissues, which then creates a cancer cell1. If this
growth of abnormal cells is not stopped, it can result in death. Cancer affects
millions of people worldwide in both developed and developing countries.
The American Cancer Society estimates that 585,720 Americans are
expected to die of cancer this year alone. Being the second leading cause of
death, this disease accounts for nearly one of every four deaths1. The most
common types of cancer include: non-Hodgkins lymphoma, leukemia, and
that of the bladder, breast, colon and rectum, uterus, kidney, lung, skin,
pancreas, prostate, and thyroid2.
Currently, men in the U.S. have slightly less than a 1 in 2 lifetime risk,
while women have a little more than a 1 in 3 lifetime risk of developing some
type of cancer1. Many people believe that the process of cancer cannot be
altered, although Khambete and Kumar state that only 5-10% of cancers are
due to genetic effects, while the remaining 90-95% are caused by
environmental and lifestyle factors such as smoking, diet, alcohol intake,
physical activity, obesity, UV radiation exposure, infections, and
environmental pollutants3. It is thought that poor diet and its sequelae
(obesity, physical inactivity and alcohol intake) is one of the most significant
contributing factors to cancer risk behind smoking4.
There are many different types of treatment for cancer. The types of
treatment include, but are not limited to, surgery, chemotherapy, radiation

therapy, targeted therapy, immunotherapy, stem cell transplant, blood

fusion, and many others1. One type of cancer treatment that goes unheard of
is that of diet therapy, also known as nutritional therapy. As it is already
widely known, many foods, especially fruits, vegetables, nuts, and seeds
have a plethora of powerful properties that help protect and fight against
cancer. Since many cancers have a latent period of 10 to 20 years when cells
grow very slowly, it is possible to fight off and prevent the devastating
effects of this disease by eating a plant-based diet5.
The purpose of this review is to look at how consuming a nutrient
dense plant-based diet fights against cancer more effectively and with a
more gentle approach while maintaining a higher quality of life compared
with that of traditional and modern cancer therapies. Plant-based diet is an
integral part in cancer prevention and cancer therapy while maintaining a
high quality of life. When speaking of a plant-based diet, this is referring to a
diet free from all foods derived from animal products, while eating a diet
filled with an abundance of nutrient rich foods such as fruits, vegetables,
nuts, legumes, seeds, and grains5.
Nutritional Status and Quality of Life During Chemotherapy
Approximately 40-80% of cancer patients undergoing chemotherapy
are malnourished, decreasing their quality of life6. Malnutrition impacts most
all cancer patients throughout every stage of the disease by increasing risk
of infection, delaying wound healing, increasing treatment toxicity,
prolonging hospital stay, and increasing health related costs6. Malnutrition in

cancer patients is associated with a poorer quality of life, in terms of

physical, social, emotional, and cognitive parameters6. A cross sectional
study conducted by Vergara et al.6, including 97 subjects, 66 females and 31
males mean age 54.55 11.14 years. According to the Subjective Global
Assessment, there were 58 patients classified to have adequate nutrition
while the other 39 patients were considered to be malnourished6. Results
from ANOVA tests revealed that patients were statistically different across
the Subjective Global Assessment groups according to global quality of life,
physical, role, emotional, cognitive functioning, fatigue, nausea and
vomiting, pain, insomnia, and appetite loss6. These results exhibit that even
if cancer patients who are undergoing chemotherapy have adequate
nutrition they still only have an average quality of life.
Plant-based diet
A diet that consists of plant-based foods is known to be one of the
healthiest diets in the world. No preservatives, meat, dairy or, processed
foods, which can hinder health, especially if an individuals health is subpar
due to a disease such as cancer. It is widely known that doctors recommend
increases or regular consumption of fruits, vegetables, whole grains, and
legumes, while discouraging excess consumption of sugary and energydense foods and drinks, red and processed meats, and salty processed foods.
Plant-based diets are nutrient dense because the diets are filled with so
many powerful properties including, but not limited to: vitamins, minerals,

antioxidants, phytochemicals, phytosterols, polyphenols, proanthocyanidins,

lectins, and many others.
Phytosterols
Phytosterols or plant sterols are molecules that resemble cholesterol
but are found solely in plants7. The most common phytosterols in the human
diet are -sitosterol, campesterol, and stigmasterol7. Phytosterols are known
to lower serum low-density lipoprotein (LDL) cholesterol levels by reducing
intestinal cholesterol absorption7.
A study conducted by Llaverias et al7., examined the effects of a dietary
phytosterols supplement on tumor onset and progression using the wellcharacterized mouse mammary tumor virus polyoma virus middle T antigen
transgenic mouse model of inherited breast cancer. In the present study,
researchers fed PyMT Tg mice a 2% phytosterols mixture supplement in
either a low-fat, low-cholesterol (LFLC) or a high-fat, high-cholesterol diet
(HFHC)7. It was observed that dietary phytosterols supplementation delayed
tumor onset and progression only in mice fed an HFHC diet7. Researchers
observed that both the development of mammary hyperplastic lesions and
total tumor burden were reduced after dietary phytosterols supplementation
in the female mice fed a high-fat, high-cholesterol diet7. The presence of
less-advanced lesions was also observed in the phytosterols-fed mice during
a blind, histopathologic examination of the mammary glands7. It can be
examined that phytosterols supplementation was effective in preventing
lipoprotein oxidation in mice fed the high-fat diet, a property that may

explain their anticancer effects since lipoprotein oxidation/inflammation has

been shown to be critical for tumor growth7. The study conducted by
Llaverias et al7., provides preclinical proof of the idea that dietary
phytosterols could prevent the tumor growth associated with fat-rich diet
consumption.
Proanthocyanidins
Proanthocyanidins are naturally occurring compounds that are widely
found in fruits, vegetables, nuts, seeds, flowers, and bark8. Most of the plantbased foods, such as fruits, berries, but also nuts, beans, some cereals such
as barley or sorghum, spices curry and cinnamon, were found to contain
exclusively the homogeneous B-type procyanidins. A-type proanthocyanidins
were only determined in curry, cinnamon, cranberry, peanut and plums,
etc.8.
The grape seed proanthocyanidins (GSPs) are mainly dimers, trimers
and highly polymerized oligomers of monomeric catechins8. GSPs have been
shown to have anti-carcinogenic activity in different tumor models reviewed
by Nandakumar et al8. The latest developments and knowledge on the
chemopreventive and chemotherapeutic effects of proanthocyanidins on
cancer include molecular targets, in vitro cell culture and in vivo animal
studies, clinical trials and bioavailability and metabolism8. These extensive
investigations with proanthocyanidins have identified various molecular
targets that can potentially be used for the treatment of cancers of various
organs8.

The activation of Nuclear Factor KappaB (NF-B) has been involved in

inflammation, cell proliferation and oncogenic processes8. Its activation
depends on the phosphorylation and subsequent degradation of IkappaB
proteins8. A number of studies reviewed by Nandakumar et al.8 have shown
that GSPs exert their anti-cancer effects through the suppression of NF-B. In
vitro treatment of human epidermoid carcinoma A431 cells with GSPs down
regulated the constitutive expression of basal level of NF-B/p65 and IKK in
these cells and simultaneously inhibits the degradation of IB protein, a
regulator of NF-B8. Apoptosis plays a major role in establishing a natural
balance between cell death and cell renewal in mature animals while
destroying excess, damaged or abnormal cells8. This down regulation of NFB sensitizes the cells to the induction of apoptotic cell death in tumor cells 8.
Mitogen-activated protein kinases (MAPK) signaling pathway is an
important upstream regulator of transcriptional factor activities8. MAPK
signaling pathway affects a wide variety of extracellular stimuli into
intracellular events and thus control the activities of downstream
transcription factors implicated in carcinogenesis8. Similar effects were also
observed in UV-exposure mouse skin when GSPs were given in the diet to the
mice8. Treatment of human epidermoid carcinoma A431 cells with GSPs also
resulted in inhibition of constitutive activation of MAPK proteins, which plays
a major role in cell growth and proliferation, and thus GSPs induce anticarcinogenic effects8. Conclusively, the in vitro and in vivo experimental data
supports the concept that proanthocyanidins, specifically GSPs hold promise

for superior chemopreventive, chemotherapeutic, and/or anticarcinogenic

agents8.
Protein Restriction
Eating a plant-based diet as a treatment of cancer can sometimes
result in consuming less protein, but the effects of eating less protein can
have some rather positive effects, especially when speaking in terms of
prostate or breast cancer, two of the most common types of cancer2,9. A
study conducted by Fontana et al.9, investigated the effects of diets with
different protein content or quality on prostate and breast cancer. To test
their hypothesis, Fontana et al.9, assessed the inhibitory effect of protein diet
restriction on prostate and breast cancer growth, serum PSA and IGF-1
concentrations, mTOR activity and epigenetic markers, by using human
xenograft cancer models. The results of this experiment showed a 70%
inhibition of tumor growth in the castrate-resistant LuCaP23.1 prostate
cancer model and a 56% inhibition in the WHIM16 breast cancer model fed
with a 7% protein diet when compared to an isocaloric 21% protein diet9.
Researchers also observed that it wasnt only protein quantity, but also
protein quality that decrease tumor growth9. A diet containing 20% plantprotein inhibited tumor weight by 37% as compared to a 20% animal dairy
protein diet9. The findings of this experiment conclusively suggest that a
reduction in dietary protein intake is highly effective in inhibiting tumor
growth in human xenograft prostate and breast cancer models, possibly

through the inhibition of the IGF/AKT/mTOR pathway and epigenetic

modifications9.
Importance of Walnuts
Hardmand10 states that researchers have identified biochemicals,
including n-3 (-3) fatty acids, tocopherols, -sitosterol, and pendunculagin,
found in walnuts and contain cancer-prevention properties. A study
orchestrated by David et al11, studied 3 groups of mice being fed a diet
containing shelled whole walnut halves (English walnuts (Juglans regia),
California walnut Commission ground to 3 mm size (WW), tocopherolstripped soyabean oil (HF), and a low-fat group (LF), using a lower amount of
stripped soyabean oil/kg diet supplying 8.7% of energy from fat. The walnut
diet, irrespective of its high fat content, resulted in notable and statistically
significant decreased genitourinary intact (GUI) weights and rate of tumor
weight gain11. In vivo studies conducted on mice in which walnuts were
included in the diet compared with a control diet show: 1) the walnut
containing diet inhibited the growth rate of human breast cancers implanted
in nude mice by ~80%; 2) the walnut containing diet reduced the number of
mammary gland tumors by ~60% in a transgenic mouse model; and lastly,
3) the reduction in mammary gland tumors was greater with whole walnuts
than with a diet containing the same amount of n-3 fatty acids, supporting
the idea that multiple components of walnuts additively or synergistically
contribute to cancer suppression10. Conclusively, this data lends support to

the conclusion that a diet high in walnuts can result in decreased prostate
tumor growth rate and reduced prostate tumor size10,11.
Lectins
Plant lectins are a significant group of biologically active glycoproteins
found in almost all organisms, including plants, vertebrates, invertebrates,
bacteria, and viruses12. Lectins are also being employed as therapeutic
agents in cancer treatment studies12. Several lectins have been found to
possess anticancer and chemopreventive properties in vitro, in vivo, and in
human studies12; they are used as therapeutic agents, preferentially binding
to cancer cell membranes or their receptors, causing cytotoxicity, apoptosis,
and inhibition of tumor growth12. Studies show that lectins from legumes
inhibit cell adhesion, proliferation and colon formation12. Lectins from
legumes can also cause hemagglutination and have cytotoxic effects on
human tumor cells12. There is scientific evidence showing that lectins founds
in plants have the following anticarcinogenic mechanisms: binding to tumoral
cell membranes, cytotoxic effects of lectins on tumor cells (decrease in
protein synthesis and induction of apoptosis), reduction of cell proliferation,
and stimulation of the immune system (cytokines, interleukin-1 and 6, tumor
necrosis factor-aplha [TNF-], induction of cells and repair damaged DNA)12.
Lectins have also been shown to modulate the growth, proliferation, and
apoptosis of premalignant and malignant cells in vitro and in vivo12.
Conclusion

Looking at the studies mentioned in this review -- one is able to see

how a plant-based diet is an integral part in cancer therapy while
simultaneously maintaining a higher quality of life. Researching the effects of
a plant-based diet on cancer and diet therapy is trending upwards as people
are looking for a more natural and holistic approach at treating cancer while
simultaneously improving the quality of life of the patient(s). The effects of a
plant-based diet on treating cancer will have a remarkable impact on the
future of dietitians and dietetic practices. Nutritional counseling has already
become a fundamental part of cancer prevention. It is only a matter of time
before nutritional therapy or diet therapy also becomes an intrinsic part of
treating cancer. Registered dietitians will possess the ability to create
individual diets for cancer patients and tailor them specifically to the
patients need(s) depending on preferences, dietary restrictions, and what
type of cancer they are diagnosed with. As evidenced by studies previously
cited, a plant-based diet not only can prevent the growth of tumors, but can
assist in the defeat of cancer in the human body. Plant-based diets are
known to improve quality of life in both healthy and diseased individuals.
Although the field is diet therapy is still new, these studies show that when
eating a diet that consists of nutrient rich plant-based foods, one is able to
not only improve quality of life, but also fight and protect against the
devastating effects of cancer.

References:
1. American Cancer Society Website.
http://www.cancer.org/cancer/cancerbasics/what-is-cancer. Accessed
November 12, 2014.
2. National Cancer Institute Website (common types of cancer url).
Accessed November 12, 2014.

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International Journal of Nutrition, Pharmacology, Neurological
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6. Vergara N, Montoya JE, Luna HG, Amparo JR, Cristal-Luna G. Quality
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11. Davis PA, Vasu VT, Gohil K, et al. A High-Fat Diet Containing
Whole Walnuts (Juglans regia) Reduces Tumour Size and Growth
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Adenocarcinoma of the Mouse Prostate Model. British Journal of

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