Monday, 24 February 2014

Endometrial Cancer In Foods Points of View

Kyle J. Norton

The incidence of endometrial cancer among white women are higher in comparison to black. According to the statistic, the risk of endometrial cancer among women is 1 in 7000. Every year, about 40,000 women in US are diagnosed with the disease. Women who carry certain mutation genes, such as  BRCA1 or the BRCA2 are associated to increased risk of endometrial cancer.
Depending to the stage and grade of the cancer, chemotherapy such as Doxorubicin, Cisplatin. Paclitaxel, Carboplatin, Topotecan may be necessary after surgery with certain side effects. Although epidemiological studies focusing the effective of vegetables and fruits in reduced risk and treatment of endometrial cancer with inconclusive results(1)(2)(3)(4), certain foods, through clinical studies have been found effectively in reduced risk and treatment of endometrial cancer with little or no side effects.
Endometrium is the inner lining of the mammalian uterus and very susceptible hormone change, particular to menstrual cycle. Endometrial cancer is a late adulthood cancer defined as a condition in which the cells of the endometrial lining of uterus have growth uncontrollably or become cancerous as a result of the alternation of cells DNA. It's the fourth most common cancer among women overall, after breast cancer, lung cancer, and bowel cancer. 

1. Cruciferous vegetables
Cruciferous vegetables are the group of  vegetables belonging to the family Brassicaceae, including cauliflower, cabbage, cress, bok choy, broccoli etc. The vegetables have been suggested to reduced risk and protect against various types of cancer(5). Indole-3-carbinol (I3C), a chemical constituent found in cruciferous vegetables, in Donryu rats study showed to be effective in inhibition of spontaneous occurrence of endometrial adenocarcinoma as well as preneoplastic lesions(6). Since
  metabolic profile of estrogens may be crucial for the endometrial carcinogenesis, Indole-3-carbinol (I3C) exerted its  anti-estrogen and induced apoptotic effects through the 2- and 4-hydroxylation pathways (catechol estrogens) and the downstream of the 16beta-hydroxylation pathway(7).

2. Garlic
Garlic is a natural superfood healer for its natural antibiotic with antiviral, antifungal, anticoagulant and antiseptic properties. Allium vegetables have been found in many studies to have an inverse association between the frequency of use of and the risk of several common cancers(8). Purified allicin, a major ingredient of crushed garlic, showed to induced apoptosis through induction of activation of caspases-3, -8 and -9 and cleavage of poly(ADP-ribose) polymerase(9) A multi-centre case-control study of 454 endometrial cancer cases and 908 controls, allium vegetables, including garlic showed a moderate protective effect in reduced risk endometrial cancer(10). But according to the Korea Food and Drug Administration, there was no credible evidence to support a  garlic intake in reduced risk of endometrial cancer(11).

3. Tomatos
Tomato is a red, edible fruit, genus Solanum, belonging to family Solanaceae, native to South America. Because of its health benefits, tomato is grown world wide for commercial purpose and often in green house. Lycopene, a major carotenoid component of tomato has been known in research community with the property to attenuate the risk of endometrial cancer, through cellular effects, either by chemical oxidation or by enzymatic cleavage inside the cells(12). In endometrial (ECC-1) cancer cell, composition of lycopene and atRA inhibited Insulin-like growth factors (IGFs) -I-stimulated cell cycle progression through G1 to S phase and decreased (retinoblastoma protein (pRb)) tumor suppressor protein dysfunction(13) or cell cycle progression(14). In the comparison of the effects of  lycopene and alpha- and beta-carotene in endometrial cancer, lycopene is more potent in inhibited basal endometrial cancer cell proliferation, and suppressed insulin-like growth factor-I-stimulated growth(15).

4. Organic soybean
Soybean is genus Glycine, the family Fabaceae, one of the legumes that contains twice as much protein per acre as any other major vegetable or grain crop, native to Southeast Asia. Now, it is grown worldwide with suitable climate for commercial profit and a healthy foods.
Phytochemicals such as daidzein, genistein, or glycitein found in soy and other legumes have been speculated to reduce the risk of endometrial cancer and specially in lean women(16).. According to the University of Hawaii Cancer Center, greater consumption of isoflavone-containing foods is associated with a reduced risk of endometrial cancer in nonhysterectomized postmenopausal women(17). In Estrogen-induced proliferation of endometrial epithelial cells, genistein found in legime and organic soy inhibited the proliferative effects of estrogen on endometrial adenocarcinoma cells presumably through activation of stromal cell ERβ(18). But In a total of 666 visits among 224 participants study conducted by University of Southern California, showed that there was no evidences to support of the effects of ISP supplementation onendometrial thickness or on the odds of endometrial hyperplasia and cancer in postmenopausal women(19).

5. Whole grain
It is suggested that whole grain reduced risk of endometrial cancer through its interaction of  sex hormone metabolism and body fat in a study of Cancer and Health cohort of 29,875 women aged 50-64 years at enrollment in 1993-1997(20).  Lignan, a chemical constituents found abundantly in whole-grain cereals, beans, berries, nuts, in animals has shown clear anticarcinogenic effects(21). A study of 23,014 Iowa women, aged 55-69 years in 1986 conducted by the University of Minnesota, indicated that an inverse association between whole grain intake and endometrial cancer and may protect against endometrial cancer among never-users of hormone replacement therapy(22). Also in a review of the literature, the University of Minnesota showed there is a striking consistency in reduced risk edometrial cancers associated with intake of whole grain(23).

6. Green Tea
Green tea contains more amount of antioxidants than any drinks or food with the same volume, and is the leaves of Camellia sinensis, undergone minimal oxidation during processing, originated from China. Green tea has been a precious drink in traditional Chinese culture and used exceptional in socialization for more than 4000 thousand years. Because of their health benefits, they have been cultivated for commercial purposes all over the world. The University of Bristol study showed that there is some positive evidence for risk reduction of  endometrial cancers with green tea consumption(24). (-)-Epigallocatechin-3-gallate (EGCG), a major polyphenol in green tea, inhibited endometrial cancer cell line through inhibiting ERK activation and inducing apoptosis via ROS generation and p38 activation(25). The population-based case-control study in urban Shanghai indicated that the reduction of risk of endometrial cancer may be  only limit to premenopausal women(26)). Some studies suggested that  tea consumption may reduce the risk of endometrial cancer but further prospective studies are needed(27).

7. Coffee
Coffee made from the roasted seeds of the genus Coffee, belonging to the family Rubiaceae native to southern Arabia. Strong evidence suggested that  drinking coffee reduced risk of endometrial cancer and there is a correlation of caffeinated coffee intake associated with lower endometrial cancer risk among obese postmenopausal women(27) but the association with decaffeinated coffee remains unclear. In a prospective cohort study, conducted by the Harvard School of Public Health, Boston, indicated that Drinking of coffee, may reduce endometrial cancer risk, but addition of substantial sugar and cream to coffee could offset any potential benefits(28). The The National Institute of Environmental Medicine study also showed a positive effect of coffee in reduced risk of endometrial cancer, especially among women with excessive body weight(29).

8.  Fatty fish
Fatty fish containing a large amounts of omega-3 fatty acids may be associated to reduced risk of endometrial cancer, but not other types of fish, according to the nationwide case-control study in Sweden(30).The Ohio State University College of Medicine and the Fred Hutchinson Cancer Research Center study showed that long-chain ω-3 (n-3) polyunsaturated fatty acids (PUFAs), derived from marine sources, consisted a anti-inflammatory effect thus reducing risk of endometrial cancer, restricted to overweight and obese women(31). In the investigation of Tohoku University Graduate School of Medicine, the study indicated that  higher intake of vegetables, peanuts, fish, and boiled egg was associated with a reduced risk for EEA(32). Unfortunately, some researchers suggested that there is no evidence to support an association between meat or fish intakes or meat mutagens and endometrial cancer(33).

9. Olive oil
Olive is belongs to the the family Oleaceae, native to the coastal areas of the eastern Mediterranean Basin and south end of the Caspian Sea. Its fruit, is also called the olive and the source of olive oil.
According to the study by the University of Athens Medical School, increased intake of monounsaturated fat, mostly olive oil, was associated with endometrial cancer risk reduction and increased olive oil intake by 1 standard deviation, reduced risk of endometrial cancer by 26% (34). In a 84 women study with intact uterus admitted to the same teaching hospital in Athens, showed that risk of endometrial cancer is reduced with intake Retinol, nicotinic acid, vitamin B- 6, and riboflavin, but olive oil was highly suggestive(35). Other researchers suggested since the incidence of cancer overall in Mediterranean countries is lower than in Scandinavian countries, the United Kingdom, and the United States, it may be a result of healthy traditional Mediterranean diet(36).

Taking altogether, without going into reviews, intake of above list foods are associated to reduced risk and treatment of endometrial cancer. As always, all articles written by Kyle J. Norton are for information & education only, please consult your Doctor & Related field specialist before applying.

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(1) Conference on "Multidisciplinary approaches to nutritional problems". Symposium on "Nutrition and health". Cruciferous vegetable intake and the risk of human cancer: epidemiological evidence BY Kim MK, Park JH(PubMed)
(2) Epidemiological studies on brassica vegetables and cancer risk by Verhoeven DT, Goldbohm RA, van Poppel G, Verhagen H, van den Brandt PA(PubMed)
(3) Brassica vegetables and cancer prevention. Epidemiology and mechanisms by van Poppel G, Verhoeven DT, Verhagen H, Goldbohm RA.(PubMed)
(4) Fruits and vegetables and endometrial cancer risk: a systematic literature review and meta-analysis by Bandera EV, Kushi LH, Moore DF, Gifkins DM, McCullough ML(PubMed)
(5) Cruciferous vegetables and cancer risk in a network of case-control studies by Bosetti C, Filomeno M, Riso P, Polesel J, Levi F, Talamini R, Montella M, Negri E, Franceschi S, La Vecchia C.(PubMed)
(6) Chemoprevention of spontaneous endometrial cancer in female Donryu rats by dietary indole-3-carbinol by Kojima T, Tanaka T, Mori H(PubMed)
(7) Effects of estrogens and metabolites on endometrial carcinogenesis in young adult mice initiated with N-ethyl-N'-nitro-N-nitrosoguanidine by Takahashi M, Shimomoto T, Miyajima K, Yoshida M, Katashima S, Uematsu F, Maekawa A, Nakae D.(PubMed)
(8) Onion and garlic use and human cancer by Galeone C, Pelucchi C, Levi F, Negri E, Franceschi S, Talamini R, Giacosa A, La Vecchia C.(PubMed)
(9) Allicin (from garlic) induces caspase-mediated apoptosis in cancer cells by Oommen S, Anto RJ, Srinivas G, Karunagaran D.(PubMed)
(10) Allium vegetables intake and endometrial cancer risk by Galeone C, Pelucchi C, Dal Maso L, Negri E, Montella M, Zucchetto A, Talamini R, La Vecchia C.(PubMed)
(11) Garlic intake and cancer risk: an analysis using the Food and Drug Administration's evidence-based review system for the scientific evaluation of health claims by Kim JY, Kwon O(PubMed)
(12) The role of lycopene and its derivatives in the regulation of transcription systems: implications for cancer prevention by Sharoni Y, Linnewiel-Hermoni K, Zango G, Khanin M, Salman H, Veprik A, Danilenko M, Levy J.(PubMed)
(13) Lycopene inhibition of IGF-induced cancer cell growth depends on the level of cyclin D1 by Nahum A, Zeller L, Danilenko M, Prall OW, Watts CK, Sutherland RL, Levy J, Sharoni Y.(PubMed)
(14) Lycopene inhibition of cell cycle progression in breast and endometrial cancer cells is associated with reduction in cyclin D levels and retention of p27(Kip1) in the cyclin E-cdk2 complexes by Nahum A, Hirsch K, Danilenko M, Watts CK, Prall OW, Levy J, Sharoni Y.(PubMed)
(15) Lycopene is a more potent inhibitor of human cancer cell proliferation than either alpha-carotene or beta-carotene by Levy J, Bosin E, Feldman B, Giat Y, Miinster A, Danilenko M, Sharoni Y.(PubMed)
(16) Phytoestrogen consumption and endometrial cancer risk: a population-based case-control study in New Jersey by Bandera EV1, Williams MG, Sima C, Bayuga S, Pulick K, Wilcox H, Soslow R, Zauber AG, Olson SH(PubMed)
(17) Legume, soy, tofu, and isoflavone intake and endometrial cancer risk in postmenopausal women in the multiethnic cohort study by Ollberding NJ1, Lim U, Wilkens LR, Setiawan VW, Shvetsov YB, Henderson BE, Kolonel LN, Goodman MT(PubMed)
(18) Genistein effects on stromal cells determines epithelial proliferation in endometrial co-cultures by Sampey BP1, Lewis TD, Barbier CS, Makowski L, Kaufman DG(PubMed)
(19) Effect of isoflavone soy protein supplementation on endometrial thickness, hyperplasia, and endometrial cancer risk in postmenopausal women: a randomized controlled trial by Quaas AM1, Kono N, Mack WJ, Hodis HN, Felix JC, Paulson RJ, Shoupe D.(PubMed)
(20) Whole grain, dietary fiber, and incidence of endometrial cancer in a Danish cohort study by Aarestrup J1, Kyrø C, Christensen J, Kristensen M, Würtz AM, Johnsen NF, Overvad K, Tjønneland A, Olsen A(PubMed)
(21) Lignans and human health by Adlercreutz H.(PubMed)
(22) Whole grain intake and incident endometrial cancer: the Iowa Women's Health Study by Kasum CM1, Nicodemus K, Harnack LJ, Jacobs DR Jr, Folsom AR; Iowa Women's Health Study(PubMed)
(23) Whole grain intake and cancer: a review of the literature by Jacobs DR Jr1, Slavin J, Marquart L(PubMed)
(24) Green tea and green tea catechin extracts: an overview of the clinical evidence by Johnson R1, Bryant S, Huntley AL(PubMed)
(25) (-)-Epigallocatechin-3-gallate induces apoptosis in human endometrial adenocarcinoma cells via ROS generation and p38 MAP kinase activation by Manohar M1, Fatima I, Saxena R, Chandra V, Sankhwar PL, Dwivedi A(PubMed)
(26) [Green tea consumption and the risk of endometrial cancer: a population-based case-control study in urban Shanghai].[Article in Chinese] by Gao J1, Xiang YB, Xu WH, Shao CX, Ruan ZX, Cheng JR, Shu XO, Gao YT(PubMed)
(26) Tea consumption and risk of endometrial cancer: a metaanalysis by Tang NP1, Li H, Qiu YL, Zhou GM, Ma J(PubMed)
(27) Caffeinated coffee, decaffeinated coffee and endometrial cancer risk: a prospective cohort study among US postmenopausal women by Giri A1, Sturgeon SR, Luisi N, Bertone-Johnson E, Balasubramanian R, Reeves KW(PubMed)
(28) A prospective cohort study of coffee consumption and risk of endometrial cancer over a 26-year follow-up by Je Y1, Hankinson SE, Tworoger SS, De Vivo I, Giovannucci E(PubMed)
(29) Coffee drinking and risk of endometrial cancer--a population-based cohort study by Friberg E1, Orsini N, Mantzoros CS, Wolk A(PubMed)
(30) Fatty fish consumption lowers the risk of endometrial cancer: a nationwide case-control study in Sweden by Terry P1, Wolk A, Vainio H, Weiderpass E(PubMed)
(31) Associations of long-chain ω-3 fatty acids and fish intake with endometrial cancer risk in the VITamins And Lifestyle cohort by Brasky TM1, Neuhouser ML, Cohn DE, White E(PubMed)
(32) Food intake and the risk of endometrial endometrioid adenocarcinoma in Japanese women by Takayama S1, Monma Y, Tsubota-Utsugi M, Nagase S, Tsubono Y, Numata T, Toyoshima M, Utsunomiya H, Sugawara J, Yaegashi N(PubMed)
(33) A prospective investigation of fish, meat and cooking-related carcinogens with endometrial cancer incidence by Arem H1, Gunter MJ, Cross AJ, Hollenbeck AR, Sinha R(PubMed)
(34) Dietary factors and the risk of endometrial cancer: a case--control study in Greece by Tzonou A1, Lipworth L, Kalandidi A, Trichopoulou A, Gamatsi I, Hsieh CC, Notara V, Trichopoulos D(PubMed)
(35) Diet in relation to endometrial cancer risk: a case-control study in Greece by Petridou E1, Kedikoglou S, Koukoulomatis P, Dessypris N, Trichopoulos D(PubMed)
(36) Cancer and Mediterranean dietary traditions by Trichopoulou A1, Lagiou P, Kuper H, Trichopoulos D.(PubMed)

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