Anticancer Properties Of Fruits And Vegetables: A Scientific Review

A Scientific Review

Ajaikumar B Kunnumakkara

• Publisher: WSPC
• Year: 2014
• eBook ISBN: 9789814508902
• Topic: Biological Sciences
• Subtopic: Science General
• Index: Biological Sciences

An estimated 12.6 million people are diagnosed with cancer every year and 7.6 million people die of the disease annually. Numerous lines of evidence suggest that lifestyle and nutrition play an important role in cancer development. As for nutrition, diets that are rich in fruits and vegetables have been shown to lower the risk of cancer incidence. In addition, several phytochemicals that are present in fruits and vegetables have been scientifically established to have properties that can prevent and treat this malevolent disease.

The primary aim of the book is to educate the public about the benefits of fruits and vegetables as they relate to cancer and their potential to contribute to the possibility of a cancer-free life. The active ingredients and modes of actions of fruits and vegetables are also discussed, along with their chemo-preventive aspects.

This clearly written, comprehensive guide explains the properties of these natural foods and substances on a cancer-by-cancer basis. Thus, this book not only informs the general public about the anticancer properties of fruits and vegetables but also provides a valuable reference for scientists and other professionals working in this area.

Contents:

• Cancer Preventive and Therapeutic Properties of Fruits and Vegetables: An Overview (Chandrasekharan Guruvayoorappan, Kunnathur Murugesan Sakthivel, Ganesan Padmavathi, Vaishali Bakliwal, Javadi Monisha and Ajaikumar B Kunnumakkara)
• Phytochemicals Safeguard the Genome: Tiny Molecules, Big Role (Sanjit Dey, Nilanjan Das, Debdutta Ganguli, Mahuya Sinha, Kunal Sikder, Swaraj Bandhu Kesh, Dipesh Kr Das, Amitava Khan, Ujjal Das, Krishnendu Manna, Sushobhan Biswas, Anirban Pradhan and Rakhi Sharma Dey)
• Phytonutrients from Fruits and Vegetables in Breast Cancer Control (Madhumita Roy, Apurba Mukherjee, Sutapa Mukherjee and Jaydip Biswas)
• Anti-Proliferative and Pro-Apoptotic Effects of Bioactive Constituents Derived from Fruits and Vegetables Against Colorectal Cancer (Sakshi Sikka and Gautam Sethi)
• Anticancer Activities of Fruits and Vegetables Against Gynecological Cancers (Sankar Jagadeeshan, Ajaikumar B Kunnumakkara, Indu Ramachandran and S Asha Nair)
• Cancer Chemopreventive and Therapeutic Properties of Fruits and Vegetables Against Head and Neck Malignancies (Jesil Mathew Aranjani, Ganesan Padmavathi, Ajaikumar B Kunnumakkara and Atulya Mathew)
• Anticancer Activities of Fruits and Vegetables Against Liver and Pancreatic Cancers (Farid A Badria, Diaaeldin M Elimam and Ahmed S Ibrahim)
• Cancer Preventive and Therapeutic Properties of Fruits and Vegetables Against Lung Cancer (Kunnathur Murugesan Sakthivel, Javadi Monisha, Ajaikumar B Kunnumakkara and Chandrasekharan Guruvayoorappan)
• Prostate Cancer: How Helpful are Natural Agents for Prevention? (Manoj K Pandey, Ajaikumar B Kunnumakkara and Shantu G Amin)
• Phytochemicals from Fruits and Vegetables as Potential Anticancer Agents: Special Reference to Skin Cancer (Jayesh Antony, Minakshi Saikia and Ruby John Anto)
• Anticancer Effects of Agents Derived from Fruits and Vegetables Against Stomach Cancer (Sakshi Sikka and Gautam Sethi)
• Cancer Preventive and Therapeutic Properties of Fruits and Vegetables Against Commonly Occurring Cancers in Humans (Javadi Monisha, Ganesan Padmavathi, Vaishali Bakliwal, Naman Katre, Jose Padikkala and Ajaikumar B Kunnumakkara)

Readership: Cancer researchers/scientists, oncologists and other health professionals working in the field; cancer patients and their families; general readers interested in either preventing or combating cancer.
Key Features:

• This book will explain the cancer chemo-preventive and therapeutic properties of fruits and vegetables, their active ingredients and their molecular modes of action; thus it will be of significant utility for cancer researchers and other professionals
• The authors of the chapters of this book are well known, highly respected scientists in the field of natural product research

1
Cancer Preventive and
Therapeutic Properties of Fruits
and Vegetables: An Overview

Chandrasekharan Guruvayoorappan, Kunnathur Murugesan Sakthivel,
Ganesan Padmavathi, Vaishali Bakliwal, Javadi Monisha
and Ajaikumar B. Kunnumakkara^*

INTRODUCTION

Cancer is one of the leading causes of death worldwide, accounting for one in every eight deaths — more than HIV/AIDS, tuberculosis, and malaria. According to GLOBOCAN (2008), approximately 12.7 million people are diagnosed with cancer every year, causing approximately 7.6 million deaths.¹ During the past several decades, numerous epidemiological and experimental studies have resulted in significant progress in understanding the molecular mechanisms of cancer development. These studies also suggest that lifestyle plays a critical role in the development of this disease. For instance, obese and diabetic patients have a greater susceptibility to cancer than lean and non-diabetic individuals. Moreover, it has been well established that a diet rich in saturated fats and red meats and low in fresh fruits, vegetables, and whole grains has been shown to increase the risk of cancer. According to the United States National Institutes of Health, “12 servings of fruits and vegetables a day” can prevent common diseases including cancer. This clearly shows the importance of fruits and vegetables in the prevention of this disease. In this chapter, we will discuss the common fruits and vegetables that are known to have anticancer properties. However, we will first place the subject in context, discussing the history, classification and development of cancer and its different treatment modalities.

Cancer

Cancer has been known since human societies first recorded their activities, but the formal study of cancer (i.e., oncology) was first documented in the seventeenth century. Cancer can be defined as a disease of uncontrolled division of abnormal cells. Cancer not only affects human and higher mammals, but it affects almost all the multicellular organisms — animals as well as plants. Nearly 175 years ago, the German microscopist, Johannes Müller, was the first to show that cancers were made up of cells. After this finding, an enormous amount of information has been amassed about this disease. Markedly, in the past two decades, rapid technological advancement has aided us as we dissever the cancer genomes, transcriptome, and proteome, in detail.

Classification of Cancer

The classification of cancer is highly complicated due to the presence of a wide variety of human cancers that arise in almost every tissue in our body. Oncologists and cancer biologists classify cancers based on the tissues of origin, regardless of organ location, focusing on similarities in cellular structure and function among tumors. A tumor is an abnormal mass of tissue that can be either benign (non-cancerous) or malignant (cancerous). Tumors can be either a solid mass comprised of epithelial or mesenchymal cells that are usually immobile, or they can be a liquid sac, which includes leukemias and lymphomas comprising neoplastic cells whose precursors are usually motile.² Further, pathologically, cancers are classified into four different types:

(1) Carcinoma: originates from epithelial cells in the skin or in other tissues that line or cover internal organ.

(2) Sarcoma: originates in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue.

(3) Leukemia: originates in blood-forming tissues of the body such as bone marrow, causing abnormal proliferation of blood cells usually, white blood cells (leukocytes).

(4) Lymphoma: originates in the cells of the immune system, also termed as cancers of the lymphoid organs such as the lymph nodes, spleen, and thymus, which produce and supply infection-fighting cells.³

Development of Cancer: Multi-Stage Carcinogenesis

Carcinogenesis, the process of cancer development, is a multi-stage process. Generally, cancer starts with a mutational event (i.e., genetic changes) in a single normal cell; then, it will develop into a multi-stage process through the acquisition of further mutations that are inherited by the progeny of that cell when it divides, thus cancer is also termed as clonal disease (Fig. 1.1). In higher animals or humans, the use of a cancer-causing agent (carcinogen) does not lead to the immediate production of a tumor. Rather, it will arise after a long latent period. Berenblum and Shubik in 1940⁴ showed that there are three major stages involved in the process of carcinogenesis. The first is initiation, which involves the mutagenic effects of the carcinogen. The second stage is promotion, which may be induced by several agents that are not directly carcinogenic (promoters) and may be followed by the chronic treatment of the carcinogens. The third stage is progression in which benign tumors either spontaneously, or followed by additional treatment of the carcinogens, will progress to invasive tumors. The latent period between initiation and the appearance of tumors is very long. After exposure to carcinogens, it may take more than 20 years before tumors develop in humans. Even in animals, if given heavy doses of carcinogens, it may take up to one-third of the animal’s total lifespan before tumors appear. Initiation and progression of cancer depend upon several external and internal factors such as tobacco use, exposure to infectious organisms, radiation, hormones, inherited mutations, and immune conditions. Uncontrolled mutations and selective expansion of cancer cells lead to tumor growth and progression, eventually spreading to other locations of the body. This proliferation of cancer cells is termed as metastasis.

Figure 1.1: Progressive model for multi-stage carcinogenesis.

Treatment Strategies for Cancer

Options for the treatment of cancer are expanding at a high rate. Current strategies for treating cancer involve surgery, radiation, or drugs — either singly or in combination.⁵

Surgery

Surgical treatment involves excision of tumor, the most frequently employed form of tumor therapy worldwide. In recent years, surgery combined with other treatment approaches such as chemotherapy and radiation therapy, has enhanced the effectiveness of cancer treatment. The side effects of the surgical treatment depend upon the location of the tumor, the patient’s general health, type of operation, and other factors.

Radiation therapy

Radiation therapy involves the exposure of the body to ionizing radiations like X-rays and γ-rays to selectively target the cancer tissue. It includes the uptake of radioactive iodine, which travels in the blood to kill the cancer cells and is referred to as systemic radiation therapy. Additional types of radiation therapy include external beam radiation therapy (e.g., X-ray tubes, cobalt gamma rays, and linear accelerators), brachytherapy (caesium-137, iodine-125, or iridium-192), and radiopharmaceuticals that target specific tissues. Currently, much research focuses on radiosensitizers and radioprotectors. Radiosensitizers are drugs which make the cancer cells more sensitive to the radiation therapy, in addition to anticancer drugs like 5-fluorouracil and cisplastin. Natural radioprotectors like rutin and quercetin, among others, are drugs that protect the normal cells from damage and promote the repair of normal cells caused by radiation therapy.⁶

Chemotherapy

Chemotherapy is the use of chemicals to treat cancer. Research over the past several decades has developed many chemotherapeutic agents for the treatment of cancer. These include mustard gas, cyclophosphamide, vincristine, vinblastine, taxol, tyrosine kinase inhibitors, etc. The common side effects of chemotherapy include nausea and vomiting, hair loss (alopecia), suppression of white blood cells and production of platelets (myelosuppression), diarrhea, and decreased spermatogenesis/ ovarian follicle formation. Long-term toxicity and the risk of developing resistance to chemotherapy are formidable hindrances that could limit the chronic application strategy in the chemotherapy of several cancers.

Cancer Chemoprevention

Cancer chemoprevention is a relatively new area in the field of oncology that uses naturally occurring or synthetic agents to inhibit the process of carcino genesis or to slow down the progression of cancer. Chemoprevention helps to lower the risk of developing invasive or clinically significant diseases. There are three different types of cancer chemoprevention: (1) primary prevention in high-risk healthy individuals; (2) cancer prevention in individuals who have developed pre-malignant lesions; and (3) prevention of secondary forms of cancers in patients already treated for a primary cancer. The final endpoint of all three aspects of chemoprevention is the attainment of clinical evidence for cancer reduction.⁷ Cancer chemopreventive agents prevent the transformation of pre-malignant lesions to form malignant tumors by modulating cell proliferation and/or differentiation.⁸ It has been recommended that these agents ...

Table of contents

• Cover
• Half Title
• Title
• Copyright
• Contents
• Contributors
• Preface
• 1 Cancer Preventive and Therapeutic Properties of Fruits and Vegetables: An Overview
• 2 Phytochemicals Safeguard the Genome: Tiny Molecules, Big Role
• 3 Phytonutrients from Fruits and Vegetables in Breast Cancer Control
• 4 Anti-Proliferative and Pro-Apoptotic Effects of Bioactive Constituents Derived from Fruits and Vegetables Against Colorectal Cancer
• 5 Anticancer Activities of Fruits and Vegetables Against Gynecological Cancers
• 6 Cancer Chemopreventive and Therapeutic Properties of Fruits and Vegetables Against Head and Neck Malignancies
• 7 Anticancer Activities of Fruits and Vegetables Against Liver and Pancreatic Cancers
• 8 Cancer Preventive and Therapeutic Properties of Fruits and Vegetables Against Lung Cancer
• 9 Prostate Cancer: How Helpful are Natural Agents for Prevention?
• 10 Phytochemicals from Fruits and Vegetables as Potential Anticancer Agents: Special Reference to Skin Cancer
• 11 Anticancer Effects of Agents Derived from Fruits and Vegetables Against Stomach Cancer
• 12 Cancer Preventive and Therapeutic Properties of Fruits and Vegetables Against Commonly Occurring Cancers in Humans
• Index