Tuesday, 22 November 2016

Can Neuroblastoma Be Prevented?

In recent weeks, photos of a 4-year-old girl suffering from neuroblastoma and its government-approved treatments went viral, and if that wasn't horrible enough, she sadly died this week. But instead of accepting The Way Things Are, why don't we look at ways to prevent it?

Since neuroblastoma strikes very young children, prevention may start with the parents, before they are even born. When one study aimed to investigate this, cases of children diagnosed with neuroblastoma over a period of two years from Children's Cancer Group and Pediatric Oncology Group institutions were compared to random matched controls. This yielded 538 cases and 504 matched controls. Daily use of multivitamins was linked to a 30-40% reduced risk of neuroblastoma, both during pregnancy and in the month before conception. For example, use in the second trimester was associated with a 40% lower risk. It did not seem to matter about specific vitamins or minerals, and age at diagnosis or amplification of cancer-related genes didn't have much effect on the results either.

Eat your spinach. Source: cyclonebill (CC BY SA: 2.0)
However, folate may be one specific nutrient that could prevent neuroblastoma development. In 1997, Canada began to fortify flour with folate in order to prevent neural tube defects such as spina bifida. When the rates of neuroblastoma were examined before and after its implementation, using cases registered by the Pediatric Oncology Group of Ontario, it was found that incidence rates of infant (under 1 year old) neuroblastoma fell from 1.57 cases per 10,000 births to 0.62 cases! This remained significant after adjustment for age at diagnosis and disease severity. Another study looking at cancer rates for children up to 9 years old did not find such associations, but still found a 26% reduction in the risk of Wilm's tumour in children under 5 (from 1.94 to 1.43 cases per 100,000 children). These results may mean that folate and multivitamin use affect cancer development before birth, but have less effect afterwards as children are exposed to or become deficient in more things. Some examples of foods rich in folate are lentils, asparagus and spinach, which contain 358, 268 and 262 micrograms of folate per cup respectively.

Actually, it may be best to see pregnancy multivitamins as just a complement to consuming a diet of nutrient-rich, whole foods, which contain substances that aren't found in multivitamins, but may have a preventative effect on neuroblastoma. For example, a study on mice found that DHA, an omega-3 fatty acid, caused stable disease or partial response in rats with grafted human neuroblastoma cells and no immune system to try fighting it. DHA is found in oily fish, and to a lesser extent from other animal foods especially when grass-fed. This really needs further study, especially as a preventative, with neuroblastoma being such a terrible disease. Additionally, ellagic acid has also been shown to kill off neuroblastoma cells in test tube research. This is found in some berries, other fruits and nuts, and should also be researched for preventative abilities. Something else that needs follow-up research is another lab study where ketones, produced for energy when one is on a ketogenic diet, reduced viability of neuroblastoma cells by more than half. Unlike the normal cells they were compared to, the neuroblastoma cells were not able to use the ketones for energy. Overall, research on this and natural ways to prevent neuroblastoma do look promising, and "we don't know how to prevent it" is no excuse to neglect them in cancer research.

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