Desmoid tumors, also known as aggressive fibromatosis or desmoid-type fibromatosis, are rare, non-cancerous growths that develop in the body's connective tissues. They do not metastasize, but can be locally aggressive, causing significant damage to surrounding tissues and vital structures. While there is no specific diet proven to eliminate or decrease desmoid tumors, maintaining a balanced diet and healthy lifestyle is generally recommended. This article explores nutritional considerations for individuals with desmoid tumors, including dietary adjustments to manage treatment side effects and the role of supplements.
Understanding Desmoid Tumors
Desmoid tumors are rare, with an incidence of 5-6 cases per one million of the population per annum, and the peak patient age is 30-40 years. These tumors form when fibroblasts or myofibroblasts multiply excessively, often due to a spontaneous mutation in the CTNNB1 gene, leading to overproduction of the protein beta-catenin in the cells. Although desmoid tumors are not metastatic, they can infiltrate adjacent tissues and structures as they grow, causing pain, swelling, visible deformities, impact on mobility, and pressure on nearby organs affecting bodily functions.
Diagnosis typically involves a biopsy to examine the tumor cells and confirm overproduction of beta-catenin. Magnetic resonance imaging (MRI) is usually the preferred imaging test to monitor and measure desmoid tumors, except for mesenteric desmoid tumors, where computed tomography (CT) scans are often more suitable due to bowel motion.
General Nutritional Recommendations
While there isn't a specific diet for desmoid tumors, general healthy eating guidelines are beneficial. Adults should aim to:
- Eat plenty of whole grains, fruits, vegetables, and low-fat dairy products.
- Get protein from both animal and plant-based sources, like beans, lentils, tofu, nuts, and seeds.
- Limit alcoholic beverages and foods with sodium, added sugars, and saturated fats.
A balanced diet supports overall health and immune function, which is particularly important when dealing with a desmoid tumor and its treatments.
Read also: The Hoxsey Diet
Managing Treatment Side Effects Through Diet
Desmoid tumor treatment options, such as chemotherapy and radiation therapy, can cause side effects such as nausea, vomiting, and mouth sores, which may make it harder to get the necessary nutrients. Dietary adjustments can help manage these symptoms:
Nausea and Vomiting
With intense treatments, it’s important to focus on consuming high-calorie and high-protein foods and beverages for weight maintenance. The American Cancer Society recommends snacking throughout the day on yogurt, cookies, cheese and crackers, sandwiches, and other quick and easy foods. Homemade smoothies or ready-to-drink protein shakes are other great options to increase calorie and protein intake. Drink your beverages between meals to promote more intake of food during mealtimes.
Spicy, fried, or strong-smelling foods can make an upset stomach even worse. Instead, UCSF Health recommends keeping bland, salty foods like saltine crackers or pretzels nearby. Sip on clear broth, water, or juices to stay hydrated.
You’ll also want to take care to avoid foods that make your intestinal side effects worse. For example, if you’re having diarrhea, avoid high-fiber foods, such as raw fruits, raw vegetables, and other hard-to-digest foods.
Mouth Sores
Chemotherapy treatment for desmoid tumors can cause painful mouth sores. You may find it harder to eat, swallow, and even speak with these sores. To make it easier on your mouth, Penn State College of Medicine recommends eating plenty of soft, creamy foods. Examples include: Frozen treats like popsicles, ice cream, and milkshakes to soothe your mouth Creamy or blended soups Mashed potatoes with gravy Yogurt Warm, cooked cereals like cream of wheat Eggs Puddings and custards Dry, hard, or rough-textured foods can irritate the sore skin inside your mouth. Try adding sauces or gravies to soften your food for easier chewing. You can also blend food and sip it through a straw to avoid pain while eating. It’s also a good idea to avoid spicy, acidic, and salty foods.
Read also: Walnut Keto Guide
Dietary Changes for Familial Adenomatous Polyposis (FAP)
Familial adenomatous polyposis (FAP) is a genetic condition that’s associated with desmoid tumors. People with FAP develop polyps (growths) along the lining of the colon. As a result, they’re at a high risk of developing colon cancer at some point in their lives. One type of FAP - known as Gardner syndrome - is associated with a raised risk of developing desmoid tumors.
Some early stages of research have indicated that a low-inflammatory diet may be beneficial in people with FAP. One report looked at the benefits of following the Mediterranean diet. This eating style focuses on a diet rich in: Fruits and vegetables Nuts Extra-virgin olive oil Whole grains like brown rice and whole-wheat bread Legumes, like beans and lentils Fish The diet also includes a moderate amount of fermented dairy products, like cheese and yogurt. It limits intake of butter, added sugars, and red meat. A moderate amount of wine is fine, though if you don’t already drink alcohol, health experts recommend not starting.
Desmoid tumors that develop alongside Gardner syndrome are usually intra-abdominal tumors. These growths are mesenteric - meaning they form in the tissue filled with blood vessels that pad the intestines.
If a tumor begins pressing on your stomach, you may experience abdominal pain, bloating, nausea, or vomiting. To help relieve these symptoms, try eating smaller meals throughout the day and take your time. You can also try eating bland, cold foods.
The Role of Supplements
While it’s important to support your body as best you can during treatment, and using supplements might seem like a good way to do that. However, before adding any vitamins, herbs, or other supplements to your regimen, it’s important to understand how they might interact with your treatment.
Read also: Weight Loss with Low-FODMAP
The American Cancer Society emphasizes that while dietary supplements can have some benefits, they may also interfere with conventional cancer treatments. This is especially true for treatments that rely on specific chemical reactions or medications that target tumor cells.
Antioxidants (Vitamin C, Vitamin E)
Antioxidants are popular supplements because of their ability to neutralize free radicals - unstable molecules that can cause cell damage. Some studies suggest that antioxidants can protect normal cells from the damage caused by treatments like radiation or chemotherapy. However, antioxidants might also protect tumor cells, reducing the effectiveness of these treatments.
Taking large doses of antioxidants could make certain treatments, including chemotherapy and radiation, less effective. This is because therapies like radiation generate free radicals to kill tumor cells, and antioxidants may interfere with this process. Because oncologists are still debating this topic and more study is needed, it’s best to discuss any plans to take antioxidants with your health care team.
Herbal Supplements
Herbs like turmeric (curcumin) and green tea extract are often promoted for their anti-inflammatory and anticancer properties. Curcumin, for example, has shown promise in laboratory studies for its potential to stop tumor growth. However, these effects have not been consistently demonstrated in human clinical trials.
Additionally, herbal supplements can interfere with prescribed medications. Some herbs may affect how your body processes drugs used in desmoid tumor treatment, leading to reduced effectiveness or increased side effects. Always check with your oncologist before using herbal supplements, as some may interact with your treatment.
Vitamin D
Vitamin D is essential for bone health and immune function, and many people are deficient in it. Some research suggests that having enough vitamin D may lower the risk of certain cancers, although the evidence is not strong enough to recommend it for everyone.
For people with desmoid tumors, keeping enough vitamin D may support overall health, especially if treatment makes it hard to spend time outdoors. However, avoid taking very high doses unless your health care provider prescribes them.
Omega-3 Fatty Acids
Omega-3 fatty acids, found in fish oil supplements, have anti-inflammatory properties. Because inflammation is a key factor in many types of tumor growth, including desmoid tumors, reducing inflammation could be beneficial.
That said, omega-3 supplements could increase the risk of bleeding, particularly for people having surgery, although this is still debated. If you are scheduled for surgery or taking blood-thinning medications, speak to your doctor before taking omega-3 supplements.
Possible Risks of Supplements During Treatment
Taking supplements during desmoid tumor treatment comes with some risks. Some potential concerns include:
- Interference With Medications
- Overloading the Liver and Kidneys
- Unknown Long-Term Effects
Supplements That May Be Safe During Treatment
While many supplements can interfere with treatment, a few might be safe or even helpful. Always check with your health care team before starting any supplement.
- Probiotics
- Magnesium
- B Vitamins
Home Parenteral Nutrition (HPN) in Intra-Abdominal Desmoid (IAD) Tumors
Fistulae, small bowel obstruction (SBO), and malabsorption are complications of intra-abdominal desmoid (IAD) tumors that may require home parenteral nutrition (HPN). One case-control study of patients who required HPN because of fistulae, SBO, or malabsorption found that IAD patients had longer duration of HPN, were younger, and were more likely to receive HPN for malabsorption. HPN for IAD patients maintained BMI but did not increase serum albumin concentration despite receiving more protein than controls.
The Importance of Consulting Professionals
If you want to make healthier diet choices but aren’t sure where to start, talk to your doctor. They can refer you to a dietitian - a trained professional who will help you with your diet. They’ll create a diet plan designed for your specific needs. Your dietitian can also make food suggestions based on your desmoid tumor symptoms. If you have an abdominal wall or intra-abdominal desmoid tumor, it can interfere with your ability to eat. Your dietitian can recommend foods that are easier on your stomach while also making sure you’re getting the necessary nutrients.