Many thanks for your question regarding Lynch Syndrome. Whilst this Clinical Education Forum is specifically designed for practitioners to share the case details of individual clients with conditions, as opposed to be a protocol oriented information site for conditions, we are willing and able to provide you with what information we can when asked. Ideally, however, all relevant case history information would likely lead to more targeted and individualised nutritional suggestions.
After you have met with your client / patient, you are more than welcome to provide more personalised information to which we can then make a further response.
In the meantime, I am pleased to provide some information about Lynch Syndrome for you.
Lynch syndrome is caused by defects in genes responsible for detecting and repairing damaged DNA, which significantly increases the risk of cancer (primarily of the colon or uterus) in those affected by the disorder. Approximately 10 percent of colon and uterine cancers are believed to be the result of hereditary factors. Two familial disorders raise risk significantly, familial adenomatous polyposis (FAP) and hereditary nonpolyposis colon cancer (HNPCC, or Lynch syndrome). These inherited disorders are responsible for 1-2% and 3-5% of all colorectal cancers, respectively. Hereditary nonpolyposis colon cancer does not cause the multitude of polyps, but polyps are much more likely to become cancerous in those with this disorder. Those with hereditary nonpolyposis colon cancer have mutated mismatch repair genes (MMR genes), which fail to make necessary corrections to errors in DNA replication, allowing mistakes in the DNA to accumulate and colon cancer to ensue.
A study reported online on October 28, 2011 in The Lancet found that using aspirin on a regular basis reduces the risk of developing hereditary cancers by 50 percent among those with Lynch syndrome. It appears that aspirin seems effective at destroying precancerous cells rather than stopping polyps.
Long-term effect of aspirin on cancer risk in carriers of hereditary colorectal cancer: an analysis from the CAPP2 randomised controlled trial. The Lancet Volume 378, No. 9809, p2081–2087, 17 December 2011 http://tinyurl.com/7pjakal
In view of the particular link to colon cancer there are other more general factors to consider as a preventative strategy for those with Lynch Syndrome. For example, a review of nine studies found that for every 10 ng/mL increase in serum vitamin D, the relative risk of colorectal cancer decreased 15%
Gandini S, Boniol M, et al. (2011). “Meta-analysis of observational studies of serum 25-hydroxyvitamin D levels and colorectal, breast and prostate cancer and colorectal adenoma.” International Journal of Cancer 128(6): 1414-1424. http://tinyurl.com/yavcy2ye
Colonic bacteria play a central role in metabolic detoxification by secreting chemicals that encourage excretion of toxins and pathogens. Beneficial bacteria in the colon (probiotics) also ferment dietary fibre and generate compounds, such as butyrate, which nourish cells in the colon wall and protect against carcinogenesis. Therefore, a focus on probiotic and prebiotics in the diet and as supplements should be considered.
Factors such as diet, physical activity level, tobacco use, alcohol consumption and sleep patterns are associated with increased risk of colorectal cancers
Schernhammer ES, Laden F, et al. (2003). “Night-Shift Work and Risk of Colorectal Cancer in the Nurses’ Health Study.” Journal of the National Cancer Institute 95(11): 825-828. http://tinyurl.com/y9m9sats
Obesity and physical inactivity are known to increase biomarkers of inflammatory processes, such as faecal calprotectin and serum C-reactive protein (CRP); elevated levels of inflammation are linked with higher rates of colorectal cancer. Greater vegetable and fibre intake has been associated with reduced levels of faecal calprotectin, a marker of intestinal inflammation.
Higher levels of insulin and glucose in the blood can increase the risk of developing colorectal cancers.
An analysis of clinical data from 1966 through 2005 found that a diagnosis of diabetes raised the risk of colon cancer by more than 30% in both men and women. The link between elevated insulin levels and colon cancer may be mediated though the insulin-like growth factor-1 receptor (IGF-1R). Insulin activates IGF-1R, which in turn functions to stimulate cellular growth and proliferation. The diet should therefore be focused on low carbohydrate, more plant based eating and keeping sugar and free sugars low in the diet.
Larsson SC, Orsini N, et al. (2005). “Diabetes Mellitus and Risk of Colorectal Cancer: A Meta-Analysis.” Journal of the National Cancer Institute 97(22): 1679-1687 http://tinyurl.com/ya5fxpc4
Keeping inflammation low is equally important. NF-Kappa B (NF-kB), a pro-inflammatory mediator that influences more than 500 genes involved in proliferation, angiogenesis, immune evasion and metastatic spread, has been the topic of intense research. Not surprisingly, NF-kB is a target for thwarting cancer’s growth and many natural agents act on NF-kB to prevent its signalling. The most notable natural agent able to suppress NF-kB signal transmission is curcumin
Gupta SC, Kim JH, et al. (2011). “Role of nuclear factor kappaB-mediated inflammatory pathways in cancer-related symptoms and their regulation by nutritional agents.” Exp Biol Med (Maywood) 236(6): 658-671. http://tinyurl.com/yal6p234
The high intake of curcumin, and resultant inhibition of NF-kB, may be one reason that the incidence of colon cancer in India is so much lower than in the US or Europe
Aggarwal BB, Van Kuiken ME, et al. (2009). “Molecular Targets of Nutraceuticals Derived from Dietary Spices: Potential Role in Suppression of Inflammation and Tumorigenesis.” Experimental Biology and Medicine 234(8): 825-849. http://tinyurl.com/y7kmtasj
Many cultures outside the UK and US use a more diverse and greater proportion of herbs and spices in their cooking. Many spices have anti-inflammatory effects and daily consumption of a variety of spices may contribute to the lower rates of colorectal cancers in non-Western cultures.
Sinha R, Anderson DE, et al. (2003). “Cancer risk and diet in India.” J Postgrad Med 49(3): 222-228. http://tinyurl.com/2r3868
Folate deficiency is associated with greater risk of developing colorectal cancers. In a large pooled analysis of data from 13 prospective studies including over 725,000 subjects, the highest quintile of folate intake was associated with a 15% reduced risk of colon cancer compared to the lowest quintile of intake.
Kim DH, Smith-Warner S, et al. (2010b). “Pooled analyses of 13 prospective cohort studies on folate intake and colon cancer.” Cancer Causes and Control 21(11): 1919-1930. http://tinyurl.com/yanccgbj
Selenium deficiency has been linked to formation of many cancers, including colorectal cancer.
Nelson MA, Goulet AC, et al. (2005). “Studies into the Anticancer Effects of Selenomethionine against Human Colon Cancer.” Annals of the New York Academy of Sciences 1059(1): 26-32. http://tinyurl.com/yd8vad4o
Selenium is incorporated into proteins within cells, called “selenoproteins”, involved with protecting the cells from free radical accumulation that can lead to DNA damage.
You may also wish to consider Citrus pectin powder. Modified Citrus Pectin (MCP) is a type of soluble dietary fibre derived from citrus fruits that has been modified by pH and heat to form smaller units of absorbable galactose residues that are able to bind to cancer cells.
MCP has been shown to effectively inhibit growth and metastasis of various cancers including colon cancer
Liu HY, Huang ZL, et al. (2008). “Inhibitory effect of modified citrus pectin on liver metastases in a mouse colon cancer model.” World journal of gastroenterology : WJG 14(48): 7386-7391. http://tinyurl.com/y9mezb6n
The following supplements are suggested for you to consider in light of your relevant expertise and intimate understanding of the needs of your client or patient. They may be used in isolation or as part of a multi supplement strategy, but at all times the consideration of their use should be tied into the specific needs of the individual you are responsible for.
Multi with B vitamins and Antioxidants
OcuDyne II (ARG) – take 2 twice daily – http://tinyurl.com/z4ndrzx
Additional Vitamin D support
Bio-D-Mulsion Forte (BRC) – take 1 drop daily based on lab test – http://tinyurl.com/glbx4q9
Probiotics and Prebiotics
Pro Greens (ARG) – take 1 scoop daily – http://tinyurl.com/gtqgbyo
Modified Citrus Pectin (ARG) – take 1tsp twice daily
IAG prebiotic support (BRC) – take 1tsp twice daily – http://tinyurl.com/jl6rsek
Lowering Inflammation / Tumeric Support
KappArest (BRC) – take 2 with each meal – http://tinyurl.com/jms9v3n
Fatty Acids / lowering inflammation
EFA-Sirt Supreme (BRC) – take 2 three times daily – http://tinyurl.com/h3czc9x
I hope this helps answer your question
Registered Nutritional Therapist Helen Perks is collaborating with Clinical Education to bring you the first-ever Functional Medicine book club for Practitioners.
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