Abstract

Pancreatic cancer is without any doubt the malignancy with the poorest prognosis and the lowest survival rate. This highly aggressive disease is rarely diagnosed at an early stage and difficult to treat due to its resistance to radiotherapy and chemotherapy. Therefore, there is an urgent need to clarify the causes responsible for pancreatic cancer and to identify preventive strategies to reduce its incidence in the population. Some circumstances, such as smoking habits, being overweight and diabetes, have been identified as potentially predisposing factors to pancreatic cancer, suggesting that diet might play a role. A diet low in fat and sugars, together with a healthy lifestyle, regular exercise, weight reduction and not smoking, may contribute to prevent pancreatic cancer and many other cancer types. In addition, increasing evidence suggests that some food may have chemo preventive properties. Indeed, a high dietary intake of fresh fruit and vegetables has been shown to reduce the risk of developing pancreatic cancer, and recent epidemiological studies have associated nut consumption with a protective effect against it. Therefore, diet could have an impact on the development of pancreatic cancer and further investigations are needed to assess the potential chemo preventive role of specific foods against this disease. This review summarizes the key evidence for the role of dietary habits and their effect on pancreatic cancer and focuses on possible mechanisms for the association between diet and risk of pancreatic cancer.

Highlights

  • Pancreatic cancer is an aggressive disease which holds the gloomy record of having become one of the most deadly malignancies in the USA, being the fourth leading cause of cancer-related death in the USA, despite holding the 10th place in the incident rate scale [1,2]

  • The characteristic hypo vascularization of the pancreatic tissue is likely to be the cause of the presence of hypoxic areas within pancreatic ductal adenocarcinoma (PDAC), which stimulate cancer cell to adapt their metabolism to the new microenvironment and have been demonstrated to affect the efficacy of chemotherapy treatments [11,12,13]

  • A study conducted on a genetically engineered mouse model revealed that mice fed with a HFD had an increased activation of oncogenic Kras via pro-inflammatory factor COX-2, compared to the control group. This resulted in an enhancement of the number of precancerous lesions of the pancreas and pancreatic ductal adenocarcinoma in the HFD group [37]. Taken together these data strongly support the theory that obesity and a high fat diet, by causing intrapancreatic fatty infiltration and promoting inflammation in the pancreas, trigger a chain reaction leading to the activation of oncogenic Kras signalling and to the developing of chronic pancreatitis and PanIn lesions, all well-known prerequisites of pancreatic cancer [38]

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Summary

Introduction

Pancreatic cancer is an aggressive disease which holds the gloomy record of having become one of the most deadly malignancies in the USA, being the fourth leading cause of cancer-related death in the USA, despite holding the 10th place in the incident rate scale [1,2]. Recent studies have pointed out the diversity and complexity of pancreatic cancer genetics, some predisposing factors have been identified for this disease. According to some studies, a diet rich in vegetables, fresh fruit, nuts and whole grain is useful in the prevention of pancreatic cancer [1,5,6,7]. We will discuss the possible links between diet and pancreatic cancer, analysing the potential role of diet in promoting or preventing the onset of this disease

Pancreatic Cancer Progression Model
Obesity and Pancreatic Cancer
Epidemiological Studies
Experimental Studies
Diet and Pancreatic Cancer
Phytochemicals and Dietary Fibre
Dietary Compounds and Autophagy
Calorie Restriction
Findings
Conclusions
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