Dietary Carotenoids in Head and Neck Cancer-Molecular and Clinical Implications.

Katarzyna Starska-Kowarska

doi:10.3390/nu14030531

Abstract

Head and neck cancer (HNC) is one of the most common cancers in the world according to GLOBCAN. In 2018, it was reported that HNC accounts for approximately 3% of all human cancers (51,540 new cases) and is the cause of nearly 1.5% of all cancer deaths (10,030 deaths). Despite great advances in treatment, HNC is indicated as a leading cause of death worldwide. In addition to having a positive impact on general health, a diet rich in carotenoids can regulate stages in the course of carcinogenesis; indeed, strong epidemiological associations exist between dietary carotenoids and HNS, and it is presumed that diets with carotenoids can even reduce cancer risk. They have also been proposed as potential chemotherapeutic agents and substances used in chemoprevention of HNC. The present review discusses the links between dietary carotenoids and HNC. It examines the prospective anticancer effect of dietary carotenoids against intracellular cell signalling and mechanisms, oxidative stress regulation, as well as their impact on apoptosis, cell cycle progression, cell proliferation, angiogenesis, metastasis, and chemoprevention; it also provides an overview of the limited preclinical and clinical research published in this arena. Recent epidemiological, key opinion-forming systematic reviews, cross-sectional, longitudinal, prospective, and interventional studies based on in vitro and animal models of HNC also indicate that high carotenoid content obtained from daily supplementation has positive effects on the initiation, promotion, and progression of HNC. This article presents these results according to their increasing clinical credibility.

Highlights

Head and neck cancer (HNC) constitutes a group of cancers deriving from the mucosa of the upper aerodigestive system, including the oral cavity, nasopharynx, oropharynx, hypopharynx, and larynx, the latter of which represents the most common histological subtype [1,2]
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Similar conclusions were recorded by Johny et al [167] in a study of the effectiveness of the use of lycopene and the addition of hyaluronidase to lycopene in the course of clinical oral submucosal fibrosis

Summary

Introduction

Head and neck cancer (HNC) constitutes a group of cancers deriving from the mucosa of the upper aerodigestive system, including the oral cavity, nasopharynx, oropharynx, hypopharynx, and larynx, the latter of which represents the most common histological subtype [1,2]. It is anticipated to rise by a further 30% to about one million new cases annually by 2030 (GLOBOCAN; gco.iarc.fr/today) [4,5]. These alarming patient mortality rates, characterised by 5-year overall survival rates under 50%, have been attributed to a high incidence of locoregional recurrences and/or local and distant metastases [6]. Despite the availability of increasingly accurate molecular and genetic diagnostic methods and tests indicating the histological progression of the tumour from cellular atypia through dysplasia and in situ cancer to invasive form of HNSCC, most patients are diagnosed with cancer in a very advanced clinical stage [7]. Despite the development of cancer in a diagnostically accessible and visible anatomical region and the fact that HNSCC is usually preceded by the presence of precancerous lesions in the oral cavity, such as leukoplakia, erythroplakia, and oral submucosal fibrosis, most cases of HNSCC are diagnosed too late, resulting in poor treatment outcomes and high mortality

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