Abstract
Gastrointestinal (GI) cancer is a prevailing global health disease with a high incidence rate which varies by region. It is a huge economic burden on health care providers. GI cancer affects different organs in the body such as the gastric organs, colon, esophagus, intestine, and pancreas. Internal and external factors like smoking, obesity, urbanization, genetic mutations, and prevalence of Helicobacter pylori and Hepatitis B and Hepatitis C viral infections could increase the risk of GI cancer. Phytochemicals are non-nutritive bioactive secondary compounds abundantly found in fruits, grains, and vegetables. Consumption of phytochemicals may protect against chronic diseases like cardiovascular disease, neurodegenerative disease, and cancer. Multiple studies have assessed the chemoprotective effect of selected phytochemicals in GI cancer, offering support to their potential towards reducing the pathogenesis of the disease. The aim of this review was to summarize the current knowledge addressing the anti-cancerous effects of selected dietary phytochemicals on GI cancer and their molecular activities on selected mechanisms, i.e., nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB), detoxification enzymes, adenosine monophosphate activated protein kinase (AMPK), wingless-related integration site/β-catenin (wingless-related integration site (Wnt) β-catenin, cell apoptosis, phosphoinositide 3-kinases (PI3K)/ protein kinase B AKT/ mammalian target of rapamycin (mTOR), and mitogen-activated protein kinase (MAPK). In this review phytochemicals were classified into four main categories: (i) carotenoids, including lutein, lycopene, and β-carotene; (ii) proanthocyanidins, including quercetin and ellagic acid; (iii) organosulfur compounds, including allicin, allyl propyl disulphide, asparagusic acid, and sulforaphane; and (iv) other phytochemicals including pectin, curcumins, p-coumaric acid and ferulic acid. Overall, phytochemicals improve cancer prognosis through the downregulation of β-catenin phosphorylation, therefore enhancing apoptosis, and upregulation of the AMPK pathway, which supports cellular homeostasis. Nevertheless, more studies are needed to provide a better understanding of the mechanism of cancer treatment using phytochemicals and possible side effects associated with this approach.
Highlights
Cancer is a leading cause of death worldwide, being responsible for approximately 7.9 million deaths (13% of all deaths) [1]
Phytochemicals are biologically active compounds found in plants
A lot of efforts have been spent to study the activities of phytochemicals as an anticancer agent, lots of limitations are linked to these studies
Summary
Cancer is a leading cause of death worldwide, being responsible for approximately 7.9 million deaths (13% of all deaths) [1]. The rate of cancer-related death is expected to rise to an estimated 12 million deaths by 2030 [2]. Imbalance between cellular proliferation and apoptosis leads to the pathogenesis of GI cancer [7]. Patients with GI cancer become symptomatic after they have advanced lesions with either local or distant metastasis, commonly presented findings include bloating, epigastric pain, and palpable epigastric mass [9]. The prognosis of GI cancer is variable between patients depending on its progression at the time of detection. Detection of GI cancer improves the outcomes of patients. Treatments of the disease include surgery, radiation, and administration of chemotherapy components such as cisplatin, mitomycin, and docetaxel injection [11]
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