The Role of Nutritional Status, Gastrointestinal Peptides, and Endocannabinoids in the Prognosis and Treatment of Children with Cancer

Abstract

Neoplastic diseases in children are the second most frequent cause of death among the young. It is estimated that 400,000 children worldwide will be diagnosed with cancer each year. The nutritional status at diagnosis is a prognostic indicator and influences the treatment tolerance. Both malnutrition and obesity increase the risk of mortality and complications during treatment. It is necessary to constantly search for new factors that impair the nutritional status. The endocannabinoid system (ECS) is a signaling system whose best-known function is regulating energy balance and food intake, but it also plays a role in pain control, embryogenesis, neurogenesis, learning, and the regulation of lipid and glucose metabolism. Its action is multidirectional, and its role is being discovered in an increasing number of diseases. In adults, cannabinoids have been shown to have anti-cancer properties against breast and pancreatic cancer, melanoma, lymphoma, and brain tumors. Data on the importance of both the endocannabinoid system and synthetic cannabinoids are lacking in children with cancer. This review highlights the role of nutritional status in the oncological treatment process, and describes the role of ECS and gastrointestinal peptides in regulating appetite. We also point to the need for research to evaluate the role of the endocannabinoid system in children with cancer, together with a prospective assessment of nutritional status during oncological treatment.

Medicinal Cannabis in Cancer Treatment

“…Schab et. al mentioned studies have shown that cannabinoids have hindered the growth of rhabdomyosarcoma and neuroblastoma cells and stopped cell cycle progression in osteosarcoma cells in children [11]. Moreover, it was found that CB1 expression may help foreshadow the shrinking of lowgrade gliomas in children [11].…”

“…al mentioned studies have shown that cannabinoids have hindered the growth of rhabdomyosarcoma and neuroblastoma cells and stopped cell cycle progression in osteosarcoma cells in children [11]. Moreover, it was found that CB1 expression may help foreshadow the shrinking of lowgrade gliomas in children [11]. Another review on the role of cannabinoids in pediatric oncology indicated that a majority of previous studies were based on acute lymphoblastic leukemia, suggesting that cannabinoids have the ability to eliminate cancer cells in vivo and in vitro [12].…”

Cannabinoids in Treating Chemotherapy-Induced Nausea and Vomiting, Cancer-Associated Pain, and Tumor Growth

“…Schab and Skoczen found that cannabinoids hindered the growth of rhabdomyosarcoma and neuroblastoma cells and stopped cell cycle progression in osteosarcoma cells in children. Moreover, they reported that CB1 expression may help foreshadow the shrinking of low-grade gliomas in children [ 16 ]. Another review on the role of cannabinoids in pediatric oncology indicated that a majority of previous studies were based on acute lymphoblastic leukemia and suggested that cannabinoids have the ability to eliminate cancer cells both in vivo and in vitro [ 17 ].…”

Interactions between Dietary Micronutrients, Composition of the Microbiome and Efficacy of Immunotherapy in Cancer Patients

“…However, micronutrient deficiencies have been linked to changes of bacterial species in the human gut microbiota affecting the host regulation of immune responses. Moreover, malnutrition is one of the common symptoms of cancer [ 81 ]. The supply of selected elements and vitamins could promote the richness of the intestinal microbiome and increase the amount of bacteria that are vital to higher effectiveness of oncological treatment ( Table 2 ).…”