# Consequences of Glucose Enriched Diet on Oncologic Patients
### Role of Sugar in Cancer Metabolism
#### 1.2.5 Dietary Changes for Effective Cancer Therapy  
According to [70], several fasting practices have been indicated to suppress cancer in mice. Even when initiated later in life, intermittent fasting reduces the growth of lymphoma and sarcoma in mice and prevents lymphoma in old mice (from 7 to 10 months of age). The combination of chemotherapy and prolonged fasting cycles (48-60 h) dramatically boosted responsiveness to therapy in mice xenograft models of neuroblastoma, glioma, melanoma, and breast cancer. A drop in systemic levels of insulin-like growth factor 1 (IGF1) is most likely the principal mechanism by which fasting reduces the development of cancer, however, pharmacological or genetic alterations are still needed to validate the molecular components of fasting's anticancer effect. An alternate fasting mimetic diet consisting of a periodic regimen low in protein and calories resulted in an anticancer effect similar to that of continuous fasting [71]. This diet may be more beneficial than the severe extended fasting routine since it is simpler to comply with and would likely not affect the patient's fitness as much as prolonged fasting would, which is significant because cancer patients are typically more fragile than healthy people [70; 71; 72]. As demonstrated in Figure 3, at point a, the tumors feed on the patient's nutrition. The nutrients that cancer patients ingest become accessible to the tumors. Dietary alterations of certain nutrients can have an anticancer effect through numerous pathways, which are schematically indicated here. Hypothetically, it is conceivable to boost the efficiency of anti-neoplastic medications through dietary modifications by multiple methods. For instance, dietary histidine supplementation increases the response to methotrexate in a mouse model with leukemia. Cancer immunotherapy is used to treat numerous types of cancer and is currently being studied to detect additional kinds of cancer. There is a clear association between the immune response relevant to the tumor and the diet. For example, ketogenic or low-calorie diets are connected to a decrease in the production of immune suppressive ligands such as PDL-1 (orange) and an increase in tumor-infiltrating CD8 + T cells (purple). A vitamin that is innocuous to healthy tissues but could be harmful to cancer cells due to its extraordinary metabolism may inhibit tumor progression if supplied through diet. For example, when paired with chemotherapy, mannose stops pancreatic cancer xenografts from progressing. Since nutrients provided by the host are crucial for the survival and growth of tumors, reducing the intake of nutrients that are important for the tumor but not for other organs can slow tumor growth [70]. Most of the glucose that enters cancer cells is directed into glycolysis and consequently pyruvate production. Even though the quantity of pyruvate required in the tricarboxylic acid (TCA) cycle for the creation of ATP in tumors is surprisingly minimal, this part of glucose metabolism is crucial for in vivo cancers. Although the degree of the [PERSON] effect varies among tumor types in vivo, it gives a fair illustration of how tumor cells can reorganize their metabolic programs to satisfy their own metabolic needs [70]. Glucose increases pro-oncogenic signaling. In vivo, the effects of insulin efficiently reduce blood glucose levels. Dietary sugar intake boosts blood glucose levels; the pancreatic beta cells detect this and quickly release insulin in response. Insulin decreases blood glucose levels principally thanks to the increase of glucose absorption by the liver and skeletal muscle. Yet, insulin is also recognized by tumor cells, which have insulin receptors that initiate the downstream phosphoinositide 3-kinase (PI3K) signaling pathway. Most cancer cells demonstrate abnormal PI3K activation, which promotes cancer growth through anabolic metabolism, survival, positive cell cycle control, and other mechanisms.