Wednesday, 26 August 2015

Diabetes as a risk factor to cancer: Functional role of fermented papaya preparation as phytonutraceutical adjunct in the treatment of diabetes and cancer

Volume 768, October 2014, Pages 60–68
Cancer Risks and Perspectives: Molecular Mechanisms

Diabetes as a risk factor to cancer: Functional role of fermented papaya preparation as phytonutraceutical adjunct in the treatment of diabetes and cancer


Cancer incidence and mortality is linked to hyperglycemia and some anti-diabetes drugs.
FPP is a safe nutraceutical adjunct for augmenting therapeutic regimens in diabetes and cancer management.
FPP through its hypoglycemic and antioxidant sensing may impact and mitigate the side effects of anticancer drugs.
FPP can diminish the intensity of side effects associated with acute radiation therapy.
FPP can maintain the integrity of erythrocyte during cancer chemotherapy augmenting compliance of treatment.


Oncologists and diabetologists quote scientific data from epidemiological and in vitro studies to show that high levels of insulin and glucose, in combination with oxidative stress and chronic inflammation, can heighten the risk of developing cancer amongst patients with diabetes. Although the cancers that have been consistently associated with type 2 diabetes include pancreatic, colorectal, breast and liver cancer, the preponderance of the disease risk factors such as obesity, inflammation, hyperglycemia, hyperinsulinaemia (as a result of insulin resistance and oxidative β-cell damage) and the indirect influence of anti-diabetic medications are increasingly being defined. Fermented papaya preparation (FPP) has defined antioxidant and immune-modulating potentials. The ability of FPP influence signaling cascades associated with cell growth and survival presents a rational for chemopreventive adjunct that can be used in combination with traditional redox based therapies that target oxidative stress in the cancer micro environment. It is further suggested that the demonstrated efficacy FPP to control blood glucose, excessive inflammation and modulate free radical-induced oxidative damage which are triggers of liver, bladder, breast and prostate cancers in type 2 diabetics, may favorably mitigate the side effects of ensuing diabetes and cancer therapy. What remains paramount is early cancer detection and early determination of propensity risks for diabetes. The education of patients, proper dietary management and compliance with therapeutic regime directed at cancer and diabetes encapsulate challenges of global magnitude.


  • Fermented papaya preparation;
  • Diabetes and cancer treatment;
  • Oxidative stress and antioxidants;
  • Hyperglycaemia and hyperinsulinaemia;
  • Oxidative stress and inflammation;
  • Modulation cancer therapy side effects


  • T2DM, Type 2 diabetes mellitus;
  • IGF-1, insulin-like growth factor;
  • IGFBP-3, insulin-like growth factor binding protein-3;
  • PI3K, phosphatidyl inositol 3-kinase;
  • AKT, protein kinase B;
  • MAPK, mitogen-activated protein kinase;
  • ISO, International Organization for Standardization;
  • TNF-α, tumor necrosis factor-alpha;
  • IL, interleukin;
  • IFN-γ, interferon-gamma;
  • FPP, fermented papaya preparation;
  • ROS, reactive oxygen species;
  • As2O3, arsenic trioxide;
  • NF-κB, nuclear factor kappa-light-chain-enhancer of activated B cells;
  • ALT, alanine aminotransferase;
  • H2O2, hydrogen peroxide;
  • MC-PROXYL, 3-methoxycarbonyl-2,2,5,5-tetramethyl-pyrrolidine-1-oxyl;
  • Fe-NTA, ferric nitrilotriacetate complex;
  • HCV, hepatitis C virus;
  • PC12, pheochromocytoma;
  • CCl4, carbon tetrachloride;
  • AST, aspartate aminotransferase;
  • GPx, glutathione peroxidase;
  • PPARγ, peroxisome proliferator activated receptor gamma;
  • AMPK, adenine monophosphate-activated protein kinase;
  • NO, nitric oxide
Corresponding author at: Department of Pharmaceutical Sciences, School of Pharmacy, American University of Health Sciences, Signal Hill, CA 90755, USA.
Corresponding author at: ANDI Center for Biomaterials Research, University of Mauritius, MSRI Building, Reduit, Mauritius.