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30 Among the pathways activated by IR and IGF-1R signaling are the RASRAFMEK1/2extracellular signal-regulated kinase (ERK)-1/2 pathway 34 and the phosphatidylinositol-3-kinase (PI3K)AKTmammalian target of rapamycin (mTOR) pathway, two fundamental pathways for tumor cell proliferation and survival (Figure 2)

They include: [3] American College of Gastroenterology European Association for Endoscopic Surgery American Society of Colon and Rectal Surgeons World Gastroenterology Organization This speaks volumes to the importance of adopting dietary changes to prevent or treat this medical condition

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