I fasted through 12 cycles of irinotecan and avastin and found that I had greatly reduced side effects to those that I was warned of, mainly fatigue and diarrhea. I fasted 36 hours prior to treatment plus the day of and broke the fast on the third day, so somewhere between 60 and 72 hours altogether. My oncologists were fully supportive on the condition that I maintain my weight which I was somewhat able to do. I emailed Dr Longo asking his advice on how to tailor fasting with CRC patent chemo and this was his reply
"If the oncologist agrees, the patient can fast for 3 days before and 1 day after chemo. Depending on what type of chemo is being administered and at what intervals this could change. Patients should avoid re-feeding (resuming their regular diet) until the chemotherapy is below toxic blood levels (usually 24-48 hours after administration). Although we have rarely seen negative side effects caused by fasting (high liver toxicity markers in 1 patient fasting and receiving a chemo cocktail) there are some potential risks so keep that in mind. For example, an early re-feeding immediately after the chemo could cause liver damage, because of the combination of hepatotoxic drugs with the proliferation of the liver caused by fasting. For this reason is important to have a minimum of 24 hours after the chemotherapy is administered. Also, several patients have fainted while taking hot showers after several days of fasting probably because of the major reduction in blood pressure and glucose levels after day 1 of fasting. The patient should not drive or operate machinery or should be accompanied by someone during the fasting period. Most people can drive while they are fasting but for a few this could be a problem so unless you know fasting does not affet your ability to drive, don’t drive. Starting 24 hours after the chemotherapy, the patient should only eat rice, pasta or a similar source of carbohydrates + soups + fruit juices for a period of 24 hours. Then, a normal diet can be resumed, paying particular attention to nourishment (vitamins, minerals, proteins, essential fats). The patient should also try to return to within 2-3% of their body weight before doing another fasting cycle. Obese patients should consult their doctors on whether some of the weight loss caused by fasting is advisable and whether they should try to remain at the lower body weight. Diabetic patients should not undergo fasting unless this is approved by their diabetologist. Subjects on hypertension medication should also talk to their doctor about the blood pressure drop caused by fasting and the risk of combining fasting with medications. Until clinical trials are completed fasting will remain an experimental procedure and should only be considered with the approval of the oncologist and when other viable options are not available or are known to be ineffective.
Between fasting cycles, a low sugar accompanied by a mostly plant based 0.8 grams/kg of body weight/day protein intake diet (approximately 10% calories from proteins) is recommended but a registered dietitian should be consulted to avoid malnourishment and unwanted weight loss. "
Following those 12 cycles I had 6 months NED so maybe the fasting attributed to that. I have now started a planned 4 week cycle again as have more distant lymph node metastasis and am fasting again. Like DK I think it could work, the science makes sense and it is something else I am doing to actively assist my healing.
Dx 3/14. Stage 111b. Aged 51 Mother of 4
3/14 Sigmoidectomy (6 positve lymph nodes out of 15)
12 rounds of oxaliplaton, 5 F-U and leucovorin
9/14 PEP scan tumor in superaclavicular lymph node
1/15 PEP activity in the lymph nodes in abdomen.
12 rounds irinotecan and avastin
9/15 PEP activity in the lymph nodes in sternum
10/15 Radiation SBRT
1/16 PEP activity in another 2 superaclavicular lymph nodes
2/16 irinotecan and avastin
3/16 NED but CEA 6.1