Fasting and Chemo benefits

[WebChub]

Checking to see if anyone has seen benefiting from fasting before and after a chemo session. Saw a USC research paper highlighting some potential benefits. Would appreciate any feedback. Ref: https://news.usc.edu/78953/fasting-and- ... motherapy/

[dudette]

I fasted during my 4 cycles of chemo. However, I didn't do chemo without fasting and can't offer a comparison. My onc agreed with the fasting research.

I always meant to contact Prof Longo because for most CRC patients who are on 48hrs 5-FU (making it almost 3 days of chemo with oxi or iri) the suggested fasting of 48 hours before and 24 hours after chemo is tough.

That's why I modified it to fasting during the chemo. The cancer responded extremely well to the treatment. Unfortunately I'm not able to confirm that fasting contributed to it but I'd do it again.

[JDinNC]

I read about fasting after I had completed my chemo. The concept was very interesting...

[ktwmn]

Hmmm, I fast while undergoing the FULL FURY plus avastin...not because of any research that it is more effective but because basically I have no appetite for 2-3 days... Then I bulk up afterwards until the next time. I wonder if I fasted the day before if I would be less nauseated? I find the nausea the first two days worse than with FolFOX.

[DK37]

I have both read Dr. Longo's papers & discussed with him directly.

**IF** a patient is not having trouble maintaining weight, I personally see potential for benefit & limited downside risk. It is obviously complicated for most CRC patients' chemo due to the common use of a pump.

I currently am taking FOLFIRI but with bolus 5-FU instead of pump. Logistically it is easy to fast at least 40 hours pre-infusion & 24 hours afterwards. I think it for sure helps me with nausea. Does it help me with efficacy? No way to know since no comparator. My personl view is that if: 1. It is safe 2. There is preclinical data showing it may help 3. It is scientifically plausible --- then I do it.

Once again, I only would do this myself if I had no trouble maintaining weight, which I am able to do with the fast (my appetite is good except near infusion).

-DK

[Shân]

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.

Shan