Our Experiment Fasting Around Chemo

[chay]

I just picked up on the advice given "thickdescription" before she decided to try fasting around chemo.

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 dietician should be consulted to avoid malnourishment and unwanted weight loss.

That seems like good advice, and her experience will be interesting to track.

[Aussie Girl]

Hi, Thanks for that post. It was very interesting and challenging. If you are following up those 2013 trials, please post again if you find out how they went.

I've only just started my TCH therapy, unfortunately with some marked side effects to my gut (diarrhea with anorectal ulceration) by Day 6 and hospital admission on Day 7with febrile neutropenia. I now qualify under the Australian health system for a Neulasta white cell boosting injection so that last bit shouldn't happen again.

I think you were amazing to do that fasting, especially doing it together. I don't know if I am prepared for that extent of fasting. I feel nauseous and faint if I miss a meal, but I am thinking of restricting calories in the hope of reducing the gut effects.

Hope you are both going strong.

[chay]

Hi Aussie Girl,

Thanks for your kind note. I hope your next rounds go more smoothly. I hope, too, that you have people supporting you. Don't hesitate to ask questions this way. If you feel like it, let me know how your next round goes, too.

If I run across more fasting research, I'll share.

Best wishes,

--
Dan

[chay]

Here's an update summarizing on-going research on fasting.
https://news.usc.edu/63669/fasting-t...immune-system/

Excerpt:

“PKA is the key gene that needs to shut down in order for these stem cells to switch into regenerative mode. It gives the OK for stem cells to go ahead and begin proliferating and rebuild the entire system,” explained Longo, noting the potential of clinical applications that mimic the effects of prolonged fasting to rejuvenate the immune system. “And the good news is that the body got rid of the parts of the system that might be damaged or old, the inefficient parts, during the fasting. Now, if you start with a system heavily damaged by chemotherapy or aging, fasting cycles can generate, literally, a new immune system.”

Prolonged fasting also protected against toxicity in a pilot clinical trial in which a small group of patients fasted for a 72-hour period prior to chemotherapy, extending Longo’s influential past research.

“While chemotherapy saves lives, it causes significant collateral damage to the immune system. The results of this study suggest that fasting may mitigate some of the harmful effects of chemotherapy,” said co-author Tanya Dorff, assistant professor of clinical medicine at the USC Norris Comprehensive Cancer Center and Hospital. “More clinical studies are needed, and any such dietary intervention should be undertaken only under the guidance of a physician.”