Fasting during Chemo?
I recently came across an article about fasting 2 days before and 1 day after chemo. It's suppose to minimize side effects and make treatment more manageable. I have just started treatment and looking for helpful advice for coping with side effects. I was wondering if anyone else has heard of this
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We were instructed to eat prior to chemo at my chemo class. I had no trouble the day of chemo, came home and ate leftover grilled salmon. Woke the next morning with some nausea, took my zofran and an hour later ate a hard boiled egg and sipped room temp gingerale. Watermelon pieces have tasted really good. I've been using a plastic spoon as someone recommended and so far no metallic tasting food. I get full fast so have been eating small amounts several times a day, and drinking my fluids in between.
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I read about that study soon after my first chemo. They said it made the chemo work better. Now I realize humans are not necessarily the same as mice, but I figured, why not give it a try? Nothing tasted good anyway by then, so fasting was no big deal for me. They fasted the mice for 3 days, and I thought that was a bit much, so I aimed for 24 hours before & 12 hours after chemo. I did that for the remaining 5 treatments. Nothing but water (lots and lots of water). It was not difficult. And you know how the standard advice is to eat more to prevent nausea? Well, this may be a coincidence, but the worst nausea I had was with that first chemo. Had little to none when I was fasting. Interesting.
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I tried fasting for my fifth infusion, about 18 hours before and 7 hours afterwards. My side effects seemed less that cycle and surprisingly, in conjunction with cold cap use, areas on the side of my head above my ears where I lost hair started to grow back and are already 1/2 in long.
I did experience uncontrollable diarrhea the evening of my infusion, and I wasn't at home or in a bathroom when it started. It came out of nowhere and I didn't feel ill before it started. So, I would stick around home/the bathroom just to be on the safe side.
Also, my MO had me taking a steroid before and after my infusion and it is supposed to be taken with food. I didn't remember to take it since I wasn't eating and I didn't have any swelling problems at all during any of my rounds, even though I was only doing a half-dose of steroids. It might be something to consider if you have swelling issues though presumably the fasting would protect your healthy cells from the chemo thereby negating the need for the steroids.
I didn't fast for my final round as I was having some side effects from Zoladex/Goserelin, which were making me feel lousy. I have been losing some of the new hair growth. In hindsight I probably should have fasted again.
Here are some links on the subject in case you are interested to learn more:https://news.usc.edu/41212/fasting-makes-brain-tum...
http://www.youtube.com/watch?v=LGafhm1cuSI
https://news.usc.edu/29428/
fasting-weakens-cancer-in- mice/ http://www.nzherald.co.nz/
health/news/article.cfm?c_id= 204&objectid=11269661 0 -
I started chemo in June.. On the advice on my GP/specialist, I have fasted for the first 2 cycles of AC. I have had 'manageable' SE's. I still have nausea but no vomiting. I do have a little diahrrea whereas everyone else in constipated. I am instructed to eat with my dexamethasone on chemo day, so I eat a tbsp of coconut oil... It's gross but keeps my body in the fasting state (according to my dr). My oncologist knows I'm fasting and is ok with it. I will continue to do so as I think it helps with SE's and it helps kill the cancer...btw on the first fasting cycle I still had coffee with almond milk each morning and I was sicker after my chemo than the second time when I drank only tea...You have to fast 48 hrs before chemo and 24hrs after. This is very difficult but I think well worthwhile. It causes the healthy cells to hibernate and the cancer cells can't do this so they drink up the chemo (nothing else for them to feed on).
I haven't tried the other way though, so I will never know the difference. My advice would be to do it! Good luck with your chemo!
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Agness, Your post regarding this on the coldcap forum led me to many searches and I found the articles you referenced above- and then I found this thread. Thank you so much for posting; I would never even of had an inkling. I'm fasting for tomorrow's chemo, my second, and hope to report on the side effects.
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Harrysmom, I have had 4 x AC infusions and have fasted 48 hrs before and 24 after. I had about 2 tbsp avocado before the last one (for the dexamethasone) and I did feel a little more nausea than usual. Before that I had been taking 1tbsp of coconut oil before each infusion but just couldn't do it anymore...so gross! I did allow myself tea and nestle good life water while fasting (0 calories). My counts have always been good on chemo day, no Neulasta shot needed, no vomiting, no mouthsores, I had a little diahrrea, sore ankles and feet, still had exhaustion and nausea, pretty good appetite after that. I never tried it the other way so I will never know the difference.
Please post your results, I'm curious to know!
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I want to try fasting during chemo to minimize side effects and help with cold cap results. I have had a hard time with steroids in the past so anything that will reduce the need for them is worth a shot. Maybe this is a silly question but when fasting, what is allowed besides water? Juices? Coconut oil with the steroids - will any oil suffice?
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DaniellaD, definitely no juice as it would have sugar in it. Basically, water and tea. One thing with the coconut oil, it gave me a bit of diahrrea I think, right after I received the chemo. I think a tbsp of avocado worked ok for me too. I did the oil the first 3 times but did get diahrrea after infusion...the 4th time I used avocado and no diahrrea. I think it does help SE's quite a bit. Good Luck!
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Daniella - with fasting you are trying to trigger your body into protective mode against starvation. Your body can use your fat stores for energy during the time you fast. Water, perhaps unsweetened tea, will keep you hydrated.
You don't want foods that will be able to be converted into glucose, that would counteract the fast. So no juice, fruit, carbs, protein. This isn't like a weight-loss juice fast.
Coconut oil and avocado are very fatty and therefore won't likely interfere with the shift in metabolism. Look up ketosis if you want to understand more.
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Thanks ladies
Agness - you did 18 hours before and 7 after. I believe Harrysmom did 36 hours before and 12 after. I mention this as she and I are doing weekly taxol. I did read that it was most important to do 24 hours after for maximum benefit. I'm wondering what protocol to use since the studies were not on people doing weekly treatment. Thoughts?
I'm looking up ketosis. I kind of have an idea. I remember an old boyfriend doing Atkins and the basics..
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here is the link to the fasting regarding early refeeding harming the liver.
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Good to know Daniella. Perhaps that is why I had the diarrhea.
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Hi! I can report that my SEs were remarkably less for my last tx when I fasted. I avoided a killer headache, body aches, and suffered from less D. I was also much less tired the day of- and happy as hell to have food the next day. I'm fasting for 24hrs after for my next tx based on the article from Daniella.
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harrysmom - I emailed Dr Longo and asked if he had a recommendation based on his research for weekly treatments. I included a waiver of course understanding that he is not an oncologist and that any recommendations would be based on his research. I didn't hear back from him. I'm going to try and email the doctors involved in the 10 patient study. I think definitely 24 hours after is important. Wondering if maybe just 24 hours before is sufficient. I've been combing pubmed for more studies.
How's the hair with the fasting?
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Dr. Longo suggested 48 hours before and 24 hours after for weekly treatment. He stressed that you need to make sure you put any weight lost back on during non-fasting days.
I don't think I can make it for 48 hours before! I think I'll shoot for 36 hours and see how I make out.
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Just thought I'd check in. I fasted about 40 hours before. Took my steroids with two tbs of avocado (which tasted like steak after all that time!). The steroids made me so crazy - sweating, heart palpitations, anxiety through the roof. After my second dose it got worse. I was jumping out of my skin. I took an Ativan and was still crazy. My dr saw me and decided no more oral steroids, just steroids in my premeds.
I'm sort of breaking my fast bc I'm having decaf coffee with coffemate. No carbs or protein. Just 1gram sugar. It's been 15 hours. I won't eat food for awhile - this afternoon after I've gotten at least a gallon of water in me and exercised a little to help push out the chemo. I don't think I'll make a full 24 hours bc that would mean no food until 4:30. I lost 4 lbs since my last drs appt so can't afford to lose more. I'm thinking that since I do such a low dose of taxol that it will flush out faster than the people doing dose dense treatments every three weeks. So the critical 24 hours may not be strictly applicable for someone doing weekly tx. Then again, Dr. Longo did say to hold out for 24 hours with my tx. No SEs to report. Zero. Yet this was only my first tx. Food for thought.
BTW - bought these drinks - powerade zero. Basically nothing in them but electrolytes and potassium. I found them while searching for alternatives safe during water fasting. Ended up on the pro Ana website - yikes! Didn't realize it until I read a few posts that these poor girls were anorexics. Anyway, they suggested powerade zero to keep in fasting state. Bought them at walmart. Probably good for after the fast or during if you feel you're missing too many electrolytes.
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You don't tend to have side effects until the third day after taxol. I had Taxotere with Carboplatin and days 3-10 I was pretty much in a pit with the side effects.
Taxols push potassium out if you so making sure you are getting enough in your diet is important if you don't want a lot if cramping. Hopefully fasting staves off that side effect.
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Thanks Agness. I'll drink lots of powerade zero when I officially break my fast. Should I consider a potassium supplement?
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I looked into potassium supplements, they aren't helpful at all. Focus instead on potassium-rich fruits and veggies and you get a lot more for your money: cantelope, sweet potatoes, oranges, spinach, raisins, etc.
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Happy to report that my only SE was a little fatigue yesterday and a headache last night. Today is day 3 and nothing to report. Thank goodness nothing serious. Don't have much of an appetite and my mouth is a little dry. I'm forcing myself to eat properly so I don't lose any weight. I didn't last the full 24 hours post chemo fasting wise but almost. All in all, first chemo infusion was a success. Only eleven more to go.
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The other side of the coin: I never fasted and the only time I had nausea was when they removed the Amend from the protocol. When, they put it back, bingo, no nausea. I've been on Taxol twice (total of 3 + 5 cycles) with 2 years in between, and my side effects (slight neuropathy and fatigue) were almost nil on the second round of Taxol. Maybe my body had become accustomed to it.
But that's just me, and shows why a study is more helpful in understanding the role of fasting.
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Update: I fasted during my last treatment 48 before and 24 sf. I just had nausea. I did take my dexamethasone with coconut oil and that caused some diarrhea. It was not major and didn't last long. I will be fasting for my next treatment.
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alexgram - I agree more studies need to be published to prove the effects of fasting during chemo. The Mayo Clinic will complete its trials in 2015. In the meantime, fasting for me is not only to minimize side effects as I am aware that the SEs with weekly taxol are not too awful. For me it's also about the effectiveness of the chemo on any lingering cancer cells. Not suffering from SEs is a bonus. I've read all the studies published, and have been in touch with the scientists and clinical trial directors of various studies. I'm not suggesting fasting is for anyone to try; simply stating my results so far. And yes, I do realize with only one treatment done that this is all very presumptuous.
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hello ladies, I completed 3 FEC and 3 taxotere rounds from. May 2011 ( 3 week cycle ) I fasted from the second treatment for 5 cycles so can compare the difference. My first round of chemo I ate normally as the nausea allowed and I had the usual effects of constipation and gastro block and altered taste and nausea.
For subsequent treatment cycles I fasted for 72 hours pre chemo and 24 hours post chemo. 5 cycles in all. I discussed this with my oncologist first with reference to the research by Dr Longo. I was healthy (apart from cancer) and had a healthy BMI . I found that My side effects were much lessened especially the taste disturbances and gastro symptoms. My blood counts were always good and I suffered no neuropathy at all on Taxotere. ( I also took acetyl L Carnitine to help prevent this) and never even had a tingle in my hands or feet!
All in all I came through chemo without a scratch and recovered well after each cycle- I worked right through chemo and rads later. The fatigue built up as the treatments went on but that I gather is pretty normal. Fasting was that- only water, tea coffee or diet soft drinks. I took dexamethasone without food and that was fine. If I had to do it again I would not hesitate to fast for chemo treatments. I am a scientist and find the theory to be worth the minor discomfort of being hungry and a good trade off for the potential benefits of increasing chemo effectiveness while protecting healthy cells.
I was 47 at treatment and have now reached 50 and feeling fantastic. I am on Femara now but I lost weight and exercise to help with side effects- it works!!
Best of all I am 3 years out and no recurrence despite being stage 3 at diagnosis.
I hope that my experience gives you some support, but stress that everyone is different and should discuss their particular situation with their MO. ((Robyn))
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Thanks Robyn_S! I'm going to continue to fast. My treatments are weekly so I shoot for 40 hours before and 24 hours after. I have a low BMI and from what I understand, my body will go into a "starve" state quicker with less fat to hold onto. Correct me if I'm wrong. I am trying to make sure I gain all the weight back before my next treatment.
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What about drinking chicken broth? When you are fasting can you drink that along with just water? I am newly diagnosed, going today to meet with the oncologist for the 1st time. I have been reading all of your posts & I'm thinking that I'm going to give it a try.
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I only drink water or herbal tea. I have found that Powerade zero contains no sugars, carbs or proteins so I think you can do that one, too. I drank some before I broke my fast after my last treatment because I'm on taxol which pushes potassium and magnesium. Powerade Zero has both plus calcium. I found out about it while reading up on water fasting on the Pro Ana website. Whoops! I was reading through and wondering what the heck these girls were talking about and then I realized it wasn't a health site. Chicken broth is not recommended because it has protein and carbs which turn into sugar. If you are need something, try vegetable broth. You want to keep your body in a fasting state. I took two tablespoons of avocado the morning of my infusion - it's high fat and just enough to get me through. Hot water and lemon will curb the hunger pangs which I suffered terribly this time. That may be because my husband did not stop talking about food from the time I started my fast until when I finished! I swear that talking about food while your wife is "hangry" are grounds for divorce.
I'm two days out of my last infusion. I am weekly so I fast about 40 hours before and 22 hours after (I can't seem to hold out for the last two hours recommended!) You have to make up the weight lost - if any. I start out with simple carbs - like pastina in chicken broth. Then you can eat normally. The only side effects I have had so far is a rash of little pimples across my face which may be the taxol or the steroids in my premeds. Last infusion SEs were a little sore throat a few nights that I just gargled with warm water and salt to relieve. A little tired but that may be more to do with running after my toddler, not sleeping enough and keeping up with my daily house chores. Good luck!
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Thanks so much for the info on the broth. Praying that my treatments are weekly or further apart. I'm still going to try to continue to work during all of this & a little concerned about the weakness associated with fasting. Any thoughts or ideas?
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I really don't get weak - just a little tired and irritable. You only fast for 48 hours before and 24 after. I do less because I have weekly treatment.
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So I am working with a dr and nutritionist for my fasting and diet. For my AC every 3 weeks I did the 48 hrs before and 24 after fasting. Now that I am done with AC, I am doing 12 weeks of weekly taxol. For this am doing a keto diet 24 hrs prior to chemo (15g carbs only) and then fasting 12 hrs before chemo & 12 after, plus another keto an additional 12 hrs after the fasting ends. Hope that makes sense!
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