Fasting, Fasting Mimicking and Time-Restricted Feeding During Chemotherapy

Cancer therapy involves various treatments to combat malignant cell growth, with chemotherapy being a common approach.

Traditionally, managing weight loss (cachexia), during chemotherapy has been a focus due to its link to poor immunity and prognosis. However, recent research indicates that some patients experience weight gain during chemotherapy, however, it is more likely in prostate, ovarian, and breast cancer patients.

The integration of complementary approaches such as fasting, fasting mimicking diets (FMDs), and time-restricted feeding (TRF) alongside chemotherapy has gained attention.

These methods show potential in enhancing chemotherapy’s efficacy while reducing its side effects.

Fasting triggers physiological responses that protect normal cells, possibly inhibiting tumour growth while maintaining healthy cell integrity – a phenomenon known as differential stress resistance (DSR).

This may reduce chemotherapy-related side effects and improve quality of life (QoL).

Animal studies suggest fasting can reduce organ damage, immunosuppression, and tumour growth.

Fasting lowers blood glucose, insulin, and insulin growth factor 1 (IGF-1), impeding tumour expansion fuelled by glucose. It also boosts autophagy, which helps suppress tumourigenesis, and reduces inflammation and oxidative stress, crucial in the reduction of cancer development.

Fasting

Limited research suggests fasting for 48-72 hours before, during, or after chemotherapy shows promise in reducing toxicity and improving quality of life (QoL). However, this approach can be challenging for people to stick to.

Fasting Mimicking Diets

There are more small studies available on a 20-40% kilojoule restriction, demonstrating benefits in side effect reduction and patient tolerance.

Time-Restricted Feeding

This involves various intermittent fasting patterns (such as the 16:8), potentially enhances chemotherapy efficacy and mitigates side effects.

Overall, these approaches seem safe for well-nourished patients and improve treatment response, but more research is needed for definitive conclusions.

“Although promising, there is a lack of large number human trials, with existing studies often involving small, well-nourished patients. Whether undernourished patients benefit from fasting remains unclear,” says Bowel Cancer Australia Nutritionist Teresa.

“In all cases, the oncology team need to be involved in the decision-making process to ensure the ongoing safety of the patient.”