Fasting to Reduce Side Effects of Chemotherapy

During the time that I was searching for a medical oncologist I could trust to supervise my chemotherapy, I saw that some patients who were posting on breastcancer.org were reducing the side effects of their chemotherapy by fasting. Valter Longo, PhD., Professor at the University of Southern California Davis School of Gerontology, had been studying the effects of fasting on longevity when he discovered that fasting also protects against the side effects of chemotherapy. He found that it causes the normal cells to turn off to protect themselves, but the cancerous cells are unable to turn off. The chemo is therefore able to kill the cancerous cells while reducing the damage to normal cells. Dr. Longo explains his research on You Tube.

Since I didn’t have a medical oncologist yet anyway, I emailed Dr. Longo to see if there were any working with fasting and breast cancer at USC. I also volunteered to enter a clinical trial, but there was no oncologist nor any clinical trial available for my particular type of cancer at that time. However, he encouraged me to consider fasting on my own if I had no other viable options, with the approval of my oncologist. I emailed my integrative oncologist to see what he thought. He said that he not only knew of the research, but that he was planning to recommend it to me. He attached a research paper with case histories of patients who have done this with apparent benefit. Their results were very similar to what patients on breastcancer.org were reporting. They still had hair loss, fatigue, and other side effects, but apparently in a milder form than would be expected based on the chemicals they were using. He said that Valter told him that even the oncologists at USC fast before chemo now when they get cancer.

Dr. Longo’s subjects had used a water fast, but my integrative oncologist said it would be healthier for me to use coconut water and a specially-blended botanical tea. He referred me to a dispensary in Oregon that would make the tea for me. I was to drink the mixture throughout the fast. He said that the drink contains an excellent blend of electrolytes, many protective botanical compounds, and almost no calories. The calorie deprivation causes normal cells to dramatically decrease their metabolic rate, so that they are much less vulnerable to the chemotherapy agents. The malignant cells, however, are unable to decrease their metabolic rate, and so remain sensitive to the chemo. He said the drink would help protect me from the effects of chemotherapy and also provide beneficial weight loss instead of the weight gain that chemotherapy usually causes.

Dr. Longo’s research was based on a 5-day fast: 3 days before chemo until one day after, but I was afraid I couldn’t go that long. My integrative oncologist said I would still benefit from fasting for 3 days: 1 day before chemo to one day after.  He told me not to drive during the fasts, to monitor blood pressure, and to inform my medical oncologist of the fasting. For fasting fluids he recommended that the mixture that would be compounded for me be mixed 50/50 with coconut water, and I was to drink as much as desired.

I finally decided on a medical oncologist who would supervise my chemotherapy, and I informed her of the fast.  She was not aware of the research, but she had no objection.  I was to have four infusions of Taxotere and Cytoxan three weeks apart, beginning on June 21.

On June 18, I did a 24 hour trial fast using my integrative oncologist’s recommended liquids, just to see whether I could really do it. I had never fasted before except for required medical procedures like colonoscopies. It turned out to be do-able. I was hungry and in a foul mood but I did not feel sick.

On June 20 I took Decadron (a steroid to prevent the allergies that people commonly have to Taxotere) and started the fast. I noticed that the Decadron had a “speed” effect and lowered my appetite, which was nice. I had the infusion on June 21, and when I went home that night, I felt all right. They told me I would feel OK that day and the next because of the steroid. The third day should be the test. On the third day I still felt OK. In fact, since I could drive again I went to a gentle qigong class. That night I went to a meditation class at the Cancer Support Community. I was beginning to think that I had escaped the side effects, but later that evening I started to feel bad.

On the fourth day the side effects hit –like being hit with a truck. I crawled into bed and started wondering whether it wouldn’t be better to just die now.  I had heard that each chemo session is worse, and that it stays in your body so you don’t start to feel normal for about a year. I was not really in pain, but it was extremely uncomfortable. I had no energy, and sleep didn’t help. I did not want to do this.   My integrative oncologist suggested that next time I try a longer fast to see whether I would do better in terms of side effects. He reminded me that the side effects will go away.

The fourth day, Friday, seemed to be my low point, and I started to slowly feel better after that. I was not feeling well enough to go to my Monday dance class, but I planned to join my walking group on Tuesday, one week after my infusion, for our regular 5 mile beach walk. However, that morning I had an attack of diarrhea and thought I had better stay home.

I had a session with my lymphedema doctor, and she said that each chemo cycle will get worse in terms of side effects. I asked my integrative oncologist if that was true, because if it was, I was going to quit. He said it was not necessarily true. The effects are pretty much the same each cycle, and the variable is the patient’s fatigue and mental factors, along with any suppression of blood cells and such.  He reminded me that in the case studies of patients who fasted, some of them started fasting in later chemo cycles, and they had fewer side effects than they had in the earlier cycles when they did not fast. He thought that if I fasted longer during the next cycle, I would have an easier time. He thought that it probably takes more time for my normal cells to lower their metabolism in response to fasting, so they don’t take up so much chemotherapy.

On July 5, two weeks from my infusion, I felt fine except for bit of gastric activity. I walked 5 miles with my group and later that week I took a Salsa dancing class. I also started meeting people again for lunches and dinners. According to patients I spoke with, my experience was pretty typical: After the steroid wears off, you feel worse and worse for the first week or so, then gradually start to feel better and better, with one good week before the next infusion. The only symptoms I never got rid of were the gastrointestinal ones: diarrhea (but only once or twice a day, so I could live with it) and burping.

My second infusion was July 12. This time I fasted for four days, and I think it helped. I felt very lethargic afterward, but not as sick. Or maybe I felt better because I knew what to expect and wasn’t so freaked out, or maybe it was a combination of the two. I felt queasy around some food, especially the healthy food I was supposed to eat, which looked revolting to me. I had a chemical taste in my mouth, and the only things that appealed to me were bland “comfort foods” from my childhood. My gastrointestinal issues were still bothering me, too. I had a massive attack at about the same time it had happened during my last round of chemo. After that I had diarrhea every day, so I needed to stick close to home, but it didn’t bother me too much, and other than that I was feeling better. By this time I had lost 10 pounds while everyone else in chemo was gaining weight. I had started feeling better a little sooner this cycle, but I did notice that during my third week, when I went back to my dance classes I could only do half a class. After the first cycle I had been able to do the whole thing. I also noticed that I was very bad at walking up hills or steps, or doing anything that raised the heart rate. I discussed this with my medical oncologist, and she said it would get worse after the third and fourth infusions, but that I would probably return to normal in 6 or 7 months. I knew that some people my age never get it back, and I was worried.

My integrative oncologist  said that my exercise tolerance would come back after chemo, and it might not get worse with the next infusions if I fast longer. He wanted me to exercise as much as I felt comfortable with. My next door neighbor walked her dog every day for about 30 minutes, and she got in the habit of calling me to see if I wanted to join them. It was an easy walk and a good way to get out of the house, so I would go when I felt up to it. I also went to as many dance classes and beach walks as I could handle. For emotional support and self-improvement I continued attending my support group at the Cancer Support Community, my weekly meditation group, and meetings with my life coach as much as I could.

I decided I would do 5 day fasts for the third and fourth infusions. Partly I was impressed by the improvement fasting seemed to bring and by my integrative oncologist’s encouragement, but more than that I remembered what my lymphedema doctor had said about the third and fourth ones being much worse, and she had scared me.

The third infusion was August 2. I fasted for 5 days. Afterwards I did not feel too sick, just lethargic. I went on a 5 mile beach walk with my walking group one week after the infusion. Previously it had taken 2 weeks before I could do that. I noticed that I had no problem so long as I walked slowly on flat ground. However, I couldn’t do anything that raised the heart rate.

I went to a restorative yoga class and I asked the teacher if she thought my problem could indicate heart damage. She said that my symptom is very common and usually means that the body is using all its energy to repair itself after chemo and has nothing left over for hills and stairs. She said that most people recover over time.

Other people I asked thought that, since no one had told me this could be a potential side effect, I should ask my medical oncologist whether an echocardiogram is warranted. I did ask her, and she did think my symptoms were atypical, so she scheduled an echocardiogram. The results came back normal, which made me feel better.

I was excited that that the next infusion, August 23, would be my last. The infusion went smoothly. I felt sick and tired for about a week, and then I started to emerge.

I was not having a big problem with lymphedema, but I knew that my upcoming radiation was expected to make it worse, so I was glad the lymphedema doctor was in the picture. When I went to see her, she said that of all the patients she sees, I have done the best in chemotherapy—that while all the other patients are dragging and sick, I am blooming. She asked for the contact information for my integrative oncologist, to pass on to her other patients, and for information about the fast. I didn’t feel blooming, but I had survived chemo and was very grateful that it was over.

Dr. Longo wanted the details of my fast and my side effects for his records. I told him that during each fast I felt hungry but did not have symptoms of low blood sugar, such as headaches and nausea, probably because I was drinking coconut water and herbal tea. I lost an average of about 5 lb. during each fast, which was fine since I was overweight, but the weight started coming back as soon as I stopped fasting.

I started feeling better about a week after each infusion. After chemo ended I felt pretty normal, but if I did anything to raise the heart rate, like stairs, hills, or a fast pace, I was short of breath and exhausted. I could still walk at least 5 miles if I went slowly and on flat ground. I went to my dance classes, but I could only do about half as much as before. My taste buds were still not normal, and I had diarrhea every day, although not severe. I had used Glutamine to prevent neuropathy and an oral rinse with baking soda and salt to prevent mouth sores, and I did not get either one. I thought I had some symptoms of chemobrain during the first infusion cycle, but not after that.

I had used cold caps and saved the hair on my head (I describe that experience in another blog).  Most of my body hair was gone, but it started coming back about two months after chemo ended. I had used cold oven mitts with gel packs on my fingers and toes during each infusion, and my fingernails and toenails came through unscathed.

As of this writing, it’s 7 years after chemo.  So far as long term damage is concerned it’s hard to say, because some of the side effects associated with chemotherapy, such as memory loss, fatigue, heart damage, cataracts, lowered immunity, hearing loss and tooth damage, are also associated with old age.  All those things are worse for me than they were before chemo, but I am also older.

Since I had chemo, there has been more research suggesting that chemo may do more harm than good, and I would recommend that anyone contemplating chemo weigh this information carefully.  You can read about it in another blog.  If I had it to do over, would I do it?  I don’t know what I would finally decide, but I do know that I would read the research.