This is absolutely true: "I certainly think this is worth exploring further but as you said I do not see how anyone on their own as a single individual could evaluate and determine if any improvements or negative effects in fighting myeloma is a result of fasting, drug treatments, and a host of other potential factors. This is very hard to do even in a monitored clinical trial setting."
The above is a persuasive argument against not trying approaches that have not been extensively studied in peer review articles and trials. It is subscribed to by people who espouse scientific, almost religiously statistical, approach to disease treatment.
That said, the fact that you cannot measure the effect with certainty, or that there have not been definitive studies measuring the effect, does not mean that there is no such effect. It is basically your own trial of one, and ultimately, that trial of one is all that matters.
I personally have read volumes on top of volumes of research and am rather in realistic terms with the current state of multiple myeloma treatment. Precisely for that reason, i.e. lack of cure and lack of sustained chronic disease status, I take risks that may seem unsound to other people.
The way I see it, I have X number of years with maintenance Revlimid. I just turned 40. If fasting 48 hours once a month trips my Revlimid maintenance (something that I sincerely doubt, but even if it happens, I would probably never know it for sure per the above quote), I've just eaten up possibly an undeterminable amount of my limited Revlimid borrowed time. So be it.
Just one patient's view. I apologize for belaboring this point, but in my mind, this is an extremely important topic, and the choice whether to go the unbeaten path (i.e. no scientific proof path) is a very hard one and deserves some ruminating upon. Good luck.
Forums
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ivanm - Name: Ivan Mitev
- Who do you know with myeloma?: self
- When were you/they diagnosed?: August, 2011
- Age at diagnosis: 37
Re: Fasting to regenerate immune system - anyone done it?
I was posting this morning and caught wind of this discussion/thread. I just wanted to lend my two cents (for what it is worth) and put out a word of caution when interpreting preclinical (and even early preclinical studies). The caveat to my comments is that everyone has the right to make his/her own decisions about what happens to their bodies.
This is a very interesting discussion regarding a very interesting article published in Cancer Stem Cells - an excellent journal. I do agree with Dr. Landau's comments regarding caution with application of these findings. These are preliminary and are only looking at "normal" stem cells. Nowhere in the publication do they discuss the effects of prolonged fasting on cancer cells or cancer "stem/progenitor" cells.
A lot of the discussion revolves around the possibility of protecting normal hematopoietic stem cells (HSC) and the mice from chemotherapy -- demonstrating chemoresistance, increased senescence, and immune reconstitution in an IGF-1/PKA dependent manner in HSCs in mice.
These same attributes would not be beneficial if fasting had the same effects on cancer cells or, in our case specifically, myeloma cells. As such, it will be important for studies to demonstrate preferential effects on normal HSC and not on cancer cells. This would in turn promote further studies in different settings -- if not ongoing already -- to determine if this was beneficial or, even, harmful ... A long and imperfect process, to Ivanm's point.
I would take care in translating these findings into your own management strategies. As we all know, whether we like it or not, not everything that makes sense in the lab (including a vivarium) translates to the clinic, and even when something does make it to the clinic, it may not yield much benefit (and may even do harm).
This is a very interesting discussion regarding a very interesting article published in Cancer Stem Cells - an excellent journal. I do agree with Dr. Landau's comments regarding caution with application of these findings. These are preliminary and are only looking at "normal" stem cells. Nowhere in the publication do they discuss the effects of prolonged fasting on cancer cells or cancer "stem/progenitor" cells.
A lot of the discussion revolves around the possibility of protecting normal hematopoietic stem cells (HSC) and the mice from chemotherapy -- demonstrating chemoresistance, increased senescence, and immune reconstitution in an IGF-1/PKA dependent manner in HSCs in mice.
These same attributes would not be beneficial if fasting had the same effects on cancer cells or, in our case specifically, myeloma cells. As such, it will be important for studies to demonstrate preferential effects on normal HSC and not on cancer cells. This would in turn promote further studies in different settings -- if not ongoing already -- to determine if this was beneficial or, even, harmful ... A long and imperfect process, to Ivanm's point.
I would take care in translating these findings into your own management strategies. As we all know, whether we like it or not, not everything that makes sense in the lab (including a vivarium) translates to the clinic, and even when something does make it to the clinic, it may not yield much benefit (and may even do harm).
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Dr. Ken Shain - Name: Ken Shain, M.D., Ph.D.
Beacon Medical Advisor
Re: Fasting to regenerate immune system - anyone done it?
I did want to mention a study from Dana Farber from back in 2009. It shows a patients immune cells could be helping protect the myeloma cells from chemotherapy. Note this study is from animal models as well and I have never seen a follow up study in humans. I agree with Dr. Shain and Dr. Landaus comments.
"Multiple myeloma cancer cells thwart many of the drugs used against them by causing nearby cells to turn traitor – to switch from defending the body against disease to shielding the myeloma cells from harm – Dana-Farber Cancer Institute scientists report in the October issue of Cancer Cell.
The researchers found that immune-system cells known as plasmacytoid dendritic cells (pDCs) essentially assume a new identity in the presence of myeloma – promoting the growth and survival of malignant myeloma cells, helping them fend off drugs, and depleting the overall strength of the immune system. The discovery not only helps explain a little-understood aspect of myeloma biology, but also suggests a new angle of attack on the disease. Researchers found that compounds that alight on specific sites on pDCs restore the cells' original disease-fighting character and remove a trigger of myeloma cell growth.
"Our study found an unusually large number of pDCs in the bone marrow of multiple myeloma patients," says Dharminder Chauhan, JD, PhD, of Dana-Farber, who co-led the study with Ajita Singh, PhD. "pDCs are known to be immune system 'effector' cells – the first responders of the body's attack on disease. But why are they present in such abundance in myeloma patients' marrow?""
"In the current study, Chauhan and his colleagues zeroed in on those interactions in experiments involving laboratory-grown samples of myeloma cells and animals with the disease. They found that when pDCs latch onto myeloma cells, a mutual release of proteins affects both sets of cells. In myeloma cells, these proteins cause a spurt of growth. In the pDCs, the effect is something like that of a police officer bribed to join a gang of hoodlums. The cells abandon their role as immune system sentinels and become the protectors of myeloma cells.
"This is the first time that immune system cells have been found to be converted to another function," says Chauhan, who is also a principal associate in medicine at Harvard Medical School. Investigators don't yet know how the conversion occurs, but they suspect the proteins cause a different set of genes to be activated within the pDCs."
http://www.sciencedaily.com/releases/2009/10/091005123043.htm
"Multiple myeloma cancer cells thwart many of the drugs used against them by causing nearby cells to turn traitor – to switch from defending the body against disease to shielding the myeloma cells from harm – Dana-Farber Cancer Institute scientists report in the October issue of Cancer Cell.
The researchers found that immune-system cells known as plasmacytoid dendritic cells (pDCs) essentially assume a new identity in the presence of myeloma – promoting the growth and survival of malignant myeloma cells, helping them fend off drugs, and depleting the overall strength of the immune system. The discovery not only helps explain a little-understood aspect of myeloma biology, but also suggests a new angle of attack on the disease. Researchers found that compounds that alight on specific sites on pDCs restore the cells' original disease-fighting character and remove a trigger of myeloma cell growth.
"Our study found an unusually large number of pDCs in the bone marrow of multiple myeloma patients," says Dharminder Chauhan, JD, PhD, of Dana-Farber, who co-led the study with Ajita Singh, PhD. "pDCs are known to be immune system 'effector' cells – the first responders of the body's attack on disease. But why are they present in such abundance in myeloma patients' marrow?""
"In the current study, Chauhan and his colleagues zeroed in on those interactions in experiments involving laboratory-grown samples of myeloma cells and animals with the disease. They found that when pDCs latch onto myeloma cells, a mutual release of proteins affects both sets of cells. In myeloma cells, these proteins cause a spurt of growth. In the pDCs, the effect is something like that of a police officer bribed to join a gang of hoodlums. The cells abandon their role as immune system sentinels and become the protectors of myeloma cells.
"This is the first time that immune system cells have been found to be converted to another function," says Chauhan, who is also a principal associate in medicine at Harvard Medical School. Investigators don't yet know how the conversion occurs, but they suspect the proteins cause a different set of genes to be activated within the pDCs."
http://www.sciencedaily.com/releases/2009/10/091005123043.htm
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Mark
Re: Fasting to regenerate immune system - anyone done it?
I cannot find what Dr. Landau defines as prolonged fasting. How many calories per day for how many days?
Prof. Valter Longo and Prof. Tanya Dorff at USC did the study.
Prof. Valter Longo and Prof. Tanya Dorff at USC did the study.
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coachhoke - Name: coachhoke
- When were you/they diagnosed?: Apri 2012
- Age at diagnosis: 71
Re: Fasting to regenerate immune system - anyone done it?
I cannot get to the article in Cell without paying $39 USD. Too expensive. However this clinical trial is underway. http://clinicaltrials.gov/ct2/show/NCT00936364
I disagree with Dr. Heather Landau about the risk. It seems to me there is a lot less risk in 72 hours of fasting than in any known MD's "standard of care" medical intervention. So yesterday, as I had no infection underway, I got a blood draw for a base line CBC. Next? 3 days fast each 21. I would like to see the paper, but I propose to myself to get a CBC after 1/4 year, look at the numbers, and make a judgement call. If I see a 40% improvement in the relevant cell count, then I will feel pretty certain it works.
Wish me luck.
I disagree with Dr. Heather Landau about the risk. It seems to me there is a lot less risk in 72 hours of fasting than in any known MD's "standard of care" medical intervention. So yesterday, as I had no infection underway, I got a blood draw for a base line CBC. Next? 3 days fast each 21. I would like to see the paper, but I propose to myself to get a CBC after 1/4 year, look at the numbers, and make a judgement call. If I see a 40% improvement in the relevant cell count, then I will feel pretty certain it works.
Wish me luck.
Re: Fasting to regenerate immune system - anyone done it?
I'm 61 and healthy. I've done eight of these fasts intermittently. The main consequence is losing a pound or two each fast of about three days. I am 5 ft 7 in (1.7 m). I went from 173 pounds (78.5 kg) to 155 pounds (70 kg), and from 23 percent body fat to 17 percent. I didn't monitor my white blood count, just thought I'd try it. I planning on doing such a fast once a quarter.
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Earthian
16 posts
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