Modified fasting for 3 days before chemo and 24 hours after chemo will put normal cells into a maintenance mode, not reproducing as much, but cancer cells can't stop. Starved, they are more vulnerable to chemotherapy, and normal cells are relatively protected. Even if fasting didn't help slow tumors and improve the effectiveness of chemotherapy, it does improve the symptoms of chemotherapy, and people's weights and WBC counts rapidly bump up with eating again.
Forums
Re: High-dose chemo and fasting
This the the fasting I read about, I was looking for tips on helping with side effects and saw this:
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Ellen w - Name: Ellen
- Who do you know with myeloma?: Husband
- When were you/they diagnosed?: January 2015
- Age at diagnosis: 52
Re: High-dose chemo and fasting
Hello Ellen:
This is an interesting topic that I have posted on before. For the ASCT, weight loss is a serious issue that can cause weakness. Surprisingly, studies have shown that underweight persons and right weight persons actually have worse early survival than overweight persons, due to the additional weakness caused by the low weight. So I would say that fasting might be a good idea for an ASCT if you are more than 20 pounds above your ideal weight. If not, I would not think so.
In any case, since weight loss is such a big issue with the ASCT process, I would definitely ask your doctor. Good luck
This is an interesting topic that I have posted on before. For the ASCT, weight loss is a serious issue that can cause weakness. Surprisingly, studies have shown that underweight persons and right weight persons actually have worse early survival than overweight persons, due to the additional weakness caused by the low weight. So I would say that fasting might be a good idea for an ASCT if you are more than 20 pounds above your ideal weight. If not, I would not think so.
In any case, since weight loss is such a big issue with the ASCT process, I would definitely ask your doctor. Good luck
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JPC - Name: JPC
Re: High-dose chemo and fasting
Hi, the buddy has put on 30 lbs (14 kg) since starting all this. (He had to work very hard two years ago to lose it.) I did know that having extra weigh helps. I just like the idea that you could protect some of the body's fast-growing cell by fasting for twos days before chemo.
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Ellen w - Name: Ellen
- Who do you know with myeloma?: Husband
- When were you/they diagnosed?: January 2015
- Age at diagnosis: 52
Re: High-dose chemo and fasting
To clarify some of the points people have made here in the thread, I thought it might be useful to include some references / additional reading.
First, regarding the research JPC mentioned regarding body weight and survival in myeloma patients, including body weight prior to a stem cell transplant, here are a few articles:
"Obesity's Impact On Myeloma Stem Cell Transplant Outcomes: Not What You Probably Expected," The Myeloma Beacon, July 8, 2011.
"Further Evidence Of A Positive Link Between Weight At Diagnosis And Survival In Multiple Myeloma Patients," The Myeloma Beacon, Dec 30, 2013.
These studies are probably worth emphasizing because they look specifically at myeloma patients, and one of them deals specifically with stem cell transplantation.
Ellen's question is motivated by discussions that in many cases have been sparked by an article that appeared in a publication that was published by the U.S. National Cancer Institute, the NCI Cancer Bulletin. In particular, there was an article published in July, 2012 that discussed research that's been conducted by Dr. Valter Longo at USC. It is discussed in this archived copy of the Bulletin:
"To Eat or Not to Eat: With Cancer Therapies, That Is the Question", The NCI Cancer Bulletin, July 10, 2012 (link to archived copy; link sometimes does not work - just try again if it doesn't)
You can find links to some of the studies mentioned in this article at this list of Pubmed search results.
It's also worth mentioning in regard to this topic that a related discussion took place here in the forum about a year ago.
"Fasting to regenerate immune system - anyone done it?" (forum disc. started Jun 7, 2014)
The discussion includes contributions from Beacon Medical Advisors Dr. Heather Landau (Sloan-Kettering) and Dr. Ken Shain (Moffitt).
Hope this helps a bit with the discussion here, which has been very good.
First, regarding the research JPC mentioned regarding body weight and survival in myeloma patients, including body weight prior to a stem cell transplant, here are a few articles:
"Obesity's Impact On Myeloma Stem Cell Transplant Outcomes: Not What You Probably Expected," The Myeloma Beacon, July 8, 2011.
"Further Evidence Of A Positive Link Between Weight At Diagnosis And Survival In Multiple Myeloma Patients," The Myeloma Beacon, Dec 30, 2013.
These studies are probably worth emphasizing because they look specifically at myeloma patients, and one of them deals specifically with stem cell transplantation.
Ellen's question is motivated by discussions that in many cases have been sparked by an article that appeared in a publication that was published by the U.S. National Cancer Institute, the NCI Cancer Bulletin. In particular, there was an article published in July, 2012 that discussed research that's been conducted by Dr. Valter Longo at USC. It is discussed in this archived copy of the Bulletin:
"To Eat or Not to Eat: With Cancer Therapies, That Is the Question", The NCI Cancer Bulletin, July 10, 2012 (link to archived copy; link sometimes does not work - just try again if it doesn't)
You can find links to some of the studies mentioned in this article at this list of Pubmed search results.
It's also worth mentioning in regard to this topic that a related discussion took place here in the forum about a year ago.
"Fasting to regenerate immune system - anyone done it?" (forum disc. started Jun 7, 2014)
The discussion includes contributions from Beacon Medical Advisors Dr. Heather Landau (Sloan-Kettering) and Dr. Ken Shain (Moffitt).
Hope this helps a bit with the discussion here, which has been very good.
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Boris Simkovich - Name: Boris Simkovich
Founder
The Myeloma Beacon
Re: High-dose chemo and fasting
Hi Boris, I have read the piece on weight and improved outcomes. But huddy didn't like when I told him that obesity improves outcomes. He was pretty pissed with me.
P.S. - He isn't obese; dex just made it hard to keep his head out of the fridge.
P.S. - He isn't obese; dex just made it hard to keep his head out of the fridge.
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Ellen w - Name: Ellen
- Who do you know with myeloma?: Husband
- When were you/they diagnosed?: January 2015
- Age at diagnosis: 52
Re: High-dose chemo and fasting
I wasn't able to swallow, didn't eat, and I still had nausea. So I would say fasting doesn't help. Plus, by eating you help your body recover.
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lattecat - When were you/they diagnosed?: 2010
- Age at diagnosis: 54
Re: High-dose chemo and fasting
I had not heard about fasting before SCTs before now, so my dad did not try it. He is a thin person anyway, so he worked out and ate as much as possible before his transplant in early May 2015 knowing that nausea and weight loss were pretty much a guarantee.
The only time my dad was nauseated enough to vomit was one of the first nights after the high-dose chemo when the nurse on call (they were all wonderful, and this is the only negative thing I have to say about any of the transplant nurses) made him change his order from beef stew to a broth based soup because he "probably wouldn't be able to handle it", then took it away while he was sleeping, so he only had a bite. Who doesn't feel like puking when there's nothing on your stomach but drugs??
After that night, my mom and I made sure to always be there at meal time to make sure my dad ordered what he wanted and ate it all. He would nap between bites, but he almost always finished. He would have eggs, a bagel and French toast for breakfast. Chicken sandwiches and soup for lunch. More soup, sometimes spaghetti, and always jello or pudding for dinner. Most days, he was able to walk laps around the nurses station.
He only lost 10 lbs, which was still a lot on his thin frame, but not the 40-55 or so pounds (18-25 kg) the nurses said would be typical (30% of body weight is what we were told!). He is recovering quite nicely and has been able to put back most of the weight he lost, thanks to diet and exercise.
I think, in most cases, the other posters are right. The drugs they have to combat nausea are plentiful. Ask for those drugs at the first sign of anything "funky." Even a flutter. There is no hope once nausea is full blown. If you find something isn't helping after a couple tries, tell the nurses it's not working and you'd like to try something else. They will be more than happy to oblige. For my dad and pretty much everyone in our support group, Ativan (lorazepam) was their miracle worker.
So if your goal is simply to try to avoid as much nausea as possible, my recommendation is stay ahead of the nausea with drugs and eat as much as possible! If your goal is better disease outcomes as a result of fasting, I don't know anything about that
Best of luck to you!
The only time my dad was nauseated enough to vomit was one of the first nights after the high-dose chemo when the nurse on call (they were all wonderful, and this is the only negative thing I have to say about any of the transplant nurses) made him change his order from beef stew to a broth based soup because he "probably wouldn't be able to handle it", then took it away while he was sleeping, so he only had a bite. Who doesn't feel like puking when there's nothing on your stomach but drugs??
After that night, my mom and I made sure to always be there at meal time to make sure my dad ordered what he wanted and ate it all. He would nap between bites, but he almost always finished. He would have eggs, a bagel and French toast for breakfast. Chicken sandwiches and soup for lunch. More soup, sometimes spaghetti, and always jello or pudding for dinner. Most days, he was able to walk laps around the nurses station.
He only lost 10 lbs, which was still a lot on his thin frame, but not the 40-55 or so pounds (18-25 kg) the nurses said would be typical (30% of body weight is what we were told!). He is recovering quite nicely and has been able to put back most of the weight he lost, thanks to diet and exercise.
I think, in most cases, the other posters are right. The drugs they have to combat nausea are plentiful. Ask for those drugs at the first sign of anything "funky." Even a flutter. There is no hope once nausea is full blown. If you find something isn't helping after a couple tries, tell the nurses it's not working and you'd like to try something else. They will be more than happy to oblige. For my dad and pretty much everyone in our support group, Ativan (lorazepam) was their miracle worker.
So if your goal is simply to try to avoid as much nausea as possible, my recommendation is stay ahead of the nausea with drugs and eat as much as possible! If your goal is better disease outcomes as a result of fasting, I don't know anything about that
Best of luck to you!-
BallerinaBritt - Name: BallerinaBritt
- Who do you know with myeloma?: dad
- When were you/they diagnosed?: November 3, 2014
- Age at diagnosis: 58
Re: High-dose chemo and fasting
I think the research on weight prior to transplant shouldn't be interpreted as saying you should make yourself obese before a transplant. It's just saying that it's better to have some weight in reserve.
Also, the idea of bulking up a bit before a transplant is not as crazy as it may seem. One of the forum members who posted updates in the forum about his transplant did exactly that – he put on some extra pounds before his transplant precisely to have some reserve for when he couldn't eat as much. You can read his transplant postings here:
"MattSchtick's Stem Cell Transplant" (started July 9, 2014)
About the cyclophosphamide given before transplants -- Although one of the reasons it's given is because it does have an anti-myeloma effect, it's mainly given to stimulate stem cell production to increase the chances of a successful harvest. The "high-dose chemo" you usually hear people talk about when it comes to transplants is really the high-dose melphalan (as people here already have pointed out).
Also, the idea of bulking up a bit before a transplant is not as crazy as it may seem. One of the forum members who posted updates in the forum about his transplant did exactly that – he put on some extra pounds before his transplant precisely to have some reserve for when he couldn't eat as much. You can read his transplant postings here:
"MattSchtick's Stem Cell Transplant" (started July 9, 2014)
About the cyclophosphamide given before transplants -- Although one of the reasons it's given is because it does have an anti-myeloma effect, it's mainly given to stimulate stem cell production to increase the chances of a successful harvest. The "high-dose chemo" you usually hear people talk about when it comes to transplants is really the high-dose melphalan (as people here already have pointed out).
Re: High-dose chemo and fasting
I didn't lose any weight over the transplant process, since the nurses weighed me every day as an outpatient and always encouraged me to stay the same weight. I drank Ensure, as well as eating mild foods such as apple sauce and yogurt, as well as toast, to keep my weight up, even though I didn't feel well, and couldn't taste much either. My sense of smell was so distorted for a time that even a mild scent such as dishwashing soap smelt like rotten food!
Fortunately all returned to a new normal after several weeks, although I did actually lose some of my sense of smell from the transplant. Basically I was told by my transplant doctors and nurses that this was not the time to try to lose any weight. I thought that since I was being put through such an intense medical experience that I should cooperate with their advice!
Fortunately all returned to a new normal after several weeks, although I did actually lose some of my sense of smell from the transplant. Basically I was told by my transplant doctors and nurses that this was not the time to try to lose any weight. I thought that since I was being put through such an intense medical experience that I should cooperate with their advice!
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Nancy Shamanna - Name: Nancy Shamanna
- Who do you know with myeloma?: Self and others too
- When were you/they diagnosed?: July 2009
Re: High-dose chemo and fasting
I had tandem transplants in July and November 2012. Nausea was a major problem for me. I was on 4 anti-nausea medicines without any relief. They finally had to give me all my medicines by IV since I could not keep anything down, I was a little overweight at 150 and left after my second transplant weight 87 so extra weight was good for me. My results were wonderful with remission so complete I did not need any maitanence chemo. So my recommendation is enjoy your meals now, taste as others has mention after the transplant can be an issue. I wish you the best and the Beacon is a great source of information for us all .
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Music box lady - Name: Margie
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: 2012
- Age at diagnosis: 60
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