Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Cancer
Published in: BMC Cancer 1/2018

Open Access 01-12-2018 | Research article

The effects of short-term fasting on quality of life and tolerance to chemotherapy in patients with breast and ovarian cancer: a randomized cross-over pilot study

Authors: Stephan P. Bauersfeld, Christian S. Kessler, Manfred Wischnewsky, Annette Jaensch, Nico Steckhan, Rainer Stange, Barbara Kunz, Barbara Brückner, Jalid Sehouli, Andreas Michalsen

Published in: BMC Cancer | Issue 1/2018

Login to get access

Abstract

Background

This pilot trial aimed to study the feasibility and effects on quality of life (QOL) and well-being of short-term fasting (STF) during chemotherapy in patients with gynecological cancer.

Methods

In an individually-randomized cross-over trial patients with gynecological cancer, 4 to 6 planned chemotherapy cycles were included. Thirty-four patients were randomized to STF in the first half of chemotherapies followed by normocaloric diet (group A;n = 18) or vice versa (group B;n = 16). Fasting started 36 h before and ended 24 h after chemotherapy (60 h-fasting period). QOL was assessed by the FACIT-measurement system.

Results

The chemotherapy-induced reduction of QOL was less than the Minimally Important Difference (MID; FACT-G = 5) with STF but greater than the MID for non-fasted periods. The mean chemotherapy-induced deterioration of total FACIT-F was 10.4 ± 5.3 for fasted and 27.0 ± 6.3 for non-fasted cycles in group A and 14.1 ± 5.6 for non-fasted and 11.0 ± 5.6 for fasted cycles in group B. There were no serious adverse effects.

Conclusion

STF during chemotherapy is well tolerated and appears to improve QOL and fatigue during chemotherapy. Larger studies should prove the effect of STF as an adjunct to chemotherapy.

Trial registration

This trial was registered at clinicaltrials.gov: NCT01954836.
Literature
1.
Lee C, Raffaghello L, Brandhorst S, Safdie FM, Bianchi G, Martin-Montalvo A, Pistoia V, Wei M, Hwang S, Merlino A, et al. Fasting cycles retard growth of tumors and sensitize a range of cancer cell types to chemotherapy. Sci Transl Med. 2012;4(124):124ra127.CrossRef
2.
3.
Tannenbaum A, Silverstone H. The influence of the degree of caloric restriction on the formation of skin tumors and hepatomas in mice. Cancer Res. 1949;9(12):724–7.PubMed
4.
Michalsen A, Schneider S, Rodenbeck A, Lüdtke R, Huether G, Dobos GJ. The short-term effects of fasting on the neuroendocrine system in patients with chronic pain syndromes. Nutr Neurosci. 2003;6(1):11–8.CrossRefPubMed
5.
Michalsen A, Li C, Kaiser K, Lüdtke R, Meier L, Stange R, Kessler C. In-patient treatment of fibromyalgia: a controlled nonrandomized comparison of conventional medicine versus integrative medicine including fasting therapy. Evid Based Complement Alternat Med. 2013;2013:908610.CrossRefPubMedPubMedCentral
6.
Choi IY, Piccio L, Childress P, Bollman B, Ghosh A, Brandhorst S, Suarez J, Michalsen A, Cross AH, Morgan TE, et al. Diet mimicking fasting promotes regeneration and reduces autoimmunity and multiple sclerosis symptoms. Cell Rep. 2016;15(10):2136–46.CrossRefPubMedPubMedCentral
7.
Walford RL, Harris SB, Weindruch R. Dietary restriction and aging: historical phases, mechanisms and current directions. J Nutr. 1987;117(10):1650–4.CrossRefPubMed
8.
Safdie FM, Dorff T, Quinn D, Fontana L, Wei M, Lee C, Cohen P, Longo VD. Fasting and cancer treatment in humans: a case series report. Aging. 2009;1(12):988–1007.CrossRefPubMedPubMedCentral
9.
10.
Colman RJ, Anderson RM, Johnson SC, Kastman EK, Kosmatka KJ, Beasley TM, Allison DB, Cruzen C, Simmons HA, Kemnitz JW, et al. Caloric restriction delays disease onset and mortality in rhesus monkeys. Science. 2009;325(5937):201–4.CrossRefPubMedPubMedCentral
11.
Lee C, Longo VD. Fasting vs dietary restriction in cellular protection and cancer treatment: from model organisms to patients. Oncogene. 2011;30(30):3305–16.CrossRefPubMed
12.
Raffaghello L, Lee C, Safdie FM, Wei M, Madia F, Bianchi G, Longo VD. Starvation-dependent differential stress resistance protects normal but not cancer cells against high-dose chemotherapy. Proc Natl Acad Sci U S A. 2008;105(24):8215–20.CrossRefPubMedPubMedCentral
13.
Lee C, Safdie FM, Raffaghello L, Wei M, Madia F, Parrella E, Hwang D, Cohen P, Bianchi G, Longo VD. Reduced levels of IGF-I mediate differential protection of normal and cancer cells in response to fasting and improve chemotherapeutic index. Cancer Res. 2010;70(4):1564–72.CrossRefPubMedPubMedCentral
14.
Michalsen A, Kuhlmann MK, Lüdtke R, Bäcker M, Langhorst J, Dobos GJ. Prolonged fasting in patients with chronic pain syndromes leads to late mood-enhancement not related to weight loss and fasting-induced leptin depletion. Nutr Neurosci. 2006;9(5–6):195–200.CrossRefPubMed
15.
Boschmann M, Michalsen A. Fasting therapy - old and new perspectives. Forschende Komplementärmedizin Res Complement Med. 2013;20(6):410–1.CrossRef
16.
Michalsen A, Li C. Fasting therapy for treating and preventing disease - current state of evidence. Forschende Komplementarmedizin (2006). 2013;20(6):444–53.CrossRef
17.
Schunemann HJ, Akl EA, Guyatt GH. Interpreting the results of patient reported outcome measures in clinical trials: the clinician's perspective. Health Qual Life Outcomes. 2006;4:62.CrossRefPubMedPubMedCentral
18.
Winkels RM, Beijer S, van Lieshout R, van Barneveld D, Hofstede J, Kuiper J, Vreugdenhil A, van Warmerdam LJC, Schep G, Blaisse R, et al. Changes in body weight during various types of chemotherapy in breast cancer patients. e-SPEN J. 2013;9(1):e39–44.
19.
de Groot S, Vreeswijk MP, Welters MJ, Gravesteijn G, Boei JJ, Jochems A, Houtsma D, Putter H, van der Hoeven JJ, Nortier JW, et al. The effects of short-term fasting on tolerance to (neo) adjuvant chemotherapy in HER2-negative breast cancer patients: a randomized pilot study. BMC Cancer. 2015;15:652.CrossRefPubMedPubMedCentral
20.
Dorff TB, Groshen S, Garcia A, Shah M, Tsao-Wei D, Pham H, Cheng CW, Brandhorst S, Cohen P, Wei M, et al. Safety and feasibility of fasting in combination with platinum-based chemotherapy. BMC Cancer. 2016;16(1):360.CrossRefPubMedPubMedCentral
Metadata
Title
The effects of short-term fasting on quality of life and tolerance to chemotherapy in patients with breast and ovarian cancer: a randomized cross-over pilot study
Authors
Stephan P. Bauersfeld
Christian S. Kessler
Manfred Wischnewsky
Annette Jaensch
Nico Steckhan
Rainer Stange
Barbara Kunz
Barbara Brückner
Jalid Sehouli
Andreas Michalsen
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2018
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-018-4353-2

Other articles of this Issue 1/2018

BMC Cancer 1/2018 Go to the issue

Research article

IΚΚε cooperates with either MEK or non-canonical NF-kB driving growth of triple-negative breast cancer cells in different contexts

Research article

Decisional conflict of physicians during the decision-making process for a simulated advanced-stage cancer patient: an international longitudinal study with German and Belgian physicians

Research article

MTH1 deficiency selectively increases non-cytotoxic oxidative DNA damage in lung cancer cells: more bad news than good?

Research article

Mechanism of recipient cell-dependent differences in exosome uptake

Research article

Lesions of “uncertain malignant potential” in the breast (B3) identified with mammography screening

Research article

Association between cyclooxygenase-2 (COX-2) 8473 T > C polymorphism and cancer risk: a meta-analysis and trial sequential analysis
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine
Image Credits