Fasting

An artichoke is a splurge for my budget, a delight to my palate, and often included in my fasts. 

For years, I have been aware of the health benefits of various forms of fasting.  When I discovered that I have a serious illness, I overcame decades of fear of and resistance to fasting in a moment.  

I embraced my best understanding of a Fasting Mimicking Diet(FMD).  Very quickly, I found I actually like fasting in this way.  I also found it to be really helpful to me terms of mental clarity, better metabolic lab markers, more abundant energy, and some weight loss.  

After 5 days of a FMD, I returned to a regular diet with an emphasis on vegetables and low glycemic index foods.  I then embraced a FMD two days per week.  Typically I fasted during my work days, because the increased energy and mental focus were welcome on those days.  Benefits continued. 

As chemotherapy began, inspired by some very preliminary but very promising research and supported by the nutritionist I hired to guide me, I used the FMD on the three days before and the day of my chemo infusions.  This was much harder.  My chemo sessions were every three weeks and resulted in me not enjoying food very much for about a week or so.  The three days before the next infusion were the days when my appetite was the most normal.  Limiting my food those days was a disappointment.  

Results:

1. I have responded in very promising ways to the chemo with a noticeable decrease in the size of my cancer, both by physical exam and by ultrasound. Preliminary studies indicate that by fasting, I may have measurably increased my chance of Complete Pathologic Resolution (no cancer cells found at surgery) which is correlated with longer survival.  

2. NORMAL white blood cell (WBC) counts throughout my chemo even without taking the WBC stimulating medication for the last three cycles.  Not just "good enough to get chemo" levels, but NORMAL.  Low WBC counts are associated with more serious infections during chemo.  Having low WBC counts is a common reason for people to have their chemotherapy sessions delayed or discontinued.  One important predictor of good outcome with chemotherapy is being able to complete the course of treatment.  Getting every one of my infusions on time felt like a victory.  Seeing that this one marker of the health of my immune system was normal was really reassuring, especially since I was getting treatments during the delta wave of COVID-19. 

3. I had very few side effects to chemotherapy.  No vomiting.  No nausea. Minimal intestinal upset of any kind. No neuropathy. Moderate fatigue. My oncologist is impressed. I can't say I felt GOOD during chemo, but I had some pretty good weeks of being able to take my normal walks and be physically active. 

4. I was able to forgo using dexamethasone which is typically given as a pre-med for chemo to reduce side effects.  Dexamethasone is a steroid and will raise blood sugar and insulin levels.  I wanted to avoid that for many reasons, but mostly cause what I am reading suggests that keeping blood sugar and insulin levels low is important in preventing and treating cancer.

5. My Hemoglobin A1C levels went from borderline to NORMAL.  Not yet ideal, but I expect that with the next blood draw.  I likely prevented developing diabetes, which is its own challenge and is correlated with poorer outcomes in cancer. 

6.  A feeling of agency.  I really liked being able to do something for myself that was likely helping me be healthy. Being treated by a team of medical professionals can sometimes feel really passive.  Having things I was doing to help my success helped me feel more active. 

7. Loss of weight to close to my high school weight. Some of that loss was due to chemo (so not healthy), but I think I have gained that part back.  My weight is now stable despite a return to a more varied diet that includes whole grains and some rare sweet treats. 

It was hard.  I didn't like feeling hungry so many days.  I frankly worried some days at how much weight I lost in the week after a treatment. It's not for everyone.  I am very glad I did it.  I am already resuming a pattern of eating less on the days I am in the office, and will likely resume something similar to a 1-2 days/week FMD after recovering from surgery.