Advanced Prostate Cancer
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Jevtana, Carboplatin, and fasting

My father will begin chemo next week. We reviewed the plan with Dr.Dorff and followed Dr. Kwon’s recommendations except she said it would be better to begin with Jevtana instead of Docetaxel. As i was looking through many of the posts and reading the responses from others i noticed that fasting and chemo is a good idea. And interestingly Dr. Dorff when at USC was part of the team that conducted the study. I failed to mention it today because there were 1000 other questions i had about beginning chemo the side effects and damage to organs etc. I find it interesting that she never mentioned it. I did email

Her and maybe because it’s Friday she never got back to me. So for those of you that have fasted what do you eat/ drink etc. what is a tolerable schedule 72 hours fasting before and after? Just water? Or is low calorie food acceptable. I couldn’t find any info online about a set fasting diet. Any info would help. Thank you all for your encouraging and amazing responses. I am learning so much from this site and i wish all of you the power to fight and succeed!

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Hi, I started chemo last week (Fri 19 Jan). I have read about Randy Kam on this site who appears to have a great response to chemo and wanted to copy his approach. Also my sis in law is a gyno oncologist, she doesn't see a lot of prostates but she treats a lot of cancer. She advised me to try fasting before chemo.

I discussed this with my treating MO and he said "There is no evidence to support this" - but then again he did not try to dissuade me. Of course there are no fixed protocols for this, so I am making this up as I go along and this is what i did:

- ate on Tuesday as usual. I fast 16 hrs each day and restrict eating to an 8hr window. Last meal approx 6pm Tuesday evening.

- water fast Wednesday, Thursday and Fri morning prior to chemo.

- Got out of car 2km from the hospital and walked the rest of the way prior to chemo appointment

- chemo infusion Friday lunch time

- light dinner (salad) Fri evening.

- normal eating on Saturday.

9 days later, and I am feeling fine. I have been exercising every day since chemo and have not noticed any fatigue or nausea. Only side effect so far is strange sensations in lining of mouth (now subsided) and loss of taste.

So is this because of fasting? Dunno. But I will try it again next time (19 Jan).

Here is some more info

drfuhrman.com/learn/library...

Good luck!

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I asked his MO which ironically conducted the study on fasting prior to chemo. She does not recommend it for my father since he is diabetic and is on metfformin. Fasting could lead to liver complications on metformin. I really have heard such great things about it, but now I’m not positive about having my father do it.

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For many great tips on chemo preparation and avoiding side effects, see the following site:

theprostateadvocate.com/obs...

Good Luck, Clint

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Hello,

I made a veggie broth with tomato paste, curry and whatever veggies I had in fridge. I would also have black coffee and diet green tea. I would sip it throughout the day and was still working 6 days/week - so that kept my mind off my belly. I would eat the pm after the am chemo on Thursday.

sciencedaily.com/releases/2...

I don't know what the effect will be on your Dad's diabetes - but fasting will lower insulin and IGF-1 which is associated with cancer. It could actually normalize his blood sugars. Is he on insulin also? Also, Metformin may have action against cancer.

I would start with a day fast and see how that goes with the chemo and then increase it the next time.

I was spared a lot of the side effects and I feel that it was due to my normal cells going into "hibernation" and not eating. Cancer is just voracious and if you starve them then feed it chemo, then maybe get a better response

My best to you and your Dad and please keep us updated.

Randy

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Hi Randy,

Dr. Dorff his MO (that was part of conducting the study at USC on fasting and chemo) doesn’t recommend it because he is on the metformin. Apparently when fasting the metformin can have harsh effects on the liver?? Were you in metformin as well??

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Hey,

I'm not an MD, just a DDS, but IMHO if he is fasting then he won't need the Metformin anyways. So, discuss this with him about stopping the Metformin whilst fasting. I didn't start the Metformin until after my last chemo.

Is he on 500mg 2x/day?

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He is on 1000 2x/day his blood sugars Have been 110-120 when on it. Metformin is also been studied to reduce the spread of PCA. I believe the reason that my father is on it because since Lupron his HBA1c has gone up and now is considered full diabetic.

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I am curious to hear what DrDorff says about fasting for chemo on Men not diabetic, and not on Metformin. I know she was somehow connected to Dr Liebowitz, and another Dr. who has since moved his practice to Asia, but all were highly respected back in the day. Thank You

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She really only recommended that my father doesn’t do it because of liver damage. But i will ask her when i see her next week..

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Thank You!! This could be important to many of us, I value Dr Tanya Dorffs opinion.

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Definitely will ask!!

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“Your dad has diabetes, so it is not safe for him to fast. Specifically with metformin, there can be liver toxicity during refeeding. So unfortunately it will not be a good option for him.”

This is her exact reply

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Okay, well we can't have him have liver damage. Does he already have a liver problem? Just found this:

"Although gastrointestinal intolerance is frequent, metformin-induced hepatotoxicity is rare. Fewer than 10 cases have been reported (1). In all of those cases, metformin was associated with concomitant intake of other potentially hepatotoxic drugs."

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As far as we know, no liver problems. His AST/ALT all Phos have all been within normal. Crossing our fingers that no damage with Jevtana and carboplatin..

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Well, if the MO thinks it could be an issue then he shouldn't fast. I feel that since he became a diabetic from the Lupron, that there hasn't been long term liver damage and that fasting could help him deal with the effects of chemo and get a better response, but you have to make the call to risk the liver in order to gain the benefits of the fast. I also found these:

sciencedaily.com/releases/2...

wakeup-world.com/2017/11/27...

I also take Berberine which has action for Diabetes and against prostate cancer:

sepalika.com/type-2-diabete...

medsci.org/v12p0063.htm

Randy

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I just did a very quick look at it and it is dangerous to take when on metformin. So i will ask MO if we could stop the metformin for a while and see if it would be effective. All will be more clear when i speak with her tomorrow. I truly appreciate all this information. We will see she may not like that idea but bottom line it’s my fathers choice to get the best out of each treatment.

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