Abstract
Fasting during the holy month of Ramadan is a religious ritual practiced bythe majority ofMuslims around the globe. This daytime fasting is short-term or intermittent fasting, which may be associated with valuable health benefits, particularly in cancer patients. A prospective cohort study ofpre- and post-fastingevaluationof 37 colorectal cancer(CRC)patients was conductedat King Abdulaziz Medical City (KAMC) and King Abdullah Specialized Children's Hospital (KASCH)-oncology outpatient clinics. The study aimedto assess the impact of fasting duringthe holy monthofRamadan on the tolerability of chemotherapy side effects and to assess changes in the levels of carcinoembryonic antigen (CEA) and lactate dehydrogenase (LDH) tumor biomarkers, which are primarily associated with certain types of carcinomas, including CRC. A totalof33patients(89.2%) had fasted at least part of the month of Ramadan.Twenty-seven patients (73%)reported "Serenity" after fasting during Ramadan with improved tolerability of chemotherapy side effects.However,theresults did not reveal any significant difference in the measuredlaboratoryvariables betweenpre-fastingvalues and by the end of the 30 days of Ramadan. Although statistically insignificant, the levels ofCEA andLDH were reduced in46.9%and55.6%of patients, respectively. The mean level of CEA in the fasting group was substantially reduced by more than 40%, attributed to the highly significant decline of CEA levels in three patients(p=0.0283).Moreover, there were no significant differences between pre- and post-fasting blood creatinine levels or estimated glomerular filtration rates, ruling out any possible adverse effects of fasting on renal function. The current study confirms the safety and tolerability of intermittent fasting in CRC patients actively receiving chemotherapy, which is consistent with several reports. Nonetheless, the results did not reveal a significant decrease in CEA and LDH tumor biomarkers.
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