10 ms·

Starvation Based Chemotherapy: A Novel Approach for Cancer Treatment [pdf]

67 points by sjcsjc 12y ago

reasonattlm 12y ago
In HTML format: http://www.omjournal.org/fultext_PDF.aspx?DetailsID=582&type=fultext http://www.omjournal.org/fultext_PDF.aspx?DetailsID=582&type...
junto 12y ago
Site seems a bit slow, so here's the abstract: Abstract Cancer patients undergoing chemotherapy treatment are advised to increase food intake to overcome the therapy-induced side effects, and weight loss. Dietary restriction is known to slow down the aging process and hence reduce age-related diseases such as cancer. Fasting or short-term starvation is more effective than dietary restriction to prevent cancer growth since starved cells switch off signals for growth and reproduction and enter a protective mode, while cancer cells, being mutated, are not sensitized by any external growth signals and are not protected against any stress. This phenomenon is known as differential stress resistance (DSR). Nutrient signaling pathways involving growth hormone/insulin-like growth factor-1 axis and its downstream effectors, play a key role in DSR in response to starvation controlling the other cell maintenance systems, such as autophagy and apoptosis, that are related to the tumorigenesis. Yeast cells lacking these effectors are better protected against oxidative stress compared to normal cells. In the same way, starvation protects many cell lines and mice against high-dose chemotherapeutic drugs. According to a series of studies, fasting results in overall reduction in chemotherapy side effects in cancer patients. Data shows that starvation-dependent differential chemotherapy is safe, feasible and effective in cancer treatment, but the possible side effects of starvation limit its efficacy. However, further studies and clinical trials may result in its implementation in cancer treatment. Keywords: Starvation; Dietary restriction; Differential stress resistance; Differential chemotherapy; Nutrient-signaling pathways.
- tormeh 12y ago
  tl;dr: Starving causes normal cells to get less sensitive to chemo while cancer cells remain just as sensitive as during normal eating. Starving better than just eating little.
- saalweachter 12y ago
  > Dietary restriction is known to slow down the aging process and hence reduce age-related diseases such as cancer Isn't this, uh, wrong? My understanding was that calorie restriction was very promising in some animals, but that the studies were never positive for humans or large primates.
  - Evgeny 12y ago
    I don't think strict studies in humans are even possible at all. I believe there were primate studies, but not very well designed, and there are some in progress.
  - leshow 12y ago
    It's definitely not a statement that should be taken as prima facie. The author having it in their abstract shows their bias.
fithisux 12y ago
I thought that 6-MP did the same without making the patient starve. Only "bad" cells starve.
adwf 12y ago
Note that this paper is heavy on theory, not so much on the evidence. The only "proof" of this conjecture is right at the end where they mention 10 people tried starvation before chemo and reported feeling less side-effects afterwards. I'm actually trying out an intermittent fasting diet right now for weight loss. I'm just always skeptical of new fad diets when they start claiming all sorts of health benefits beyond weight loss.
- debacle 12y ago
  IF is only really about weight loss as an ancillary benefit to the actual benefits. It's incredibly easy to gain weight on IF if you are trying - just eat more - but IF helps you eat less via about a half-dozen different vectors. http://www.marksdailyapple.com/fasting-weight-loss/ http://www.marksdailyapple.com/fasting-weight-loss/ The above is a good meta-resource on how and why IF helps you eat less.
- reasonattlm 12y ago
  http://www.ncbi.nlm.nih.gov/pubmed/?term=intermittent+fasting http://www.ncbi.nlm.nih.gov/pubmed/?term=intermittent+fastin... http://www.ncbi.nlm.nih.gov/pubmed/?term=calorie+restriction http://www.ncbi.nlm.nih.gov/pubmed/?term=calorie+restriction
- Rainymood 12y ago
  >I'm actually trying out an intermittent fasting diet right now for weight loss. I'm just always skeptical of new fad diets when they start claiming all sorts of health benefits beyond weight loss. Weightloss. To me, still means in < out. I tried everything (keto, atkins, low carb, high carb, paleo) and intermittent fasting just seems to work for me. I fast (skip breakfast/lunch and drink coffee) and start eating when I get back home out of work. I love it because I build up a 'caloric buffer', for when something unexpected happens (random cake/donuts/birthday). IF allows me to adjust my calories at the end of the day as I see fit.
  - adwf 12y ago
    Exactly, it's all about "in < out". But it's the psychology that has me trying the intermittent approach. I don't eat excessively normally, so any weight gain I have is due to being 100-200 calories over on a vaguely consistent basis, which leads to weight gain in the long term. I figure I can stick to a diet better when it's only 1 day in 4 when I have to cut calories. Whereas if I was any good at cutting a moderate amount of calories every day, I probably wouldn't need to be dieting in the first place! ;)
JamesBell 12y ago
So since we all develop cancer cells at some point doesn't this same logic hold to not "feed" them? And we might not be able to starve constantly but we can avoid producing insulin. I hope more studies can prove the links between dietary choices and cancer.
- agumonkey 12y ago
  A biology student told me that Cancer cells are "running" in a partial state and don't require the same amount of nutrients that normally functioning cells do, therefore if you stop feeding cells altogether, the healthy ones will die first.
  - titanomachy 12y ago
    The idea behind this article is that the normal cells will slow down in response to starvation, while the cancer cells will keep going at full tilt because their regulatory mechanisms are shot.
- bryondowd 12y ago
  From the abstract posted by Junto, it looks like the idea isn't to starve the cancer cells, it's to starve the healthy cells. The point being that when starving, healthy cells stop growing and become less susceptible to chemo drugs, while the cancer cells ignore the starvation and keep growing, so do not get the same protection. Imagine a TV scene where the hero starts yelling 'get down' in a crowded area before a gunfight breaks out. The 'bad guys' stay upright and the confused civilians duck, so fewer civilians get shot. IANABiologist
  - ansible 12y ago
    It is an interesting theory, that does make sense... not that "making sense" means that the theory is true! It may be worthwhile to conduct more studies in this direction. I'd be interested to know how soon after the patient stops eating will be the maximum difference in response between normal and cancer cells. And if this is more effective for short chemo treatments, or for the longer ones.
DanielBMarkham 12y ago
So if the doctor says you have cancer but they can't start the chemo for a week or two, just stop eating? At best you kill off some of the cells and give your immune system a slight boost. At worst you lose some weight that might buy you a few days later on down the line? I'm not sure there's anything useful here.
- jbob2000 12y ago
  You didn't understand the article. You aren't trying to starve the cancer cells, you're trying to toughen up the normal cells. When starved, normal cells 'harden up' so to speak, whereas the cancer cells continue business as usual. When the chemo is administered, normal cells aren't as easily destroyed, but the cancer cells are.
  - DiffEq 12y ago
    Yes, I think "Toughen the cells" as you said is the right way of distilling this article; also note that subjecting yourself to periods of high heat or cold can produce a similar response. The mechanism, in part, is thought to be from what is called "Heat Shock" proteins. http://en.wikipedia.org/wiki/Heat_shock_protein http://en.wikipedia.org/wiki/Heat_shock_protein As I said before, these proteins are made not just from heat exposure, but from other stress such as fasting and extreme cold exposure. Anyway, I think it is interesting as there is a reasonable amount of ancient literature linking fasting with health(for instance, Isaiah 58:8). Interesting how long science can take to "rediscover" certain basic things the ancients picked up on.
rip747 12y ago
Can someone explain to me what is exactly meant by starvation in the article? Does it means that you don't go without any food for a number a days? Restrict your calorie in take to only 600 throughout the day? Only eat a single meal at night while fasting throughout the day? There really any specifics that I can see.
- stoicy 12y ago
  I don't have any authority to comment what they mean in this particular article, but I have studied the issue quite a bit. So I give you my own world view, whatever it's worth. To get a quick therapeutic effect of starvation, the starvation has to endure several days. During that time the patient drinks water and doesn't ingest any calories at all. There are no exact rules, but after about 4 days the therapeutic effects kick into action, and about 7 days is the maximum. After that the starvation starts to make more harm than good. This is not easy for a normal person accustomed to a western diet, let alone for someone going through chemotherapy. For someone who already eats correctly (see my other comment in this thread) it's not such a big deal. But then again, you don't see those people on cancer wards as patients too often. As the saying goes, the best way to beat cancer is not to get one. And for that intermittent fasting is outstanding. In practice it means you eat one or two large portions of food a day. Between the last one of today and the first one of tomorrow should be about 16 hours, give or take. This gives you constant daily beneficial effects of fasting, and once you get accustomed to it and eat the right food, it feels great. Some recommend a couple of 4-6 days fastings a year on top of this. It's a piece of cake for someone who has practiced such eating habits for some time.
  - barry-cotter 12y ago
    >For someone who already eats correctly (see my other comment in this thread) it's not such a big deal. But then again, you don't see those people on cancer wards as patients too often. There are plenty of people on cancer wards who had perfectly healthy diets. Most of them are old, because cancer and cardiovascular disease are both primarily diseases of age. There are also cancers like brain cancer, most of which just show up because you were unlucky, not because of any environmental or genetic risk factor. Finally there are plenty of cancers that run in the family like, oh, breast cancer. So there are tons of people on cancer wards who ate perfectly healthy diets. Yours, with codial loathing

67 points by sjcsjc 12y ago

In HTML format: http://www.omjournal.org/fultext_PDF.aspx?DetailsID=582&type=fultext http://www.omjournal.org/fultext_PDF.aspx?DetailsID=582&type...

junto 12y ago

Site seems a bit slow, so here's the abstract: Abstract Cancer patients undergoing chemotherapy treatment are advised to increase food intake to overcome the therapy-induced side effects, and weight loss. Dietary restriction is known to slow down the aging process and hence reduce age-related diseases such as cancer. Fasting or short-term starvation is more effective than dietary restriction to prevent cancer growth since starved cells switch off signals for growth and reproduction and enter a protective mode, while cancer cells, being mutated, are not sensitized by any external growth signals and are not protected against any stress. This phenomenon is known as differential stress resistance (DSR). Nutrient signaling pathways involving growth hormone/insulin-like growth factor-1 axis and its downstream effectors, play a key role in DSR in response to starvation controlling the other cell maintenance systems, such as autophagy and apoptosis, that are related to the tumorigenesis. Yeast cells lacking these effectors are better protected against oxidative stress compared to normal cells. In the same way, starvation protects many cell lines and mice against high-dose chemotherapeutic drugs. According to a series of studies, fasting results in overall reduction in chemotherapy side effects in cancer patients. Data shows that starvation-dependent differential chemotherapy is safe, feasible and effective in cancer treatment, but the possible side effects of starvation limit its efficacy. However, further studies and clinical trials may result in its implementation in cancer treatment. Keywords: Starvation; Dietary restriction; Differential stress resistance; Differential chemotherapy; Nutrient-signaling pathways.

tormeh 12y ago
tl;dr: Starving causes normal cells to get less sensitive to chemo while cancer cells remain just as sensitive as during normal eating. Starving better than just eating little.
saalweachter 12y ago
> Dietary restriction is known to slow down the aging process and hence reduce age-related diseases such as cancer Isn't this, uh, wrong? My understanding was that calorie restriction was very promising in some animals, but that the studies were never positive for humans or large primates.
- Evgeny 12y ago
  I don't think strict studies in humans are even possible at all. I believe there were primate studies, but not very well designed, and there are some in progress.
- leshow 12y ago
  It's definitely not a statement that should be taken as prima facie. The author having it in their abstract shows their bias.

fithisux 12y ago

I thought that 6-MP did the same without making the patient starve. Only "bad" cells starve.

adwf 12y ago

Note that this paper is heavy on theory, not so much on the evidence. The only "proof" of this conjecture is right at the end where they mention 10 people tried starvation before chemo and reported feeling less side-effects afterwards. I'm actually trying out an intermittent fasting diet right now for weight loss. I'm just always skeptical of new fad diets when they start claiming all sorts of health benefits beyond weight loss.

debacle 12y ago
IF is only really about weight loss as an ancillary benefit to the actual benefits. It's incredibly easy to gain weight on IF if you are trying - just eat more - but IF helps you eat less via about a half-dozen different vectors. http://www.marksdailyapple.com/fasting-weight-loss/ http://www.marksdailyapple.com/fasting-weight-loss/ The above is a good meta-resource on how and why IF helps you eat less.
reasonattlm 12y ago
http://www.ncbi.nlm.nih.gov/pubmed/?term=intermittent+fasting http://www.ncbi.nlm.nih.gov/pubmed/?term=intermittent+fastin... http://www.ncbi.nlm.nih.gov/pubmed/?term=calorie+restriction http://www.ncbi.nlm.nih.gov/pubmed/?term=calorie+restriction
Rainymood 12y ago
>I'm actually trying out an intermittent fasting diet right now for weight loss. I'm just always skeptical of new fad diets when they start claiming all sorts of health benefits beyond weight loss. Weightloss. To me, still means in < out. I tried everything (keto, atkins, low carb, high carb, paleo) and intermittent fasting just seems to work for me. I fast (skip breakfast/lunch and drink coffee) and start eating when I get back home out of work. I love it because I build up a 'caloric buffer', for when something unexpected happens (random cake/donuts/birthday). IF allows me to adjust my calories at the end of the day as I see fit.
- adwf 12y ago
  Exactly, it's all about "in < out". But it's the psychology that has me trying the intermittent approach. I don't eat excessively normally, so any weight gain I have is due to being 100-200 calories over on a vaguely consistent basis, which leads to weight gain in the long term. I figure I can stick to a diet better when it's only 1 day in 4 when I have to cut calories. Whereas if I was any good at cutting a moderate amount of calories every day, I probably wouldn't need to be dieting in the first place! ;)

JamesBell 12y ago

So since we all develop cancer cells at some point doesn't this same logic hold to not "feed" them? And we might not be able to starve constantly but we can avoid producing insulin. I hope more studies can prove the links between dietary choices and cancer.

agumonkey 12y ago
A biology student told me that Cancer cells are "running" in a partial state and don't require the same amount of nutrients that normally functioning cells do, therefore if you stop feeding cells altogether, the healthy ones will die first.
- titanomachy 12y ago
  The idea behind this article is that the normal cells will slow down in response to starvation, while the cancer cells will keep going at full tilt because their regulatory mechanisms are shot.
bryondowd 12y ago
From the abstract posted by Junto, it looks like the idea isn't to starve the cancer cells, it's to starve the healthy cells. The point being that when starving, healthy cells stop growing and become less susceptible to chemo drugs, while the cancer cells ignore the starvation and keep growing, so do not get the same protection. Imagine a TV scene where the hero starts yelling 'get down' in a crowded area before a gunfight breaks out. The 'bad guys' stay upright and the confused civilians duck, so fewer civilians get shot. IANABiologist
- ansible 12y ago
  It is an interesting theory, that does make sense... not that "making sense" means that the theory is true! It may be worthwhile to conduct more studies in this direction. I'd be interested to know how soon after the patient stops eating will be the maximum difference in response between normal and cancer cells. And if this is more effective for short chemo treatments, or for the longer ones.

DanielBMarkham 12y ago

So if the doctor says you have cancer but they can't start the chemo for a week or two, just stop eating? At best you kill off some of the cells and give your immune system a slight boost. At worst you lose some weight that might buy you a few days later on down the line? I'm not sure there's anything useful here.

jbob2000 12y ago
You didn't understand the article. You aren't trying to starve the cancer cells, you're trying to toughen up the normal cells. When starved, normal cells 'harden up' so to speak, whereas the cancer cells continue business as usual. When the chemo is administered, normal cells aren't as easily destroyed, but the cancer cells are.
- DiffEq 12y ago
  Yes, I think "Toughen the cells" as you said is the right way of distilling this article; also note that subjecting yourself to periods of high heat or cold can produce a similar response. The mechanism, in part, is thought to be from what is called "Heat Shock" proteins. http://en.wikipedia.org/wiki/Heat_shock_protein http://en.wikipedia.org/wiki/Heat_shock_protein As I said before, these proteins are made not just from heat exposure, but from other stress such as fasting and extreme cold exposure. Anyway, I think it is interesting as there is a reasonable amount of ancient literature linking fasting with health(for instance, Isaiah 58:8). Interesting how long science can take to "rediscover" certain basic things the ancients picked up on.

rip747 12y ago

Can someone explain to me what is exactly meant by starvation in the article? Does it means that you don't go without any food for a number a days? Restrict your calorie in take to only 600 throughout the day? Only eat a single meal at night while fasting throughout the day? There really any specifics that I can see.

stoicy 12y ago
I don't have any authority to comment what they mean in this particular article, but I have studied the issue quite a bit. So I give you my own world view, whatever it's worth. To get a quick therapeutic effect of starvation, the starvation has to endure several days. During that time the patient drinks water and doesn't ingest any calories at all. There are no exact rules, but after about 4 days the therapeutic effects kick into action, and about 7 days is the maximum. After that the starvation starts to make more harm than good. This is not easy for a normal person accustomed to a western diet, let alone for someone going through chemotherapy. For someone who already eats correctly (see my other comment in this thread) it's not such a big deal. But then again, you don't see those people on cancer wards as patients too often. As the saying goes, the best way to beat cancer is not to get one. And for that intermittent fasting is outstanding. In practice it means you eat one or two large portions of food a day. Between the last one of today and the first one of tomorrow should be about 16 hours, give or take. This gives you constant daily beneficial effects of fasting, and once you get accustomed to it and eat the right food, it feels great. Some recommend a couple of 4-6 days fastings a year on top of this. It's a piece of cake for someone who has practiced such eating habits for some time.
- barry-cotter 12y ago
  >For someone who already eats correctly (see my other comment in this thread) it's not such a big deal. But then again, you don't see those people on cancer wards as patients too often. There are plenty of people on cancer wards who had perfectly healthy diets. Most of them are old, because cancer and cardiovascular disease are both primarily diseases of age. There are also cancers like brain cancer, most of which just show up because you were unlucky, not because of any environmental or genetic risk factor. Finally there are plenty of cancers that run in the family like, oh, breast cancer. So there are tons of people on cancer wards who ate perfectly healthy diets. Yours, with codial loathing