More than 300,000 women in the United States receive a breast cancer diagnosis each year, making it the most common cancer affecting women. But navigating treatment—which can range from surgery to chemotherapy—and long-term health is a complex journey. Researchers are increasingly focused on how lifestyle factors can improve outcomes, and even potentially reduce the harsh side effects of treatment.
Beyond Chemotherapy: Diet, Fasting, and a Holistic Approach to Breast Cancer Care
New research explores how simple changes, like strategic fasting and weight management, can significantly impact a patient’s experience with breast cancer treatment and recovery.
- Approximately half of breast cancer diagnoses occur in women aged 50-70, but 10% are under 45 and 20% are over 70.
- A clinical trial is investigating the feasibility of 24-hour water-only fasting during chemotherapy to mitigate side effects.
- Obesity increases breast cancer risk and mortality, prompting research into effective weight loss strategies.
- Misinformation about breast cancer, particularly regarding mammograms, persists online and should be addressed with evidence-based information.
What if a simple change like a 24-hour fast could lessen the debilitating nausea and fatigue that often accompany chemotherapy? Dr. Jenni Sheng, an Assistant Professor in the Department of Oncology at the Hopkins School of Medicine, is exploring that very question.
Q: Can fasting really help with chemotherapy side effects?
A: Yes, research suggests that short-term fasting may reduce the intensity of common chemotherapy side effects like fatigue, nausea, and even lower the risk of blood clots, while potentially improving tumor response.
Dr. Sheng’s journey into oncology was shaped by her experience as an internal medicine resident at the Lewis Katz School of Medicine at Temple University. “What gravitated me the most towards the field of oncology was the potential for compassionate and longitudinal care, as well as advancement in research and therapies,” she explained. “It is a privilege to help an individual and their family through a terrifying diagnosis, and finding effective treatments that ensure a good quality of life.”
Currently, Dr. Sheng is leading several clinical trials focused on improving the lives of breast cancer patients, both during and after treatment. One study, a feasibility study, examines the impact of a 24-hour water-only fast during chemotherapy. The concept behind this approach, known as differential stress resistance, suggests that fasting can protect healthy cells while making cancer cells more vulnerable to treatment. “Fasting during chemotherapy reduces side effects by forcing healthy cells into a protective, slow-growth mode while leaving cancer cells vulnerable to treatment,” Dr. Sheng clarified. “By lowering insulin and IGF-1 levels, fasting triggers nutrient-sensing pathways that cause normal cells to focus on repair and maintenance rather than proliferation, decreasing toxicity, fatigue and gastrointestinal issues.”
Beyond managing treatment side effects, Dr. Sheng is also tackling the challenge of obesity in breast cancer patients. Obesity not only increases the risk of developing breast cancer but is also linked to a higher mortality rate. Her Adaptive Nutrition and Exercise Weight Loss (A-NEW) Study investigated strategies for effective weight management. “Lifestyle interventions alone, like diet and exercise, may not be sufficient for the majority of patients,” she noted. The A-NEW study identified a 5% weight loss threshold within eight weeks as a predictor of long-term success with behavioral interventions. For those struggling to meet that goal, the study integrated FDA-approved weight-loss medication, Contrave (a combination of naltrexone and bupropion). Results showed that roughly half of patients who initially responded poorly to behavioral changes began to lose weight with the addition of medication.
Dr. Sheng also addressed the spread of misinformation surrounding breast cancer, particularly concerning mammograms. “While social media and other digital platforms have the power to spread knowledge, they also have the ability to propagate misinformation,” she cautioned. “There are individuals and sites that state that mammograms are not safe and should be avoided because of radiation; I disagree with that recommendation. Mammograms are standard of care, and help to diagnose breast cancers as early as possible. This helps to not only improve survival outcomes but also reduce the change of needing more intensive treatments for higher stage breast cancer. The radiation that one would receive from a mammogram is very small, [less than] a year of natural background radiation.”
Advances in breast cancer detection, such as 3D mammography and abbreviated breast MRIs, alongside the increasing use of artificial intelligence in analyzing mammograms, are improving early diagnosis. However, Dr. Sheng emphasized the importance of equitable access to care. “We have all these wonderful diagnostics, and we need to make sure that everyone has access to regular primary and gynecologic care to ensure that routine breast cancer screening is completed.”
Finally, Dr. Sheng highlighted the collaborative nature of cancer care. “Cancer care is multidisciplinary and we convene on a weekly basis to discuss new and complex cases. We work closely with a breast surgeon, radiation oncologist, pathologist and radiologist to give our patients comprehensive care, and the best possible treatment experience and outcome.”
