From the Guidelines
Fasting during Ramadan is not recommended for patients undergoing chemotherapy due to the potential risks of malnutrition, dehydration, and worsening of chemotherapy side effects. According to the ESPEN guidelines on nutrition in cancer patients 1, dietary provisions that restrict energy intake should be avoided in patients with or at risk of malnutrition. While some studies suggest that short-term fasting may increase the effectiveness and tolerability of cytotoxic treatment 1, the current evidence is not sufficient to recommend fasting during chemotherapy, especially considering the risks of malnutrition and potential harm.
Key considerations for patients undergoing chemotherapy include:
- Maintaining adequate nutrition and hydration to support the immune system and overall health
- Managing chemotherapy side effects, such as nausea, fatigue, and dehydration, which can be exacerbated by fasting
- Ensuring timely and consistent administration of chemotherapy medications and supportive care
- Prioritizing preservation of life and health, as emphasized by the Islamic principle of necessity (darura)
Patients should consult both their oncologist and religious advisor for personalized guidance, taking into account individual circumstances, such as the specific chemotherapy regimen, cancer type, and overall health status. Alternative acts of worship, like feeding the poor (fidya) or making up missed fasts when healthier, may be recommended by religious authorities. Ultimately, the decision to fast during Ramadan while undergoing chemotherapy should be made with caution and careful consideration of the potential risks and benefits.
From the Research
Fasting During Ramadan for Patients Undergoing Chemotherapy
- The decision to fast during Ramadan for patients undergoing chemotherapy should be made on an individual basis, taking into account the patient's overall health and the potential risks and benefits of fasting 2, 3.
- Some studies suggest that fasting during Ramadan may be safe and tolerable for patients with certain types of cancer, such as colorectal cancer, and may even improve the tolerability of chemotherapy side effects 3.
- However, other studies have found that fasting may not have a significant impact on the quality of life of cancer patients during treatment, and may even be associated with negative effects such as unintentional weight loss 4.
- The effects of fasting on chemotherapy treatment response are not well understood, and more research is needed to fully understand the potential benefits and risks of fasting for patients undergoing chemotherapy 2, 5.
- Patients who wish to fast during Ramadan should consult with their healthcare provider to determine the best course of action, and to discuss any potential risks or benefits of fasting in their individual situation 6, 3.
Potential Risks and Benefits
- Potential benefits of fasting during Ramadan for patients undergoing chemotherapy may include improved tolerability of chemotherapy side effects and potential anti-cancer effects of fasting 3, 5.
- Potential risks of fasting during Ramadan for patients undergoing chemotherapy may include unintentional weight loss, dehydration, and electrolyte imbalances 4.
- The risk of adverse effects from fasting may be higher for patients with certain underlying health conditions, such as diabetes or kidney disease 6.
Guidance for Healthcare Providers
- Healthcare providers should work with patients to determine the best course of action for fasting during Ramadan, taking into account the patient's individual health needs and the potential risks and benefits of fasting 6, 2.
- Patients who are deemed to be at high risk for adverse effects from fasting should be advised against fasting, while those who are deemed to be at low risk may be able to fast safely with proper monitoring and guidance 6.
- Healthcare providers should be aware of the potential benefits and risks of fasting during Ramadan for patients undergoing chemotherapy, and should be prepared to provide guidance and support to patients who wish to fast 3, 5.