Even Without Steroids, Cancer Patients Experience Less Chemo Side Effects on Fasting Mimicking Diet

In 1971 President Nixon declared a “War on Cancer”, and signed the National Cancer Act on December 23, 1971. Since the early 70s the focus in cancer research has been on drug development, as well as early preventative screenings.

But a somewhat eyebrow raising trend in cancer treatment, is exploring ways to treat certain cancers by combining standard of care therapies and nutritional intervention. Based on decades of aging research, nutritional pathways in the body are used in a targeted way to impact the cancer patient microenvironment and oncogenes. Early human pilot studies are testing whether a few days of fasting with food, followed by refeeding can make chemotherapy more targeted and less toxic.

A recent study investigated whether the fasting mimicking diet (FMD) influenced the toxicity or effectiveness of chemotherapy in women with early-stage breast cancer. The fasting mimicking diet is a four-day meal replacement designed to provide vital nutrients. The FMD triggers the body to switch from an anabolic (growth state) to catabolic (repair state) metabolism, and for cells to enter into a protected state.

The authors of the randomized controlled study assigned 131 women with stage II/III breast cancer to receive either a low calorie fasting mimicking diet or their regular diet three days before and throughout neoadjuvant chemotherapy.

Chemotherapy administered to shrink a tumor prior to surgery is known as neoadjuvant chemotherapy.

Researchers observed that women on the FMD were more likely to experience a 90 to 100 percent tumor cell loss as compared to women on a regular diet. Patients on the FMD had less DNA damage in T-lymphocytes from chemotherapy than those on the regular diet.

A fasting-mimicking diet (FMD) combined with chemotherapy resulted in a 300-400% increase in the chance of killing 90-100% of cancer cells in women with breast cancer. DNA damage in T-cells was less in patients who received the FMD with chemotherapy.

Interestingly, a steroid Dexamethasone was not given to the FMD group. But there was no difference in toxicity between both groups.

Dexamethasone is an antiemetic drug, belonging to a class of drugs that is effective against vomiting and nausea. Antimetics are typically used to treat motion sickness and the side effects of general anaesthetics and chemotherapy directed against cancer. Administering steroids is a standard practice to help chemotherapy patients stave off naseau and handle chemo side effects.

According to the study: “This suggests that the FMD may obviate the need for dexamethasone in the prevention of the side effects of chemotherapy. Importantly, DNA damage in T-lymphocytes was less in patients who received the FMD in combination with chemotherapy compared to those receiving chemotherapy while on a regular diet, suggesting that the FMD protected these cells against the induction of DNA damage by chemotherapy.”

Steroids like dexamethasone are routinely given to cancer patients directly following chemotherapy, but also can trigger serious spikes in insulin.

Typical cancer dietary guidelines encourage chemo patients to consume a high protein diet to combat malnutrition or muscle wasting.

Only normal weight patients were involved in this study to guard against cachexia or muscle wasting. Fasting faces the challenge of going against nutritional guidelines in cancer therapy that are deeply entrenched. And patient compliance in this study was problematic, indicating that patients may need to be followed carefully or supported by a dietician in future larger mult-site studies still in the planning stage.

For now, this pilot trial suggests that (for certain cancers) new nutritional as well as steroid administration options, could be on the horizon.



5 Mind-Blowing Medical Breakthroughs You Might’ve Missed During Covid

These days the media focus is on all things virus, catching a virus, and how to treat a virus. So you’d be forgiven if you missed some important news in science. But here’s five exciting breakthroughs that went under the radar:

ONE – No “Blood Boys” or Younger Donors Required for Healthy Aging

In the hit TV series HBO’s Silicon Valley, tech oligarch Gavin Belson receives blood transfusions from a young donor. “Blood boys” is both a biohack and social meme, a slightly creepy way to defy aging.

Back in 2005, a UC California, Berkeley research lab made conjoined twins by sewing together an old and a young mouse – each mouse shared blood and organs. The blood from the young mice seemed to rejuvenate tissues in the old mice.

The 2005 study sparked the idea of parabiosis that young blood might contain special proteins that could act as a “fountain of youth’. San Francisco based startup Ambrosia began offering an $8,000 procedure involving transfusion of blood plasma from a young donor.

Now according to lead researcher Irina Conboy, her lab has upended the idea that young blood slows aging. In a new experiment, simply diluting blood plasma in old mice reversed aging in the brain, liver, and muscle.

In this new experiment, the breakthrough came from testing out a new mini dollhouse-size plasma exchange device, specially built for the mice. Old mice had half of their plasma replaced with a saline and albumin mixture.

According to Conboy, the study suggests there’re proteins in old blood that are responsible for accelerating aging.

The plasma exchange lowers the concentrations of many pro-inflammatory proteins which increase with age while enabling a rebound in beneficial proteins which improve new blood vessel growth.

Today plasma exchange can be done by Therapeutic Plasma Exchange (TPE) a well-established medical procedure and FDA-approved.

TWO – Forget Light, Dark – Liver Clock Tied to Disease Risk Factors

There’s a circadian clock in your brain, regulated by light and dark cycles. But the body also has a circadian clock in the liver and when we eat may drive risk factors for cardiometabolic disease.

Time restricted eating in a ten hour window (7am to 7pm for example) in a pilot study, was found to be an effective adjuvant treatment to treat metabolic syndrome. In the clinical trial, patients were put on medication to treat hypertension or statins for cholesterol, but were still eating in a 14 hour window.

After switching to a ten hour eating window, patients’ metabolic markers and disease risk factors improved. Time restricted eating (TRE) is now being tested in the clinical setting as an “add-on” to pharmacological treatment for diseases like hypertension and diabetes.

THREE –  Cytokine Storms When Exercise-Induced, Improve Fitness

Interleukin 6 (IL-6) is used as a biomarker of inflammation and to guage disease progression in Covid patients. But sports science is now learning that IL-6 acts as a double-agent cytokine.

IL-6 had previously been classified as a proinflammatory cytokine. But now researchers are learning that in the context of exercise IL-6 can also serve an anti-inflammatory role through rapid activation of an anti-inflammatory cytokine know as IL-10.

Exercise turns on the body’s own anti-oxidant system. Our body’s anti-oxidant pathway is a hundred times more powerful than any antioxidant that you could take in a pill.

We’ve all been told to megadose antioxidants to boost our immune system. But some sports science researchers are shedding new light on this health hack. According to early pilot studies involving elite athletes, taking a pre-workout (especially Vitamin E) before a gym session may blunt some of the benefits of exercise such as increased production of mitochondria or possibly muscle remodeling.

According to some early human clinical trial data, timing matters in regards to taking megadose antioxidants; if taken too close a workout these trendy supplements, might do more harm than good.

FOUR – Fasting and Cancer Clinical Trials Expand from Mice to Humans

In a recent study, a fasting-mimicking diet (FMD) combined with chemotherapy resulted in a 300-400% increase in the chance of killing 90-100% of cancer cells in women with breast cancer. DNA damage in T-cells was less in patients who received the FMD with chemotherapy.

Fasting may impact the same genes that control cancer. Proto-oncogenes function as key negative regulators of the protective changes induced by fasting. Scientists’s hypothesis is that cells expressing oncogenes, and therefore the great majority of cancer cells, can’t respond to the protective signals generated by fasting.

Normal healthy cells can switch to maintenance pathways, and stop trying to grow during fasting. But some cancer cells may be addicted to consuming sugar. Cancer cells will continue trying to divide as much as possible, even when nutrients are scarce.

In the 1930s Otto Warburg proposed that damaged mitochondria and an altered metabolism are a hallmark of cancer. Human clinical trials are now hoping to find if for certain types of cancers, lowering sugars and proteins can make chemotherapy treatments less toxic and more targeted.

FIVE – Using Stem Cells To Transport Mitochondria

In the movie Replica a genetic scientist played by Keanu Reeves, uses embryonic stem cells to clone and re-grow his family in the garage.

But outside Hollywood not all stem cell research is aimed at regenerating tissue. With Covid19 a different type of stem cell is coming into focus, the mesenchymal stem cell.

Mesenchymal stem cells (MSCs) can secrete growth and repair factors. But it’s now been observed using electron microscopy, that an MSC can make cell-to-cell contact with a damaged lung cell, project a small microtubule out of its cell wall, and via this microscopic tube transport healthy mitochondria to rescue damaged lung cells via cell to cell contact and tiny nanotubes.

This isn’t the first time nanotubes have been observed transporting materials in between cells, in cell to cell contact. Science has known that natural killer Tcells dock on to cancer cells to use tiny tubes to insert killer toxins, and kill them. And now a nanotubule has been observed extending from a mesenchymal stem cell, and transporting stemy new mitochondria into a damaged lung cell.

MSC stem cells reside in the niche in bone marrow. Normally, these stem cells lie in a dormant state.  When the body has been injured, the mesenchymal stem cell “homes” to the site of injury and secrets growth factors to help injuries heal.

A study headed by Dr. Bhattacharya at Columbia University, observed MSCs injected into lungs attached directly to alveolar epithelium. Scientists observed a delivery of mitochondria from MSCs to the injured alveolar epithelium. The MSCs fix mitochondria and restore normal ATP levels, surfactant release, and fluid transport in the lungs.

In the clinic setting, MSCs are typically used to repair orthopedic injuries like a torn rotator cuff. Using MSCS to do cell-to-cell contact is fairly new.

A Phase 1/11 Trial of MSC for Severe ARDs, is currently underway to test the safety of giving Covid19 ARDS patients three different doses of mesenchymal stem cells, to repair lungs and mitochondria damage.