Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Correspondence
  • Published:

Fasting in oncology: a word of caution

Nature Reviews Cancer volume 19, page 177 (2019)Cite this article

Subjects

We read with interest the Opinion article by Nencioni and colleagues (Fasting and cancer: molecular mechanisms and clinical application. Nat. Rev. Cancer 18, 707–719 (2018))1 on molecular mechanisms involved in the potential application of fasting in oncology. We accept that fasting and calorie restriction may represent an intriguing springboard for developing future strategies with potential benefits in cancer treatment. However, we would like to point out that the clinical application of fasting and fasting-mimicking diets (FMDs) should only be undertaken with extreme caution, and that the media’s enthusiasm for this approach is excessive and unjustified.

According to a recent consensus article, while the results obtained by fasting in cellular and animal models might conceivably be transferred to and benefit patients with cancer in terms of treatment response, toxicity and survival remain to be ascertained2.

This is a preview of subscription content, access via your institution

Relevant articles

Open Access articles citing this article.

Access options

Buy this article

  • Purchase on SpringerLink
  • Instant access to the full article PDF.

USD 39.95

Prices may be subject to local taxes which are calculated during checkout

References

  1. Nencioni, A. et al. Fasting and cancer: molecular mechanisms and clinical application. Nat. Rev. Cancer 18, 707–719 (2018).

    Article  CAS  Google Scholar 

  2. Caccialanza, R. et al. To fast, or not to fast before chemotherapy, that is the question. BMC Cancer 18, 337 (2018).

    Article  Google Scholar 

  3. O’Flanagan, C. H. et al. When less may be more: calorie restriction and response to cancer therapy. BMC Med. 15, 106 (2017).

    Article  Google Scholar 

  4. Bauersfeld, S. P. et al. The effects of short-term fasting on quality of life and tolerance to chemotherapy in patients with breast and ovarian cancer: a randomized cross-over pilot study. BMC Cancer 18, 476 (2018).

    Article  Google Scholar 

  5. Longo, V. D. & Fontana, L. Calorie restriction and cancer prevention: metabolic and molecular mechanisms. Trends Pharmacol. Sci. 31, 89–98 (2010).

    Article  CAS  Google Scholar 

  6. Lee, C. & Longo, V. D. Fasting versus dietary restriction in cellular protection and cancer treatment: from model organisms to patients. Oncogene 30, 3305–3316 (2011).

    Article  CAS  Google Scholar 

  7. Lee, C., Raffaghello, L. & Longo, V. D. Starvation, detoxification, and multidrug resistance in cancer therapy. Drug Resist. Updat. 15, 114–122 (2012).

    Article  CAS  Google Scholar 

  8. Longo, V. D. & Mattson, M. P. Fasting: molecular mechanisms and clinical applications. Cell Metab. 19, 181–192 (2014).

    Article  CAS  Google Scholar 

  9. Vernieri, C. et al. Targeting cancer metabolism: dietary and pharmacologic interventions. Cancer Discov. 6, 1315–1333 (2016).

    Article  CAS  Google Scholar 

  10. Brandhorst, S. et al. Protective effects of short-term dietary restriction in surgical stress and chemotherapy. Ageing Res. Rev. 39, 68–77 (2017).

    Article  Google Scholar 

  11. Dorff, T. B. et al. Safety and feasibility of fasting in combination with platinum-based chemotherapy. BMC Cancer 16, 360 (2016).

    Article  Google Scholar 

  12. de Groot, S. et al. The effects of short-term fasting on tolerance to (neo) adjuvant chemotherapy in HER2-negative breast cancer patients: a randomized pilot study. BMC Cancer 15, 652 (2015).

    Article  Google Scholar 

  13. Carneiro, I. P., Mazurak, V. C. & Prado, C. M. Clinical implications of sarcopenic obesity in cancer. Curr. Oncol. Rep. 18, 62 (2016).

    Article  Google Scholar 

  14. Arends, J. et al. ESPEN guidelines on nutrition in cancer patients. Clin. Nutr. 36, 11–48 (2017).

    Article  Google Scholar 

  15. Caccialanza, R. et al. Nutritional support for cancer patients: still a neglected right? Support. Care Cancer 25, 3001–3004 (2017).

    Article  Google Scholar 

Download references

Acknowledgements

The authors gratefully thank P. Baines for assistance in editing the manuscript.

Author information

Authors and Affiliations

  1. Clinical Nutrition and Dietetics Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy

    Riccardo Caccialanza & Emanuele Cereda

  2. Department of Oncology, San Bortolo General Hospital, Vicenza, Italy

    Giuseppe Aprile

  3. Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo and Department of Internal Medicine, University of Pavia, Pavia, Italy

    Paolo Pedrazzoli

Authors
  1. Riccardo Caccialanza
    View author publications

    Search author on:PubMed Google Scholar

  2. Giuseppe Aprile
    View author publications

    Search author on:PubMed Google Scholar

  3. Emanuele Cereda
    View author publications

    Search author on:PubMed Google Scholar

  4. Paolo Pedrazzoli
    View author publications

    Search author on:PubMed Google Scholar

Contributions

R.C. researched data for the article, contributed to the discussion of content, wrote and edited the manuscript before submission. G.A. and P.P. contributed to the discussion of content, wrote and edited the manuscript before submission. E.C. researched data for the article, contributed to the discussion of content, and edited the manuscript before submission.

Corresponding author

Correspondence to Riccardo Caccialanza.

Ethics declarations

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Caccialanza, R., Aprile, G., Cereda, E. et al. Fasting in oncology: a word of caution. Nat Rev Cancer 19, 177 (2019). https://doi.org/10.1038/s41568-018-0098-0

Download citation

  • Published:

  • Version of record:

  • Issue date:

  • DOI: https://doi.org/10.1038/s41568-018-0098-0

This article is cited by

Search

Advanced search

Quick links

Nature Briefing: Cancer

Sign up for the Nature Briefing: Cancer newsletter — what matters in cancer research, free to your inbox weekly.

Get what matters in cancer research, free to your inbox weekly. Sign up for Nature Briefing: Cancer