RAMADAN FASTING AMONG MUSLIM CANCER PATIENTS RECEIVING OUTPATIENT CHEMOTHERAPY AND BIOLOGICAL THERAPY: BEHAVIOUR & SIDE EFFECTS, A CROSS SECTIONAL STUDY.

Background and objectives:-Ramadan fasting is the fourth pillar of Islam. Several studies showed that supervised intermittent fasting may influence the course of different diseases favourably. However, few studies have examined the feasibility of Ramadan fasting in cancer patients who are receiving chemotherapy. This study aims to assess the behaviour of cancer patients who received chemotherapy and/or biological therapy -at King Abdulaziz University Hospital (KAUH)- toward fasting and to compare chemotherapy side effects in fasting and non-fasting states. Methods:- A structured questionnaire was used to interview adult cancer patients who received single day intravenous -with or without oral- chemotherapy and intravenous biological therapy during and after Ramadan at day care unit of KAUH. Assessment of chemotherapy-related side effects was graded based on National Cancer Institute Common Terminology Criteria for Adverse Events. The side effects were compared in the same patients after receiving chemotherapy and/or biological therapy during fasting and non-fasting states. Results:- A total of 77 cancer patients were surveyed.fifty five (71.4%) were females. The mean age was 50.4?SD14.9years.fifty nine (76.6%) patients fasted during Ramadan, 37% were able to complete fasting throughout the month except on the day of therapy. The likelihood to fast was significantly associated with patient?s age (P=0.003) and the number of treatment cycles (1 vs.2cycles) (P=0.008).The severity of chemotherapy-related side effects was not affected by fasting status. Conclusion:- Patients of young age and those who receive single cycle of intravenous chemotherapy are more likely to fast. There is no significant increase in chemotherapy or biological therapy side effects while fasting the days of Ramadan. Patients should be encouraged to discuss this issue with their physicians to improve the awareness and compliance to chemotherapy.