Abu Dhabi: Many people, those healthy or dealing with certain health conditions, are fasting as routine this Ramadan. But can cancer patients fast? A leading health expert in the UAE explains how each case is different and requires a specific approach.
Professor Humaid bin Harmal Al Shamsi, President of the Emirates Cancer Society, Professor of Oncology at the University of Sharjah, and Director of Oncology Services at Barjeel Holding Group in UAE/GCC, told Gulf News in an interview that there are a dozen conditions and controls for a fasting cancer patient.
He stressed the need to adhere to the guidelines in order to prevent the patient from being exposed to any health complications.
“One of the most frequently asked questions by cancer patients and their families ahead and during the holy month of Ramadan is, can the cancer patient fast? Certainly, there is no single answer for all patients, and each patient is a special case that requires specialised medical evaluation by oncologists and healthcare providers,” Al Shamsi said.
He pointed out that the fasting of cancer patients is subject to several controls, which must be known before the beginning of the Ramadan to determine the ability of each cancer patient to fast or not.
As a general rule, Al Shamsi explained, if there is any hardship on a patient from fasting, it is better not to fast - this is based on Islamic teachings.
Patients under treatment
These patients are not able to fast because of the use of intravenous fluids in the preparation of chemotherapy, and this in turn invalidates the fast according to the Islamic teachings. These patients may fast in the days after side effects subside following chemotherapy, which is often accompanied by nausea. There are special medications in the form of a patch that can be used for a one-week duration on the skin that will replace the need for oral pills or tablets and help the patient to fast with control of nausea with these patches.
For those undergoing biological or hormonal treatment subcutaneously or intramuscularly, they can fast as such treatments do not invalidate the fasting according to the Islamic rules.
What about patients taking pills? If they wish to fast, Al Shamsi said, it is acceptable to change the times of taking the pills after iftar [sunset meal to end the day’s fast], but they must make sure to take the capsules or pills before or after food, as the absorption of some of these pills and capsules changes according to the presence of food in the stomach.
Patients who need to take pills or capsules twice a day can take them at iftar or suhoor [pre-dawn meal] time, taking into account the minimum possible period between the two times to be nine to 10 hours these days in the UAE. If it is less than that, it is better to take the doctor’s opinion if they have the ability to fast or not.
It is necessary for cancer patients who wish to fast while under treatment to maintain adequate fluid intake between 1.5-2 litres between iftar and suhoor, the professor said.
Radiation therapy can be a short course for several days or an intensive long course for several weeks. During the short course, it is possible to fast with without any harm, while the intensive long course it may be possible to fast in the first days or 1-2 weeks. But as the weeks pass, the side effects increase from dryness, fatigue and lethargy and it may be exacerbated by fasting. It is preferable not to fast in this case to avoid any harm to the patient.
In the case of cancer surgery, especially major surgeries, it is not recommended to fast because the patient will need intravenous medications, as well as food and nutritional support to recover from surgery and its effects.
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What to eat?
It is necessary to point out, Al Shamsi said, that the best food for everyone, including cancer patients, is a moderate diet rich in protein, vegetables and fish, and to reduce sugars and rich carbohydrates. The “wide rumours” that cutting sugar and protein eliminates cancer cells is “an incorrect and erroneous belief”, Al Shamsi said.
“A cancer patient is more in need of protein than others, but if he wants to cut out sugar as a healthy option, there is no issue with that, but we affirm that this does not affect cancer cells or it is growth.”
Cancer patients, especially those with cancers of the gastrointestinal tract, should especially avoid heavy meals and meals irritating to the digestive system, such as spicy meals.
Most people are physically less active in Ramadan due to fasting and staying occupied with more acts of worship, Al Shamsi said. “However, we always encourage everyone to do light physical activity of 30-60 minutes per day to maintain the muscles of the body and physical fitness and this is very important for everyone and cancer patients alike,” he added.
It is important for the family to support the cancer patient and respect his or her choice to fast if the treating physician gives permission. In many cases, the family oppose the fasting of a cancer patient, which causes stress on the patient. “We must remember that fasting has a positive psychological effect and may support and strengthen the patient’s psychological state and well being.”
Al Shamsi explained: “It is important for a cancer patient to reduce disturbances and external factors that disturb his psychological condition, such as some social relationships or social media, which may carry many rumours about cancer and its treatment. This should not be a reason for social isolation, but restricting unhealthy relationships that may negatively affect his mental health, whether during Ramadan or at other times.”
The professor said: “In the end, the cancer patient and all patients must remember that ‘God does not burden a soul beyond its capacity’ [Quranic verse]. And if there is any doubt, let the patient break his fast as permitted by the Allah the Almighty. We wish you a blessed Ramadan, and we ask God to make us enjoy Ramadan in full health and wellness.”