Ramadan 2025: UAE Oncology Society sets guidelines for cancer patients fasting during Ramadan

Abu Dhabi: The Emirates Oncology Society has released specific guidelines for cancer patients considering fasting during Ramadan.

Professor Humaid Bin Harmal Al-Shamsi, President of the Emirates Oncology Society and Oncology Professor at the University of Sharjah, said that each cancer patient’s condition is unique, and a personalised approach is essential when deciding whether to fast. He stressed that there is no universal answer for all cancer patients.

During Professor Al-Shamsi explained that it is the responsibility of the attending physician to assess whether fasting is safe for each individual patient. If fasting could cause harm or discomfort, he recommended that patients refrain from fasting to protect their health.

He also clarified that cancer patients undergoing intravenous chemotherapy are exempt from fasting because the fluids used during chemotherapy invalidate the fast. However, patients may fast on days when they do not receive intravenous treatment. For those who wish to fast during chemotherapy cycles, special anti-nausea patches can be used instead of oral medication, which is often necessary after chemotherapy and can disrupt fasting. These patches can last for up to a week.

Fasting and different cancer treatments

Professor Al-Shamsi highlighted that patients undergoing targeted or hormonal therapies through subcutaneous or intramuscular injections can safely fast, as these treatments do not break the fast. Similarly, patients on oral targeted or “smart” drugs can fast, provided they adjust their medication schedule to after Iftar. However, it is crucial for patients to ensure proper timing for medication, as certain drugs may need to be taken with or without food. Consulting a physician or oncology pharmacist is advised to avoid complications.

For patients who need to take oral medication twice daily, Professor Al-Shamsi recommended scheduling doses at Iftar and Suhoor, ensuring a minimum of 9 to 10 hours between doses. If a shorter interval is necessary, patients should consult their doctor to determine if fasting is advisable.

Hydration and nutrition recommendations

Professor Al-Shamsi emphasized the importance of proper hydration for cancer patients fasting during Ramadan. He recommended a daily intake of 1.5 to 2 liters of fluids between Iftar and Suhoor. Additionally, he stressed that cancer patients should maintain a healthy, balanced diet rich in proteins, vegetables, and fish while limiting sugars and refined carbohydrates.

He addressed a common misconception that avoiding sugar and protein can help “kill” cancer cells, explaining that this is a myth. Cancer patients need more protein than others. However, patients can choose to reduce sugar as part of a healthy lifestyle, as long as it is not based on unproven beliefs.

For those with gastrointestinal cancers, Professor Al-Shamsi advised avoiding spicy or heavy foods, as these could irritate the digestive system.

Fasting and cancer treatments

Regarding cancer patients undergoing radiotherapy, Professor Al-Shamsi noted that the effect of fasting varies depending on the intensity of the treatment. Patients undergoing mild radiotherapy over a short period generally can fast without significant issues. However, those undergoing intensive radiotherapy over several weeks may be able to fast in the early stages of treatment but may find it more difficult as side effects such as dehydration and fatigue increase. In such cases, fasting may not be advisable due to the risk of additional health complications.

For patients recovering from major cancer surgeries, Professor Al-Shamsi strongly recommended against fasting, as these patients need intravenous medications and adequate nutrition to recover properly.

The role of family and psychological support

Professor Al-Shamsi emphasised the importance of family support in a cancer patient’s decision to fast. He urged families to respect the patient’s choice if they wish to fast and have received medical clearance from their doctor. Unfortunately, in many cases, family members discourage fasting, which can place unnecessary psychological pressure on the patient.

He also pointed out that fasting can have a positive psychological impact, enhancing mental well-being and resilience. To safeguard their mental health, cancer patients should avoid stressors like toxic social relationships or misleading information about cancer on social media. However, Professor Al-Shamsi advised against complete social isolation, encouraging patients to maintain healthy, supportive relationships.

Key guidelines

Professor Humaid Al-Shamsi outlined 12 essential guidelines for cancer patients who are considering fasting during Ramadan. He stressed that following these guidelines is crucial to avoid health risks.

Intravenous Chemotherapy Patients – These patients are exempt from fasting due to the use of intravenous fluids, which invalidate the fast. However, they can fast on non-treatment days and use anti-nausea patches instead of oral medication to facilitate fasting after chemotherapy.

Patients on Targeted or Hormonal Therapy (Subcutaneous or Intramuscular Injections) – These treatments do not break the fast, allowing patients to fast safely.

Oral Medications (Smart or Targeted Therapies) – Patients can fast by \adjusting medication to post-Iftar. For those who need to take medication twice daily, doses should be spaced at least 9-10 hours apart.

Hydration – Cancer patients should drink 1.5 to 2 liters of fluids between Iftar and Suhoor to stay hydrated.

Radiotherapy and Fasting

Mild radiotherapy (a few days) typically allows fasting.

Intensive radiotherapy (several weeks) may be possible at first, but fasting becomes more difficult as side effects such as fatigue and dehydration worsen.

Surgery and Fasting – Major surgeries require adequate nutrition and intravenous medication, making fasting unsuitable for post-operative recovery.

Healthy, Balanced Diet – A diet rich in proteins, vegetables, and fish is best, while reducing sugars and refined carbohydrates. The myth that cutting out sugar and protein kills cancer cells is unfounded.

Avoiding Heavy Meals – Cancer patients, especially those with gastrointestinal cancers, should avoid spicy, heavy, or irritating foods.

Physical Activity – Light physical activity (30-60 minutes daily) is recommended to maintain muscle mass and overall fitness during Ramadan.

Family Support – Families should support the patient’s fasting decision. Family pressure to avoid fasting can cause unnecessary distress.

Mental Well-being – Cancer patients should avoid stressors like negative social interactions and misleading cancer-related content online. While isolation is not recommended, maintaining healthy and supportive relationships is key to good mental health.