Intermittent Fasting and CLL/SLL
Intermittent Fasting and CLL/SLL
What are the investigators trying to do? By most measures, humans consume more food than
 needed. Over several decades, overconsumption has led to an increase in a number of diseases,
 including cancer. What if this could be reversed, or slowed down, by fasting? Would that
 improve how cancer patients respond to chemotherapy? Could simply changing eating patterns to
 reduce overall intake be a way to prevent and/or manage cancer? All of these are important
 questions and the investigators are undertaking a new initiative to study how nutrition and
 dietary behaviours affect cancer patients.

 Fasting: A way to improve overall health and increase our defenses to cancer Fasting in
 various forms has been shown to have a number of health benefits. Intermittent fasting, or
 time restricted feeding, has been shown to reverse or improve various diseases such as
 diabetes, heart disease and metabolic syndrome, decrease the risk of cancer, and
 significantly extend the life of an individual. In previous studies, fasting was
 well-tolerated with notable improvements in energy levels, sense of well-being, and sleep
 quality. In cancer patients, clinical trials have demonstrated intermittent fasting to lessen
 some of the short-term side effects of chemotherapy such as nausea, fatigue, and sleep
 quality. How fasting alters the course of cancer or improve immune defenses is not yet known
 but may be an alternative way to treat or manage cancer.

 The study plan The investigators plan to examine the effects of intermittent fasting (time
 restricted feeding) in patients with chronic lymphocytic leukemia (CLL). CLL is the most
 common chronic leukemia and is presently incurable. The advantage of choosing this patient
 population is that the cancer is easily assessed with a blood test measuring the amount of
 cancerous white cells (lymphocytes). Patients who consent to participate in this study will,
 through the support of an oncology dietitian and after a period of transition, split their
 daily feeding into a fasting period and a non-fasting period. This regime is as simple as
 skipping or having a late breakfast. At this time, participants will not be required to limit
 their total caloric intake.

 What is required from the participant? The investigators will assess whether intermittent
 fasting reduces the cancer by measuring the lymphocyte count in the blood over a period of 3
 months. Study participants will complete questionnaires to help determine if fasting causes
 any change in their quality of life. The effects of intermittent fasting on a cancer control
 system called autophagy, as well as its effects on inflammation will be studied in the Deeley
 Research Centre laboratory at BC Cancer.

 What is the short- and long-term impact? In the short-term, if intermittent fasting can have
 an effect cancer lymphocyte count or on autophagy, then investigators will proceed with
 further studies to try and optimize the effects of intermittent fasting. In the long-term,
 this study is expected to be the first-ever to shed light on how intermittent fasting may be
 linked to cancer survival and/or growth. If true, this will open up new avenues to
 re-evaluate the inclusion of diet into cancer treatment protocols.
Inclusion Criteria:

 -  Diagnosis of CLL or SLL

 -  Age </=85

 -  Lymphocytes >/=40 and <150

 -  Hemoglobin >/=100g/L

 -  Platelet >100 x 10*9/L

 -  BMI of >/= 20kg/m2

 -  Eastern Cooperative Oncology Group (ECOG) Performance Status </=2

 -  Not on anti-lymphoma therapy within the past 3 months

 -  Not receiving anti-lymphoma therapy and not expected to require initiation of
 anti-lymphoma therapy within the next 3 months

 Exclusion Criteria:

 -  Patient unable to give consent

 -  Patient on medications required to be taken with food during the fasting window

 -  Pregnancy

 -  Diabetes mellitus

 -  BMI drop to </= 18.5kg/m2 at any time during study