Fasting among Muslim cancer patients during the holy month of Ramadan

BACKGROUND AND OBJECTIVE: Muslims constitute more than 20% of the world’s population and have a significant share of its cancer cases. Many Muslim cancer patients witness the fasting month of Ramadan but we do not know which individuals elect to fast. DESIGN AND SETTING: Cross-sectional study conducted among Muslim cancer patients at the National Cancer Institute (NCI), Egypt, during Ramadan, Hijri 1430 (the month of fasting) August-September 2009. SUBJECTS AND METHODS: One-hundred and two patients being treated at the NCI were interviewed. The most common diagnoses were breast cancer (31%), acute leukemia (24%), colorectal cancer (7%), non-Hodgkin lymphoma (5%), bladder cancer (4%), lung cancer (4%), and laryngeal cancer (4%). The two sexes were equally represented and so were metastatic and nonmetastatic diseases. The outpatient:inpatient ratio was 3:1. Treatments being received by these patients included chemotherapy, radiotherapy, hormonal therapy, and non-specific therapy in 42%, 31%, 10%, and 17%, respectively. Other concomitant diseases were present in 22% of the patients. RESULTS: While 40% of patients did not fast at all during Ramadan, 36% and 24% were partial and complete fasters, respectively. Female patients, those with performance status (PS) 0 to 1, those whose disease was a non-metastatic solid tumor, and those receiving non-intravenous chemotherapy as outpatients were more likely to be fasting than their corresponding counterparts. Being a female, having PS 0 to 1, and receiving treatment as an outpatient were the only factors that were significant on multivariate analysis. Only 46% of patients sought the treating oncologist advice on whether they could fast. CONCLUSIONS: Most cancer patients fast during Ramadan, but only half of them discuss the issue with their oncologists. We hope that our study stimulates more research on this topic.