short-term fasting before chemotherapy in treating patients with cancer

Conditions: Malignant Neoplasm

Summary: this clinical trial studies short-term fasting before chemotherapy in treating patients with cancer. fasting before chemotherapy may protect normal cells from the side effects of chemotherapy.

primary objectives: i. assess the safety and feasibility of short-term fasting prior to administration of chemotherapy. secondary objectives: i. evaluate weight changes in patients who are exposed to short-term fasting prior to chemotherapy. ii. get a preliminary estimate of the longest feasible fasting period prior to chemotherapy. iii. evaluate the toxicity profile of systemic chemotherapy treatment in patients who undergo short-term fasting prior to treatment. iv. investigate changes in plasma glucose, insulin, insulin-like growth factor 1 (igf-1) and igf-1binding proteins (bp) in patients who undertake short-term fasting. outline: cohort i: patients fast 24 hours before day 1 of course 2 of chemotherapy. if fast is well tolerated, patients may escalate fasting by 12 hours for each subsequent course of chemotherapy for up to 3 courses in the absence of unacceptable toxicity. cohort ii: patients fast at the longest fasting regimen found to be safe and tolerable in cohort i before day 1 of each course of course of chemotherapy for up to 4 courses in the absence of unacceptable toxicity.

Eligibility criteria:
inclusion criteria: * histologically confirmed malignancy * scheduled to undergo 4 or more cycles of chemotherapy (with or without past chemotherapy treatment); note: acceptable chemotherapy regimens are those that have all drugs infused on the first day of the chemotherapy cycle over a period =\< 8 hours; exception: continuous 5-fu-containing regimens (such as folfox6 and folfiri) are allowed as both the 5-fu bolus as well as the oxaliplatin and irinotecan administration is completed on day 1 of chemotherapy * life expectancy of \>= 168 days (6 months) * eastern cooperative oncology group (ecog) performance status 0 or 1 * body mass index (bmi) \> 21 kg/m\^2 * weight loss \< 5% of body weight in the last 168 days (6 months) * adequate renal function (serum creatinine \ 50 ml/min) * negative pregnancy test done =\< 7 days prior to registration, for women of childbearing potential only * provide informed consent * ability to complete patient booklet by themselves or with assistance * ability and willingness to undergo \>= 24-hour fast prior to chemotherapy * willingness to be treated at mayo clinic rochester and be available for follow-up * patient willing to provide blood samples for correlative research purposes exclusion criteria: * any of the following: * pregnant women; * nursing women; * men or women of childbearing potential who are unwilling to employ adequate contraception throughout the study period * diabetes mellitus undergoing therapy with insulin or oral agents * history of low serum glucose (hypoglycemia) or insulinoma * history of syncope with calorie restriction in the past or other medical comorbidity, which would make fasting potentially dangerous * on daily medication that may not be safely taken without food; note: any non-essential medications and herbal/vitamin supplements should be held to minimize stomach upset during fasting; vitamin c use is discouraged * active gastric or duodenal peptic ulcer disease * history of significant cardiac disease, particularly uncompensated congestive heart failure new york heart association (nyha) grade 2 or more or left ventricular ejection fraction (lvef) \< 40% on any prior assessment; note: assessment of lvef prior to therapy is not required in the absence of other clinical indicators of heart disease * recent history (\< 6 months) of cerebrovascular accident or transient ischemic attacks * history of gout or elevated uric acid level * psychiatric conditions that preclude adherence to study protocol * serious intercurrent infections or nonmalignant medical illnesses that are uncontrolled or whose control may potentially be jeopardized by the complications of fasting * patients receiving parenteral nutrition * receiving steroids (except dexamethasone given for nausea prevention before chemotherapy) * patients receiving taxotere-containing chemotherapy regimens requiring pre-treatment steroid administration * receiving concomitant treatment with insulin-like growth factor (igf)-receptor blockers or monoclonal antibodies targeting the igf ligands * any of the following (prior to registration): * =\< 7 days from the time of a minor surgery; * =\< 21 days from the time of major surgery; * =\< 21 days from the time of radiation therapy * currently enrolled in a concomitant clinical trial