Forgive me as I write about two seemingly unconnected topics in this newsletter. This article is primarily a review of recent research on short term fasting in combination with tyrosine kinase inhibitors for the treatment of cancer. Seemingly unrelated, it also contains a cookie recipe that might be acceptable for people who are on these caloric restricted diets, well not while they are on the diets, but instead while they are taking a break from these diets and need or at least want to put some weight back on.
Earlier this year, back in March, a paper published in the journal Oncotarget suggested that a combination of fasting and tyrosine kinase inhibiting drugs might be an effective strategy in treating cancer.
Abstract of study: http://www.ncbi.nlm.nih.gov/pubmed/25909220
Science Daily summarized the findings of this study: “Fasting in combination with chemotherapy has already been shown to kill cancer cells, but a pair of new studies in mice suggests that a less-toxic class of drugs combined with fasting may kill breast, colorectal and lung cancer cells equally well. Fasting in combination with chemotherapy has already been shown to kill cancer cells, but a pair of new studies in mice suggests that a less-toxic class of drugs combined with fasting may kill breast, colorectal and lung cancer cells equally well.
If shown to work in humans, this combination could replace chemotherapy and make fasting a potent component of a long-term strategy to treat cancer, according to senior author Valter Longo of USC. Human clinical trials in the United States and Europe are already studying the effectiveness and safety of Longo’s strategy of cyclic fasting during cancer treatment.” http://www.sciencedaily.com/releases/2015/03/150330141927.htm
This current paper is the work of Valter Longo from USC, who originally came to our attention way back in 2008 when he suggested fasting prior to administration of chemotherapy significantly decreased treatment side effects. Science Daily:
In 2012, Longo coauthored studies that suggested that fasting made brain tumors as well as other cancers more vulnerable to chemotherapy treatments.
Brain tumors and fasting:
Other cancers: 
“….without exception, “the combination of fasting cycles plus chemotherapy was either more or much more effective than chemo alone,” said senior author Valter Longo, professor of gerontology and biological sciences at the University of Southern California.
For example, multiple cycles of fasting combined with chemotherapy cured 20 percent of mice with a highly aggressive type of children’s cancer that had spread throughout the organism and 40 percent of mice with a more limited spread of the same cancer.
No mice survived in either case if treated only with chemotherapy.
Only a clinical trial lasting several years can demonstrate whether humans would benefit from the same treatment,”
“…. in mice, the study found that fasting cycles without chemotherapy could slow the growth of breast cancer, melanoma, glioma and human neuroblastoma. In several cases, the fasting cycles were as effective as chemotherapy.”
This new idea of combining fasting with tyrosine kinase inhibition is attractive for two reasons. First, while tyrosine kinase inhibitors seem to offer benefit in treating some types of cancer, the effect is short lived. If fasting might lengthen their time of effectiveness, this would be handy. Secondly, this class of drugs tends to be much less dangerous than some of the other classes of chemotherapy drugs so they are more attractive to patients. Fasting may actually further decrease side effects from these drugs.
To quote the Science Daily article again: “”However, kinase inhibitors, though much less toxic than chemotherapy, can still be toxic to many cell types. Fasting makes them more effective, meaning that patients would have to use them for less time to achieve the same results,” Longo said. “Although we have not yet tested this, we anticipate that fasting will also reduce the toxicity of kinase inhibitors as it reduces that of chemotherapy to normal cells.” ”
The tyrosine kinase inhibiting drugs include:
rlotinib [which appears to also work well in combination with metformin, see links below],
gefitinib [also appears synergistic with metformin (2-7)]
There are a number of phytochemicals that may act as natural tyrosine kinase inhibitors including curcumin , genistein, quercetin and green tea. 
So back to this recipe I mentioned. When it comes to eating to gain weight while not fasting, there seem to be two general guidelines. First, we hope to avoid increasing IGF-1 levels too much so the suggestion we want to avoid animal protein, and in particular dairy products. Second, we would like if possible to keep sugar and starches, in particular the glycemic index of the food, as low as possible. We also want the food to supply lots and lots of calories. Nuts as we’ve written about so many times in the past offer significant protection against heart disease, stroke and neurodegeneration. Flax seeds of course provide some benefit in cancer, at least breast, and prostate. New research suggests they may offer some protection against damage from radiation therapy.  There is some more recent evidence suggesting protection against colon cancer.  Raisins, which add most of the ‘sweetness’ being inverted sugars (that is little sucrose but glucose and fructose, offering almost double the ‘sweet’ for the calories as sugar would) also add the chewiness.  We could go on and waste more of your and our day by finding references for why the cinnamon, ginger, and other ingredients are good for you, but you’ve got the idea…..
But most importantly we want the food to taste good enough that it is hard to resist eating. This recipe is a distant descendent of a Hermit Cookie Recipe. So instead I’ve been calling them Troglodyte Cookies.
Hermit Nut Cookies or bars
Grind in food processor:
Almonds 150 gm [we use almond flour from Costco for this] (1 ¼ cups)
Walnuts 150 gm [1 ¼ cup nuts. Or 2 ½ cups of mixed nuts, walnuts, pecans and almonds are all good]
Transfer to mixing bowl: Add
Flax seed meal 200 gm [2 cups]
Brown rice flour 100 gm [3/4 cup]
Add the following to the dry mixture and then mix together:
Cinnamon 1 TB
Ginger 1 TB
Cloves ½ tsp (one-half teaspoon)
Baking soda ½ tsp (one-half teaspoon)
Salt ½ tsp (one-half teaspoon)
Whole raisins 50 gram [1/2]
In the food processor blend together until very smooth:
Raisins 100 gm [1 cup]
Molasses or honey 50 gm [1/2 cup]
Oil 50 mg (extra virgin olive is our regular but also consider melted butter or coconut oil) [1/3 cup]
Vanilla 2 TB
Add this liquid mixture to the dry ingredients and mix until blended well.
Form into 48 round cookies. Bake at 325 degrees. These can also be formed into two flattened logs and baked as if they were mondel brod or biscotti, that is after the initial baking slice the logs into individual cookies and spread on the baking sheet and bake an additional 10-15 minutes until done.
Makes 40 cookies if using a small scoop or about 20-30 biscotti-ish cookies. These will not get crisp and hard like biscotti as they both lack the requisite sugars and the fruit sugars will make them chewier over time.
1. Changhan Lee, Lizzia Raffaghello, Sebastian Brandhorst, Fernando M. Safdie, Giovanna Bianchi, Alejandro Martin-Montalvo, Vito Pistoia, Min Wei, Saewon Hwang, Annalisa Merlino, Laura Emionite, Rafael de Cabo, and Valter D. Longo. Fasting Cycles Retard Growth of Tumors and Sensitize a Range of Cancer Cell Types to Chemotherapy. Science Translational Medicine, Feb 8, 2012 DOI: 10.1126/scitranslmed.3003293
3. Clin Cancer Res. 2013 Jul 1;19(13):3508-19. doi: 10.1158/1078-0432.CCR-12-2777. Epub 2013 May 21. Synergistic effects of metformin treatment in combination with gefitinib, a selective EGFR tyrosine kinase inhibitor, in LKB1 wild-type NSCLC cell lines. Morgillo F1, Sasso FC, Della Corte CM, Vitagliano D, D’Aiuto E, Troiani T, Martinelli E, De Vita F, Orditura M, De Palma R, Ciardiello F.
5. Lung Cancer. 2013 Dec;82(3):397-406. doi: 10.1016/j.lungcan.2013.09.011. Epub 2013 Sep 25. Inhibition of p38 MAPK-dependent MutS homologue-2 (MSH2) expression by metformin enhances gefitinib-induced cytotoxicity in human squamous lung cancer cells. Ko JC1, Chiu HC, Wo TY, Huang YJ, Tseng SC, Huang YC, Chen HJ, Syu JJ, Chen CY, Jian YT, Jian YJ, Lin YW.
7. http://www.ncbi.nlm.nih.gov/pubmed/24100792 Int J Oncol. 2013 Dec;43(6):1846-54. doi: 10.3892/ijo.2013.2120. Epub 2013 Oct 3. Effect of metformin on residual cells after chemotherapy in a human lung adenocarcinoma cell line. Kitazono S1, Takiguchi Y, Ashinuma H, Saito-Kitazono M, Kitamura A, Chiba T, Sakaida E, Sekine I, Tada Y, Kurosu K, Sakao S, Tanabe N, Iwama A, Yokosuka O, Tatsumi K.
8. Oncol Res. 2013;21(3):137-44. doi: 10.3727/096504013X13832473330032.
Curcumin lowers erlotinib resistance in non-small cell lung carcinoma cells with mutated EGF receptor. Li S1, Liu Z, Zhu F, Fan X, Wu X, Zhao H, Jiang L.
9. Mol Nutr Food Res. 2011 Jun;55(6):832-43. doi: 10.1002/mnfr.201000622. Epub 2011 May 2. Cancer chemoprevention with green tea catechins by targeting receptor tyrosine kinases. Shimizu M1, Adachi S, Masuda M, Kozawa O, Moriwaki H.
11. Christofidou-Solomidou M, Pietrofesa R, Arguiri E, McAlexander MA, Witwer KW.
Dietary flaxseed modulates the miRNA profile in irradiated and non-irradiated murine lungs: a novel mechanism of tissue radioprotection by flaxseed. Cancer Biol Ther. 2014 Jul;15(7):930-7. http://www.ncbi.nlm.nih.gov/pubmed/24755684
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13. Dr Schor’s raisin review has yet to appear in NMJ. Eventually it will we hope.