The Attitude of Muslim Cancer Patients Toward Fasting  During Ramadan: A Cross-Sectional Study in A Single Iraqi  Cancer Center

Ahmed Khalid Al-Mash'hadani; Yasmeen Mohammed Khalaf; Layth Mula-Hussain

doi:10.31557/apjcc.2026.11.3.373-380

Authors

Ahmed Khalid Al-Mash'hadani Department of Medical Oncology, Fallujah Teaching Hospital, Anbar, Iraq.
Yasmeen Mohammed Khalaf Department of Medical Oncology, Anbar Cancer Center, Anbar, Iraq.
Layth Mula-Hussain FRCPC Radiation Oncologist, BC Cancer Centre for the North – Prince George BC, Canada. Clinical Assistant Professor, University of British Columbia, Vancouver BC, Canada.

DOI:

https://doi.org/10.31557/apjcc.2026.11.3.373-380

Keywords:

Ramadan, Fasting, Muslim, Cancer patients, Iraq

Abstract

Introduction: Fasting of adults during the holy month of Ramadan is an important issue for Muslims as it is one of the five pillars of Islam. Muslim cancer patients usually face perplexities concerning fasting during Ramadan, as it can be exempted because of the cancer disease itself or the complications of its treatment. This issue has received limited attention in the literature and needs more interest and study.

Materials and Methods: This study was conducted on adult Muslim cancer patients who visited the Anbar Cancer Center in Anbar province, Iraq, to receive their treatment cycles during and after Ramadan of the Hijri year 1445 (the period from 11 March 2024 until 7 May 2024). All the consecutively selected patients were interviewed to assess their behaviors during Ramadan and whether they experienced treatment complications. A structured questionnaire was used during the interview, and the severity of treatment-related gastrointestinal side effects was graded using the National Cancer Institute – Common Terminology Criteria for Adverse Events (NCI–CTCAE, version 5.0).

Results: A total of 88 patients participated in this study. Sixty-four (72.7%) were females, and 24 (27.3%) were males. The median age of the participants was 49 years. Breast cancer was the most common cancer, occurring in 39 (44.3%) patients. Fifty-six (63.6%) sought advice regarding fasting from either an oncologist (54.5%) or an Imam (9.1%). Only 37 (42%) patients managed to fast during Ramadan (excluding treatment days), while 51 (58%) could not, mainly due to allowances in Islam (21, 41.2%) or fatigue (16, 31.4%).

Conclusion: Cancer patients who did not fast were more than those who could fast during Ramadan. More than half of the patients sought advice regarding fasting, and most of them discussed this issue with their oncologists. There were no significant changes observed in the treatment-related gastrointestinal toxicities among fasting patients when comparing the fasting period to the post-Ramadan period. Together with related works, the findings of this study may guide physicians, especially oncologists, in mapping a path for cancer patients during Ramadan.