{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T19:12:19Z","timestamp":1785870739349,"version":"3.56.0"},"reference-count":32,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2015,11,16]]},"abstract":"<jats:p>Follicular lymphoma (FL), the second most common non-Hodgkin's lymphoma (NHL), is well characterised by a classic histological appearance and an indolent course. Current treatment protocols for FL range from close observation to immunotherapy, chemotherapy and\/or radiotherapies. We report the case of a 42-year-old woman diagnosed by excisional biopsy with stage IIIa, grade 1 FL. In addition to close observation, the patient underwent a medically supervised, 21-day water-only fast after which enlarged lymph nodes were substantially reduced in size. The patient then consumed a diet of minimally processed plant foods free of added sugar, oil and salt (SOS), and has remained on the diet since leaving the residential facility. At 6 and 9-month follow-up visits, the patient's lymph nodes were non-palpable and she remained asymptomatic. This case establishes a basis for further studies evaluating water-only fasting and a plant foods, SOS-free diet as a treatment protocol for FL.<\/jats:p>","DOI":"10.1136\/bcr-2015-211582","type":"journal-article","created":{"date-parts":[[2015,12,11]],"date-time":"2015-12-11T00:48:52Z","timestamp":1449794932000},"page":"bcr2015211582","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":12,"title":["Water-only fasting and an exclusively plant foods diet in the management of stage IIIa, low-grade follicular lymphoma"],"prefix":"10.1136","volume":"2015","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4120-3694","authenticated-orcid":false,"given":"Alan C","family":"Goldhamer","sequence":"first","affiliation":[{"name":"Department of Nutritional Medicine, TrueNorth Health Center, Santa Rosa, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Klaper","sequence":"additional","affiliation":[{"name":"Department of Nutritional Medicine, TrueNorth Health Center, Santa Rosa, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Afsoon","family":"Foorohar","sequence":"additional","affiliation":[{"name":"Department of Nutritional Medicine, TrueNorth Health Center, Santa Rosa, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshia R","family":"Myers","sequence":"additional","affiliation":[{"name":"Department of Nutritional Medicine, TrueNorth Health Center, Santa Rosa, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2015,12,10]]},"reference":[{"key":"2025082804432867000_2015.dec10_1.bcr2015211582.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2015.04.025"},{"key":"2025082804432867000_2015.dec10_1.bcr2015211582.2","doi-asserted-by":"publisher","DOI":"10.1038\/leu.2014.91"},{"key":"2025082804432867000_2015.dec10_1.bcr2015211582.3","doi-asserted-by":"crossref","first-page":"367","DOI":"10.6004\/jnccn.2015.0047","article-title":"Is observation dead in follicular lymphoma? Still appropriate","volume":"13","author":"Jacobson","year":"2015","journal-title":"J Natl Compr Canc Netw"},{"key":"2025082804432867000_2015.dec10_1.bcr2015211582.4","first-page":"760","article-title":"Targeted approaches to the management of follicular lymphoma","volume":"29","author":"Ujjani","year":"2015","journal-title":"Oncology (Williston Park)"},{"key":"2025082804432867000_2015.dec10_1.bcr2015211582.5","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2407-12-210"},{"key":"2025082804432867000_2015.dec10_1.bcr2015211582.6","doi-asserted-by":"publisher","DOI":"10.3109\/10428191003690364"},{"key":"2025082804432867000_2015.dec10_1.bcr2015211582.7","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2008.19.4035"},{"key":"2025082804432867000_2015.dec10_1.bcr2015211582.8","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2005.02.0198"},{"key":"2025082804432867000_2015.dec10_1.bcr2015211582.9","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2006.08.6819"},{"key":"2025082804432867000_2015.dec10_1.bcr2015211582.10","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2002.03.008"},{"key":"2025082804432867000_2015.dec10_1.bcr2015211582.11","doi-asserted-by":"publisher","DOI":"10.1016\/S0959-8049(05)80086-3"},{"key":"2025082804432867000_2015.dec10_1.bcr2015211582.12","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(20000915)89:6<1205::AID-CNCR3>3.0.CO;2-5"},{"key":"2025082804432867000_2015.dec10_1.bcr2015211582.13","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijom.2008.09.004"},{"key":"2025082804432867000_2015.dec10_1.bcr2015211582.14","doi-asserted-by":"publisher","DOI":"10.1177\/0884533610386234"},{"key":"2025082804432867000_2015.dec10_1.bcr2015211582.15","doi-asserted-by":"crossref","unstructured":"Jaffe ES . The 2008 WHO classification of lymphomas: implications for clinical practice and translational research. Hematology Am Soc Hematol Educ Program 2009:523\u201331. doi:10.1182\/asheducation-2009.1.523","DOI":"10.1182\/asheducation-2009.1.523"},{"key":"2025082804432867000_2015.dec10_1.bcr2015211582.16","unstructured":"Pizzorno JM , Murray T . Textbook of natural medicine. 4 edn. Elsevier Churchill Livingstone, 2013."},{"key":"2025082804432867000_2015.dec10_1.bcr2015211582.17","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmet.2013.12.008"},{"key":"2025082804432867000_2015.dec10_1.bcr2015211582.18","unstructured":"Goldhamer A . The health promoting cookbook. Summertown, TN: Book Publishing Company, 1996."},{"key":"2025082804432867000_2015.dec10_1.bcr2015211582.19","doi-asserted-by":"publisher","DOI":"10.1089\/107555302320825165"},{"key":"2025082804432867000_2015.dec10_1.bcr2015211582.20","doi-asserted-by":"publisher","DOI":"10.1067\/mmt.2001.115263"},{"key":"2025082804432867000_2015.dec10_1.bcr2015211582.21","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1080\/030097401750065256","article-title":"Fasting followed by vegetarian diet in patients with rheumatoid arthritis: a systematic review","volume":"30","author":"Muller","year":"2001","journal-title":"Scand J Rheumatol"},{"key":"2025082804432867000_2015.dec10_1.bcr2015211582.22","doi-asserted-by":"crossref","first-page":"988","DOI":"10.18632\/aging.100114","article-title":"Fasting and cancer treatment in humans: a case series report","volume":"1","author":"Safdie","year":"2009","journal-title":"Aging (Albany NY)"},{"key":"2025082804432867000_2015.dec10_1.bcr2015211582.23","doi-asserted-by":"publisher","DOI":"10.4161\/cc.9.22.13954"},{"key":"2025082804432867000_2015.dec10_1.bcr2015211582.24","doi-asserted-by":"publisher","DOI":"10.1016\/j.mad.2005.06.007"},{"key":"2025082804432867000_2015.dec10_1.bcr2015211582.25","doi-asserted-by":"publisher","DOI":"10.1093\/carcin\/23.5.817"},{"key":"2025082804432867000_2015.dec10_1.bcr2015211582.26","doi-asserted-by":"publisher","DOI":"10.1016\/j.stem.2014.04.014"},{"key":"2025082804432867000_2015.dec10_1.bcr2015211582.27","doi-asserted-by":"publisher","DOI":"10.1158\/0008-5472.CAN-09-3228"},{"key":"2025082804432867000_2015.dec10_1.bcr2015211582.28","doi-asserted-by":"crossref","first-page":"538019","DOI":"10.1155\/2015\/538019","article-title":"Insulin-like growth factor system in cancer: novel targeted therapies","volume":"2015","author":"Brahmkhatri","year":"2015","journal-title":"Biomed Res Int"},{"key":"2025082804432867000_2015.dec10_1.bcr2015211582.29","first-page":"9","article-title":"Epithelial-to-mesenchymal transition in breast cancer: a role for insulin-like growth factor I and insulin-like growth factor-binding protein 3?","volume":"7","author":"Zielinska","year":"2015","journal-title":"Breast Cancer (Dove Med Press)"},{"key":"2025082804432867000_2015.dec10_1.bcr2015211582.30","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.29295"},{"key":"2025082804432867000_2015.dec10_1.bcr2015211582.31","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198412063112303"},{"key":"2025082804432867000_2015.dec10_1.bcr2015211582.32","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.2830310215"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2015-211582","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T11:43:41Z","timestamp":1756381421000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2015-211582"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,12,10]]},"references-count":32,"alternative-id":["10.1136\/bcr-2015-211582"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2015-211582","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,12,10]]}}}