A systematic review on the role of fish oil for the treatment of cachexia in advanced cancer: An EPCRC cachexia guidelines project

Ries, Anke; Trottenberg, Peter; Elsner, Frank; Stiel, Stephanie; Haugen, Dagny Faksvåg; Kaasa, Stein; Radbruch, Lukas

doi:10.1177/0269216311418709

Cited by 116 publications

(65 citation statements)

References 47 publications

(133 reference statements)

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“…This multimodal approach would incorporate oral nutritional supplements, exercise and anti-inflammatory medications and has been advocated in the prevention and treatment of CC. Underpinning this approach are meta-analyses suggesting that each of the interventions components, while not unequivocally associated with improved outcome, is more likely than not to be beneficial (77,88,91,94,95) . The MENAC trial (a multimodal intervention of exercise, nutrition and anti-inflammatory medication plus standard care v. standard care alone) to prevent/attenuate cachexia will test the efficacy of a multi-dimensional approach during chemotherapy.…”

Section: Multimodal Approachesmentioning

confidence: 99%

Cancer-associated malnutrition, cachexia and sarcopenia: the skeleton in the hospital closet 40 years later

et al. 2016

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An awareness of the importance of nutritional status in hospital settings began more than 40 years ago. Much has been learned since and has altered care. For the past 40 years several large studies have shown that cancer patients are amongst the most malnourished of all patient groups. Recently, the use of gold-standard methods of body composition assessment, including computed tomography, has facilitated the understanding of the true prevalence of cancer cachexia (CC). CC remains a devastating syndrome affecting 50-80 % of cancer patients and it is responsible for the death of at least 20 %. The aetiology is multifactorial and complex; driven by pro-inflammatory cytokines and specific tumour-derived factors, which initiate an energy-intensive acute phase protein response and drive the loss of skeletal muscle even in the presence of adequate food intake and insulin. The most clinically relevant phenotypic feature of CC is muscle loss (sarcopenia), as this relates to asthenia, fatigue, impaired physical function, reduced tolerance to treatments, impaired quality of life and reduced survival. Sarcopenia is present in 20-70 % depending on the tumour type. There is mounting evidence that sarcopenia increases the risk of toxicity to many chemotherapy drugs. However, identification of patients with muscle loss has become increasingly difficult as 40-60 % of cancer patients are overweight or obese, even in the setting of metastatic disease. Further challenges exist in trying to reverse CC and sarcopenia. Future clinical trials investigating dose reductions in sarcopenic patients and dose-escalating studies based on pre-treatment body composition assessment have the potential to alter cancer treatment paradigms.

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Section: Multimodal Approachesmentioning

confidence: 99%

Cancer-associated malnutrition, cachexia and sarcopenia: the skeleton in the hospital closet 40 years later

et al. 2016

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“…A systematic review of clinical trials on the therapeutic role of omega-3 FA consumption (EPA and DHA) on cancer cachexia showed that at least 1.5 g per day for more than 8-weeks period improve appetite, body lean mass, functional status, quality of life and decrease inflammatory mediators [234]. However, the available clinical data about effect of single-agent EPA on cancer cachexia are controversial and, due to lack of sufficient evidence, it is not easy to make a clear decision about its application as single agent [235][236][237][238]. However, the promising role of omega-3 FAs on acute phase responses after surgery and inhibition of protein degradation is publicized [239,233].…”

Section: Cancer Cachexiamentioning

confidence: 99%

Omega-3 polyunsaturated fatty acids and cancer: lessons learned from clinical trials

Nabavi

Bilotto

Russo

et al. 2015

Cancer Metastasis Rev

140

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Over the past decades, extensive studies have addressed the therapeutic effects of omega-3 polyunsaturated fatty acids (omega-3 FAs) against different human diseases such as cardiovascular and neurodegenerative diseases, cancer, etc. A growing body of scientific research shows the pharmacokinetic information and safety of these natural occurring substances. Moreover, during recent years, a plethora of studies has demonstrated that omega-3 FAs possess therapeutic role against certain types of cancer. It is also known that omega-3 FAs can improve efficacy and tolerability of chemotherapy. Previous reports showed that suppression of nuclear factor-κB, activation of AMPK/SIRT1, modulation of cyclooxygenase (COX) activity, and up-regulation of novel anti-inflammatory lipid mediators such as protectins, maresins, and resolvins, are the main mechanisms of antineoplastic effect of omega-3 FAs. In this review, we have collected the available clinical data on the therapeutic role of omega-3 FAs against breast cancer, colorectal cancer, leukemia, gastric cancer, pancreatic cancer, esophageal cancer, prostate cancer, lung cancer, head and neck cancer, as well as cancer cachexia. We also discussed the chemistry, dietary source, and bioavailability of omega-3 FAs, and the potential molecular mechanisms of anticancer and adverse effects.

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“…However, measuring quality of life remains controversial (10). It is not appropriate to focus on feeding without anticipating changes in physiological and psychosocial behavior (11). On the contrary, optimal nutrition in combination with systemic antiinflammatory treatment and erythropoietin improves the survival of underweight malignant patients (12,13).…”

Section: Introductionmentioning

confidence: 99%

Effects of nutritional intervention in head and neck cancer patients undergoing radiotherapy: A prospective randomized clinical trial

Kang

Huang

et al. 2016

Molecular and Clinical Oncology

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Abstract. Head and neck malignant tumors have numerous locations of the disease. After patients receive radiotherapy, their nutritional status is very poor, thus the curative effect is unsatisfactory. The aims of the present study were to investigate and analyze the nutritional status of patients with head and neck cancer undergoing radiotherapy (RT) in order to provide positive nutrition intervention for assisting the radiotherapy effect. A total of 40 patients with head and neck cancer were selected using a method of subjective global assessment (SGA) to assess nutritional status, including calorie intake and energy expenditure. In a randomized, controlled study, 20 patients received intensive dietary counseling and nutritional therapy (G1) and 20 received regular dietary as controls (G0) preradiotherapy and postradiotherapy. The primary endpoint was calorie intake and energy expenditure. The secondary endpoint was SGA rating with nutritional therapy. At the end of RT, energy intake showed a net increase in G1 (1,691±301 kcal) compared with that in G0 (1,066±312 kcal) (P<0.05); energy expenditure increased in G1 (1,673±279 kcal) compared with G0 (1,490±298 kcal) (P<0.05). The prevalence of severe malnutrition following radiotherapy was significantly different between the two study groups (10 patients in G0 and 4 patients in G1; P<0.05). The number of the normal malnutrition patients postRT in G0 decreased from 4 to 2 and conversely, in G1 it increased from 3 to 6 (P<0.05). In conclusion, patients with head and neck cancer were most malnutritioned, which impacted on clinical outcome. Timely nutritional intervention can effectively prevent weight loss and muscle wasting.Additionally, it may improve quality of life by decreasing the frequency of severe malnutrition.

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A systematic review on the role of fish oil for the treatment of cachexia in advanced cancer: An EPCRC cachexia guidelines project

Cited by 116 publications

References 47 publications

Cancer-associated malnutrition, cachexia and sarcopenia: the skeleton in the hospital closet 40 years later

Cancer-associated malnutrition, cachexia and sarcopenia: the skeleton in the hospital closet 40 years later

Omega-3 polyunsaturated fatty acids and cancer: lessons learned from clinical trials

Effects of nutritional intervention in head and neck cancer patients undergoing radiotherapy: A prospective randomized clinical trial

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