Not surprisingly, conventional nutritional support, whether in the form of oral feeding, enteral feeding or parenteral nutrition, has generally failed to either prolong survival or improve the outcome of conventional anti-neoplastic therapy.
Fish Oil and Eicosapentaenoic Acid
In healthy individuals and in patients with cancer, the production of pro-inflammatory cytokines such as interleukin (IL) 6, IL-1 and tumour necrosis factor (TFN) can be downregulated by omega-3 polyunsaturated fatty acid (FA) and eicosapentaenoic acid (EPA). Furthermore, the effects of proteolysisinducing factor (PIF), a cachectic factor produced by cancer tissue, are also inhibited by EPA.
In 1996, Wigmore et al. evaluated the effects of EPA in 18 patients with cachexia due to unresectable pancreatic cancer.2 The patients received approximately 12g of fish oil per day (2g of EPA per day) over a period of three months. This was associated with the arrest of cachexia in the majority of patients, with a small proportion of patients actually gaining weight. These findings contrast markedly with the natural history of pancreatic cancer in which patients progressively lose weight.