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

Abstract

BACKGROUND:

The European Palliative Care Research Collaboration is developing clinical guidelines on cachexia in patients with advanced cancer. A systematic review on the use of fish oil/omega-3-fatty acids (n-3-FA)/eicosapentaenoic acids (EPA) in advanced cancer patients suffering from cancer cachexia was performed as part of the guideline development.

METHODS:

The systematic literature search in Medline on the use of fish oil/n-3-FA/EPA identified 244 papers, with 38 publications included in the final evaluation. Some smaller trials, often unrandomized and without a control group, reported a good effect of n-3-FA in patients with advanced cancer and cachexia. However, the results of the larger randomized controlled trials could not support the positive results, as they mostly did not find a significant effect.

RESULTS:

Adverse effects such as abdominal discomfort, fish belching, fish aftertaste, nausea and diarrhoea were reported with a low incidence. No serious adverse effects were documented, but adverse effects often had an impact on quality of life. This often limited dose escalations or even led to discontinuation of n-3-FA.

CONCLUSION:

There is not enough evidence to support a net benefit of n-3-FA in cachexia in advanced cancer. On the other hand, adverse effects were infrequent, with no severe adverse effects. The results from the review led to a weak negative GRADE recommendation.

• Authors: Anke Ries, Peter Trottenberg, Frank Elsner, Stephanie Stiel, Dagny Haugen, Stein Kaasa, Lukas Radbruch
• Journal: Palliative medicine (Palliat Med) Vol. 26 Issue 4 Pg. 294-304 (Jun 2012) ISSN: 1477-030X [Electronic] England
• PMID: 21865295 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Review, Systematic Review)

Chemical References

• Fatty Acids, Omega-3
• Fish Oils
• Eicosapentaenoic Acid

Topics

• Cachexia (drug therapy)
• Dietary Supplements
• Eicosapentaenoic Acid (adverse effects, therapeutic use)
• Fatty Acids, Omega-3 (adverse effects, therapeutic use)
• Fish Oils (adverse effects, therapeutic use)
• Humans
• Neoplasms (complications)
• Practice Guidelines as Topic