An Eicosapentaenoic Acid Supplement Versus Megestrol Acetate Versus Both for Patients With Cancer-Associated Wasting: A North Central Cancer Treatment Group and National Cancer Institute of Canada Collaborative Effort

Abstract

This EPA supplement, either alone or in combination with MA, does not improve weight or appetite better than MA alone.

Dietary supplementation with a specific combination of high protein, leucine, and fish oil improves muscle function and daily activity in tumour-bearing cachectic mice

“…It has also been suggested that the increase in catabolic vs anabolic processes contributes to the failure to accumulate lean body mass even when nutritional intake is normal (Argiles, 2005). Clinical data from different cachectic patient groups (Wigmore et al, 1996(Wigmore et al, , 2000Barber et al, 1999Barber et al, , 2001Jatoi et al, 2004) suggest that fish oil might reduce catabolism and weight loss. Fish oil probably not only attenuates the tumour-induced inflammatory response, but also normalises the insulin resistance present in the cachectic state (Wigmore et al, 1996(Wigmore et al, , 2000Barber et al, 1999Barber et al, , 2001Jatoi et al, 2004).…”

“…Clinical data from different cachectic patient groups (Wigmore et al, 1996(Wigmore et al, , 2000Barber et al, 1999Barber et al, , 2001Jatoi et al, 2004) suggest that fish oil might reduce catabolism and weight loss. Fish oil probably not only attenuates the tumour-induced inflammatory response, but also normalises the insulin resistance present in the cachectic state (Wigmore et al, 1996(Wigmore et al, , 2000Barber et al, 1999Barber et al, , 2001Jatoi et al, 2004). Prolongation of survival has been reported in a mixed group of advanced cancer patients supplemented with n-3 fatty acids and vitamin E (Gogos et al, 1998) which might also result from immune-modulation.…”

“…The vast majority of the clinical trials in which fish oil derived n-3 PUFAs were tested report an increase (Wigmore et al, 1996(Wigmore et al, , 2000Barber et al, 1999Barber et al, , 2001Jatoi et al, 2004) or maintenance (Burns et al, 1999(Burns et al, , 2004Fearon et al, 2003) of body weight (BW), whereas in two other clinical trials no effect on the loss of BW was found (Gogos et al, 1998;Bruera et al, 2003). In the latter, however, the supplementation period was only 2 weeks (Bruera et al, 2003) and/or only a small number of patients was included (Gogos et al, 1998).…”

Dietary Supplement Use in Cancer Care: Help or Harm

“…When combined with megase, the conventional treatment for cancerrelated anorexia, no additional benefit was seen by adding 2.18 g of EPA per day [169]. However, combining fish oil (2 g three times a day) with celecoxib (200 mg twice a day) showed significantly greater improvements in appetite, fatigue, body weight, and muscle strength than with fish oil alone in a small group of subjects with advanced lung cancer [167].…”

More Is Better: A Multimodality Approach to Cancer Cachexia

“…Even twoagent combinations have been largely proven to be ineffective. RCTs of dual medical therapy using megestrol with either fish oil [3] or dronabinol [4] showed no gains in weight or appetite compared with progestin monotherapy. A more effective approach might be simultaneous, multifaceted therapy targeting the different mechanisms contributing to cachexia/anorexia syndrome (CAS).…”