Fish oil (EPA) for cancer weight loss
Fish oil rich in EPA was expected to slow cancer-related muscle wasting by damping inflammation. Randomised trials and a Cochrane review found no convincing effect on weight or survival, though fish oil is safe and sits comfortably inside general nutritional support.
Overview
Eicosapentaenoic acid (EPA) inhibits the inflammatory cascade (IL-6, TNF, proteolysis-inducing factor) implicated in cancer cachexia, and early uncontrolled studies in pancreatic cancer were encouraging. A 2007 Cochrane review of randomised trials found insufficient evidence that oral EPA improves weight, lean mass, quality of life or survival compared with placebo or standard nutritional support; the largest trials showed no benefit. Adherence to the fishy supplements is poor in anorexic patients. EPA-enriched oral nutritional supplements remain an option within dietitian-led nutrition therapy, and ESPEN guidance considers them for patients on chemotherapy at risk of weight loss, but they are not a treatment for established cachexia, for which multimodal programmes and new drugs such as GDF-15 blockade are being tested.
How it works
EPA competes with arachidonic acid, reducing pro-inflammatory eicosanoids and cytokine-driven muscle proteolysis; the effect in patients is too small to change body weight.
- Safe, well tolerated at usual doses
- Reasonable component of nutritional support
- No effect on weight or survival in Cochrane review
- Poor adherence
- Trials heterogeneous
Latest papers
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