The effect of an oral nutritional supplement enriched with fish oil on weight-loss in patients with pancreatic cancer

Abstract

Previous studies have suggested that administration of oral eicosapentaenoic acid (EPA) will stabilize weight in patients with advanced pancreatic cancer. The aim of the present study was to determine if a combination of EPA with a conventional oral nutritional supplement could produce weight gain in these patients. Twenty patients with unresectable pancreatic adenocarcinoma were asked to consume two cans of a fish oil-enriched nutritional supplement per day in addition to their normal food intake. Each can contained 310 kcal, 16.1 g protein and 1.09 g EPA. Patients were assessed for weight, body composition, dietary intake, resting energy expenditure (REE) and performance status. Patients consumed a median of 1.9 cans day(-1). All patients were losing weight at baseline at a median rate of 2.9 kg month(-1). After administration of the fish oil-enriched supplement, patients had significant weight-gain at both 3 (median 1 kg, P= 0.024) and 7 weeks (median 2 kg, P = 0.033). Dietary intake increased significantly by almost 400 kcal day(-1) (P = 0.002). REE per kg body weight and per kg lean body mass fell significantly. Performance status and appetite were significantly improved at 3 weeks. In contrast to previous studies of oral conventional nutritional supplements in weight-losing cancer patients, this study suggests that an EPA-enriched supplement may reverse cachexia in advanced pancreatic cancer.

References 25

1. 1.

   Ahlgren J. D. Epidemiology and risk factors in pancreatic cancer. Semin Oncol. 1996;23(2):241-250.

   Not in our library

2. 2.

   Beck S. A., Smith K. L., Tisdale M. J. Anticachectic and antitumor effect of eicosapentaenoic acid and its effect on protein turnover. Cancer Res. 1991;51(22):6089-6093.

   Not in our library

3. 3.

   Cohn S. H., Vartsky D., Vaswani A. N., Sawitsky A., Rai K., Gartenhaus W., Yasumura S., Ellis K. J. Changes in body composition of cancer patients following combined nutritional support. Nutr Cancer. 1982;4(2):107-119.

   Not in our library10.1080/01635588209513746

4. 4.

   Dewys W. D., Begg C., Lavin P. T., Band P. R., Bennett J. M., Bertino J. R., Cohen M. H., Douglass H. O., Engstrom P. F., Ezdinli E. Z. Prognostic effect of weight loss prior to chemotherapy in cancer patients. Eastern Cooperative Oncology Group. Am J Med. 1980;69(4):491-497.

   Not in our library10.1016/s0149-2918(05)80001-3

5. 5.

   Evans W. K., Nixon D. W., Daly J. M., Ellenberg S. S., Gardner L., Wolfe E., Shepherd F. A., Feld R., Gralla R., Fine S. A randomized study of oral nutritional support versus ad lib nutritional intake during chemotherapy for advanced colorectal and non-small-cell lung cancer. J Clin Oncol. 1987;5(1):113-124.

   Not in our library10.1200/jco.1987.5.1.113

6. 6.

   Falconer J. S., Fearon K. C., Plester C. E., Ross J. A., Carter D. C. Cytokines, the acute-phase response, and resting energy expenditure in cachectic patients with pancreatic cancer. Ann Surg. 1994;219(4):325-331.

   Not in our library10.1097/00000658-199404000-00001

7. 7.

   Falconer J. S., Fearon K. C., Ross J. A., Elton R., Wigmore S. J., Garden O. J., Carter D. C. Acute-phase protein response and survival duration of patients with pancreatic cancer. Cancer. 1995;75(8):2077-2082.

   Not in our library10.1002/1097-0142(19950415)75:8<2077::aid-cncr2820750808>3.0.co;2-9

8. 8.

   Falconer J. S., Ross J. A., Fearon K. C., Hawkins R. A., O'Riordain M. G., Carter D. C. Effect of eicosapentaenoic acid and other fatty acids on the growth in vitro of human pancreatic cancer cell lines. Br J Cancer. 1994;69(5):826-832.

   Not in our library10.1038/bjc.1994.161

9. 9.

   Fearon K. C., Falconer J. S., Ross J. A., Carter D. C., Hunter J. O., Reynolds P. D., Tuffnell Q. An open-label phase I/II dose escalation study of the treatment of pancreatic cancer using lithium gammalinolenate. Anticancer Res. 1996;16(2):867-874.

   Not in our library

10. 10.

    Gogos C. A., Ginopoulos P., Salsa B., Apostolidou E., Zoumbos N. C., Kalfarentzos F. Dietary omega-3 polyunsaturated fatty acids plus vitamin E restore immunodeficiency and prolong survival for severely ill patients with generalized malignancy: a randomized control trial. Cancer. 1998;82(2):395-402.

    Not in our library10.1002/(sici)1097-0142(19980115)82:2<403::aid-cncr21>3.0.co;2-1

11. 11.

    Hannan W. J., Cowen S. J., Plester C. E., Fearon K. C., deBeau A. Comparison of bio-impedance spectroscopy and multi-frequency bio-impedance analysis for the assessment of extracellular and total body water in surgical patients. Clin Sci (Lond). 1995;89(6):651-658.

    Not in our library10.1042/cs0890651

12. 12.

    Heinrich P. C., Castell J. V., Andus T. Interleukin-6 and the acute phase response. Biochem J. 1990;265(3):621-636.

    Not in our library10.1042/bj2650621

13. 13.

    Lai P. B., Ross J. A., Fearon K. C., Anderson J. D., Carter D. C. Cell cycle arrest and induction of apoptosis in pancreatic cancer cells exposed to eicosapentaenoic acid in vitro. Br J Cancer. 1996;74(9):1375-1383.

    Not in our library10.1038/bjc.1996.552

14. 14.

    Leaf A., Weber P. C. Cardiovascular effects of n-3 fatty acids. N Engl J Med. 1988;318(9):549-557.

    Not in our library10.1056/nejm198803033180905

15. 15.

    McMillan D. C., O'Gorman P., Fearon K. C., McArdle C. S. A pilot study of megestrol acetate and ibuprofen in the treatment of cachexia in gastrointestinal cancer patients. Br J Cancer. 1997;76(6):788-790.

    Not in our library10.1038/bjc.1997.463

16. 16.

    Meydani S. N., Lichtenstein A. H., Cornwall S., Meydani M., Goldin B. R., Rasmussen H., Dinarello C. A., Schaefer E. J. Immunologic effects of national cholesterol education panel step-2 diets with and without fish-derived N-3 fatty acid enrichment. J Clin Invest. 1993;92(1):105-113.

    Not in our library10.1172/jci116537

17. 17.

    Moldawer L. L., Copeland E. M. Proinflammatory cytokines, nutritional support, and the cachexia syndrome: interactions and therapeutic options. Cancer. 1997;79(9):1828-1839.

    Not in our library

18. 18.

    Ovesen L., Allingstrup L., Hannibal J., Mortensen E. L., Hansen O. P. Effect of dietary counseling on food intake, body weight, response rate, survival, and quality of life in cancer patients undergoing chemotherapy: a prospective, randomized study. J Clin Oncol. 1993;11(10):2043-2049.

    Not in our library10.1200/jco.1993.11.10.2043

19. 19.

    Ovesen L., Hannibal J., Mortensen E. L. The interrelationship of weight loss, dietary intake, and quality of life in ambulatory patients with cancer of the lung, breast, and ovary. Nutr Cancer. 1993;19(2):159-167.

    Not in our library10.1080/01635589309514246

20. 20.

    Perez M. M., Newcomer A. D., Moertel C. G., Go V. L., Dimagno E. P. Assessment of weight loss, food intake, fat metabolism, malabsorption, and treatment of pancreatic insufficiency in pancreatic cancer. Cancer. 1983;52(2):346-352.

    Not in our library10.1002/1097-0142(19830715)52:2<346::aid-cncr2820520228>3.0.co;2-z

21. 21.

    Simons J. P., Aaronson N. K., Vansteenkiste J. F., ten Velde G. P., Muller M. J., Drenth B. M., Erdkamp F. L., Cobben E. G., Schoon E. J., Smeets J. B. Effects of medroxyprogesterone acetate on appetite, weight, and quality of life in advanced-stage non-hormone-sensitive cancer: a placebo-controlled multicenter study. J Clin Oncol. 1996;14(4):1077-1084.

    Not in our library10.1200/jco.1996.14.4.1077

22. 22.

    Todorov P., Cariuk P., McDevitt T., Coles B., Fearon K., Tisdale M. Characterization of a cancer cachectic factor. Nature. 1996;379(6567):739-742.

    Not in our library10.1038/379739a0

23. 23.

    Wigmore S. J., Fearon K. C., Maingay J. P., Ross J. A. Down-regulation of the acute-phase response in patients with pancreatic cancer cachexia receiving oral eicosapentaenoic acid is mediated via suppression of interleukin-6. Clin Sci (Lond). 1997;92(2):215-221.

    Not in our library10.1042/cs0920215

24. 24.
    Changes in nutritional status associated with unresectable pancreatic cancer · 1997

    No notice
25. 25.

    Wigmore S. J., Plester C. E., Ross J. A., Fearon K. C. Contribution of anorexia and hypermetabolism to weight loss in anicteric patients with pancreatic cancer. Br J Surg. 1997;84(2):196-197.

    Not in our library

Cited by papers we hold 5

• Cancer Cachexia: Mechanisms and Clinical Implications · 2011
  No notice
• Growth of human gastric cancer cells in nude mice is delayed by a ketogenic diet supplemented with omega-3 fatty acids and medium-chain triglycerides · 2008
  No notice
• Induction of proteasome expression in skeletal muscle is attenuated by inhibitors of NF-κB activation · 2004
  No notice
• Reduced total energy expenditure and physical activity in cachectic patients with pancreatic cancer can be modulated by an energy and protein dense oral supplement enriched with n-3 fatty acids · 2004
  No notice
• Nutrition intervention is beneficial in oncology outpatients receiving radiotherapy to the gastrointestinal or head and neck area · 2004
  No notice

Reads

A person counts once a day per paper. We keep no cookie and no address: a reader is a hash that changes every day. Any month under five reads shows no number.