Eicosapentaenoic acid (EPA) is an essential omega-3 fatty acid, distinguished from other long-chain polyunsaturated fatty acids by its specific chemical configuration. Bluefish, swordfish, salmon, and mackerel are rich in EPA. EPA has been studied in anorexia, and omega 3 fatty acid supplementation has been evaluated for its effect in fatigue, peripheral neuropathy, and prevention of infection.
Ghoreishi, Z., Esfahani, A., Djazayeri, A., Djalali, M., Golestan, B., Ayromlou, H., . . . Darabi, M. (2012). Omega-3 fatty acids are protective against paclitaxel-induced peripheral neuropathy: A randomized double-blind placebo controlled trial. BMC Cancer, 12, 355.
Investigate omega 3 fatty acids in reducing the incidence and severity of paclitaxel-induced peripheral neuropathy
Patients were randomly assigned to receive omega 3 fatty acid supplements at a dose of 640 mg three times daily, or an identical gelatin placebo capsule. All patients received the intervention throughout treatment and for one month after chemotherapy treatment. Patients were evaluated prior to chemotherapy and one month after completion of chemotherapy. Evaluations were done by a single neurologist.
PHASE OF CARE: Active antitumor treatment
Double-blind, placebo-controlled, randomized trial
70% of patients receiving omega 3 fatty acid supplements did not develop peripheral neuropathy, compared to 40% in the placebo group (odds ratio = 0.3, .95% CI = 0.10–0.88, p = .029). There was a non-significant trend toward lower severity of symptoms in those receiving omega 3 fatty acids. No significant differences existed between groups in individual nerve conduction study results. Significant differences did exist between groups in serum EPA and DHA concentrations (p < .005) with higher levels in the experimental group. No relationship existed between serum concentrations and peripheral neuropathy scores.
Findings suggest that oral supplementation with omega 3 fatty acids may have a protective effect for development of peripheral neuropathy in patients receiving paclitaxel.
Findings suggest a neuroprotective effect of omega 3 fatty acid supplementation. These are promising results, which warrant further research in well-powered studies and in the context of other types of neurotoxic chemotherapeutic agents.
Sanchez-Lara, K., Turcott, J.G., Juarez-Hernandez, E., Nunez-Valencia, C., Villanueva, G., Guevara, P., . . . Arrieta, O. (2014). Effects of an oral nutritional supplement containing eicosapentaenoic acid on nutritional and clinical outcomes in patients with advanced non-small cell lung cancer: Randomised trial. Clinical Nutrition, 33, 1017–1023.
To determine if a nutritional supplement taken by patients with advanced non-small cell lung cancer receiving paclitaxel with cisplantin/carboplatin chemotherapy can improve body composition, fatigue, health-related quality of life (HRQOL), and overall survival.
The patients were randomized to isocaloric diet or isocaloric diet plus eicosapentaenoic-acid (EPA) supplement ProSure®. Evaluations were conducted at baseline, after the first chemotherapy cycle, and after the second chemotherapy cycle.
PHASE OF CARE: Active antitumor treatment
The ONS-EPA group exhibited significant differences in weight (p = 0.01) and lean body mass (p = 0.01). Significant improvement was also seen in calorie and protein intake (p < 0.001) when the nutritional supplement was included. The ONS-EPA group also exhibited significant improvement in inflammatory markers between time points (p = 0.02 to p = 0.05). In HRQOL, there was significant improvement in global health status between time points for the ONS-EPA group (p = 0.021). Differences were seen between groups in fatigue (p = 0.04), appetite loss (p = 0.05), and neuropathy (p = 0.05)
In this study, ONS-EPA supplementation appears to be effective in improving nutritional status and decreasing side effects (appetite loss) in patients receiving chemotherapy for non-small cell lung cancer.
More studies need to be done with EPA supplementation in this and other cancers.