Eicosapentanoic Acid The polyunsaturated fatty acid, eicosapentanoic acid (EPA), has been widely studied in animals and has demonstrated inhibition of lipolysis and muscle protein degradation associated with a cachexia model.7,58,87,88 It countered the metabolic actions of LMF and PIF by interfering with their second-messenger production (cyclic AMP and arachidonic acid, respectively), and resulted in a reversal of tumor-induced cachexia without changes in food intake in animal models.58,116,117 In a recent open label study conducted with pancreatic cancer patients, a supplement of fish oil capsules [18% EPA + 12% DHA (docosahexaenoic acid), 12 tablets per day taken orally] was investigated for three months. Patients showed decreased fatigue and a low body weight gain, as well as a reduction of acute-phase protein while taking the capsules.118 The reduction of acute-phase response (C-reactive protein) was also related to the suppression of IL-6 production.119 The effect appeared to be specific to the fish-oil supplement because it was not observed in patients receiving another polyunsaturated fatty acid, g-linolenic acid.58,118 Although nutritional supplementation alone cannot attenuate the development of weight loss in cachectic patients, the inclusion of EPA significantly increased weight gain and lean body mass, leading to an improvement in performance status.120 In a randomized, controlled study, patients with advanced cancer who received a mixed fish-oil preparation showed increased survival relative to patients who received placebo. This improvement was observed in both weight-losing and non-weight-losing subgroups of patients.121 Applicable References: 7. Davis MP, Dickerson D. Cachexia and anorexia: Cancer’s covert killer. Support Care Cancer 2000;8:180-187. 58. Tisdale MJ. Cancer anorexia and cachexia. Nutrition 2001;17:438-442. 87. Gagnon B, Bruera E. A review of the drug treatment of cachexia associated with cancer. Drugs 1998;55:675-688. 88. Argiles JM, Meijsing SH, Pallares-Trujillo J, et al. Cancer cachexia: A therapeutic approach. Med Res Rev 2001;21:83-101. 116. Beck SA, Smith KL, Tisdale MJ. Anticachectic and antitumor effect of eicosapentaenoic acid and its effect on protein turnover. Cancer Res 1991;51:6089-6093. 117. Tisdale MJ. Inhibition of lipolysis and muscle protein degradation by EPA in cancer cachexia. Nutrition 1996;12:31-33. 118. Wigmore SJ, Ross JA, Falconer JS, et al. The effect of polyunsaturated fatty acids on the progress of cachexia in patients with pancreatic cancer. Nutrition 1996;12:27-30. 119. Wigmore SJ, Fearon KC, Maingay JP, et al. 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 1997;92:215-221. 120. Barber MD, Ross JA, Voss AC, et al. The effect of an oral nutritional supplement enriched with fish oil on weight-loss in patients with pancreatic cancer. Br J Cancer 1999;81:80-86. 121. Gogos CA, Ginopoulos P, Salsa B, et al. 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;82:395-402. Response Letter from E. Bruera, M.D. MD Anderson Br J Cancer, 6/04 Remember we are NOT Doctors and have NO medical training. This site is like an Encylopedia - there are many pages, many links on many topics. Support our work with any size DONATION - see left side of any page - for how to donate. You can help raise awareness of CAM.