A Canadian study has found that a daily fish oil supplement can thwart chemotherapy-induced muscle and weight loss in lung cancer patients. The investigators, from the University of Alberta in Edmonton, said that nutritional intervention with fish oil should ideally be started early and with supplements available in liquid and capsule form.
Rachel A. Murphy, BSc, and colleagues compared the effects of fish oil with standard of care (SOC) on weight, skeletal muscle, and adipose tissue in newly referred lung cancer patients who were receiving first-time chemotherapy. The fish oil group was instructed to take 2.2 g per day of eicosapentaenoic acid (EPA) in a Fish Oil Helps Chemotherapy Patients Maintain Weight and Muscle Mass gelatin capsule or liquid starting on the first day of chemotherapy and continuing throughout the chemotherapy regimen. The SOC group received no intervention.
“The results indicate that supplementation with fish oil ameliorates muscle and adipose tissue wasting in lung cancer patients and provides a benefit over patients treated with SOC receiving first-line chemotherapy,” reported Murphy and associates.
Patients with advanced cancer frequently experience involuntary weight loss because of the disease itself and chemotherapy. As a result, patients are at increased risk of a poor treatment response, functional decline, and shortened survival. While the efficacy of nutritional intervention with fish oil has been widely studied, results have been inconsistent. The lack of agreement may be related to the time the intervention is started, contamination between treatment arms, and the use of indirect measurements of muscle mass.
"Providing patients with a choice of supplement format may be a potential approach to strengthen compliance in future trials.”
–Rachel A. Murphy, BSc
The present analysis included 16 patients who received EPA and 24 patients in the SOC group. All of the study participants were chemotherapy-naïve and had histologically confirmed nonsmall cell lung cancer. Only firsttime chemotherapy users were enrolled in order to maximize the accrual of patients with a better chance of survival. Importantly, computed tomography (CT) imaging was used to measure skeletal mass and adipose tissue. Murphy and team noted that, to their knowledge, the study is the first to use CT images to provide a direct measurement of fish oil’s effect on skeletal muscle and adipose tissue depots.
The fish oil and SOC groups had their blood drawn and anthropometric measurements obtained at baseline and throughout treatment. Patients in the SOC group lost 2.3 ± 0.9 kg, on average, while patients in the fish oil group maintained their weight (0.5 ± 1.0 kg; P
= .05). Individuals with the largest increase in plasma EPA after fish oil supplementation had the largest gains in muscle mass. Also, 69% of patients in the fish oil group maintained or gained muscle versus 29% of patients in the SOC group. Overall, patients in the SOC group lost 1 kg of muscle. Fish oil was well tolerated and produced no serious adverse events.
Most patients in the fish oil group were compliant, which the authors attributed to the availability of EPA in 2 different routes of administration. “Providing patients with a choice of supplement format may be a potential approach to strengthen compliance in future trials,” they reported.
Murphy and colleagues emphasized that the results need to be confirmed in larger randomized studies. Research will also help determine whether fish oil can help patients with other types of cancer and other chronic diseases that cause malnutrition, and whether it can help older patients at increased risk of muscle loss.
Murphy RA, Mourtzakis M, Chu QSC, et al. Nutritional intervention with fish oil provides a benefit over standard of care on weight and skeletal muscle mass in patients with non-small lung cancer receiving chemotherapy [published online ahead of print February 28, 2011]. Cancer. Feb 28. doi:10.1002/cncr.25709.