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

Previous studies have suggested that administration of oral eicosapentaenoi c acid (EPA) will stabilize weight in patients with advanced pancreatic can cer. The aim of the present study was to determine ii a combination of EPA with a conventional oral nutritional supplement could produce weight gain i n these patients. Twenty patients with unresectable pancreatic adenocarcino ma were asked to consume two cans of a fish oil-enriched nutritional supple ment per day in addition to their normal food intake, Each can contained 31 0 kcal, 16.1 g protein and 1.09 g EPA. Patients were assessed for weight, b ody composition, dietary intake, resting energy expenditure (REE) and perfo rmance 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 significa nt 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 sign ificantly. Performance status and appetite were significantly improved at 3 weeks. In contrast to previous studies of oral conventional nutritional su pplements in weight-losing cancer patients, this study suggests that an EPA -enriched supplement may reverse cachexia in advanced pancreatic cancer.