Cancer cachexia and its treatment with fish-oil-enriched nutritional supplementation

OBJECTIVE: Cachexia is a common condition affecting those with advanced can cer. This review explores mechanisms of cachexia and possible treatments de vised with these mechanisms in mind. METHODS: Selective review of the relevant scientific literature was perform ed with particular emphasis on studies performed by our group over the past 10 y involving patients with advanced pancreatic cancer. RESULTS: Cancer cachexia adversely affects patient quality of life and surv ival. It is characterized by a lack of a normal anabolic response to the pr ovision of apparently adequate nutrition. It appears to result from a persi stent response to illness stimulated by the cancer resulting in a proinflam matory cytokine and catabolic hormonal environment. Interventions that igno re this inflammatory milieu have had little success. More promising interve ntions have a broad antiinflammatory component such as nonsteroidal antiinf lammatory drugs or fish oil. Preliminary studies of a combination of fish o il as an antiinflammatory agent with nutritional supplementation show promi se in reversing weight loss with apparent gains in lean tissue and performa nce status in association with normalization of the metabolic environment i n patients with advanced pancreatic cancer. CONCLUSIONS: Cancer cachexia produces a metabolic environment that prevents the appropriate use of supplied nutrition: Antiinflammatory agents such as fish oil in combination with nutritional supplementation may reverse aspec ts of cachexia. Nutrition 2001;17:751-755. (C) Elsevier Science Inc. 2001.