Omega-3 improves treatment response and quality of life in advanced pancreatic cancer patients

Tuesday, August 4, 2015. On July 28, 2015, the Journal of Parenteral and Enteral Nutrition reported the outcome of a study of advanced pancreatic cancer patients which found improved response to chemotherapy and better quality of life with the addition of omega-3 fatty acids.

The study included 50 men and women with locally advanced or metastatic pancreatic adenocarcinoma who had not received prior chemotherapy. Participants received a standard dose of the drug gemcitabine, immediately followed by an intravenous infusion of up to 100 grams of an omega-3 rich lipid emulsion weekly for three weeks followed by one rest week, which was continued for up to six cycles. Computed tomography (CT) scans of the chest, abdomen and pelvis were conducted at the beginning of the study and at every two cycles thereafter. Quality of life and other factors were assessed by patient questionnaires completed weekly.

Stabilized disease or partial treatment response occurred in 30 of the 35 subjects who completed the study. Progression free survival was longer than that which has been observed in association with gemcitabine treatment alone. Among the 36 patients who completed at least four treatments, more than half of the subjects experienced an improvement in pain and disease symptoms. A sustained increase in global health of greater than 10% was observed in 47.2% of the participants, which is a significantly greater percentage of subjects than that which has been associated with gemcitabine in another study.

"This is the first report of the combination of a chemotherapeutic agent and intravenous omega-3 rich lipid emulsion in any cancer setting," announce authors Ali Arshad and colleagues at England's University Hospitals of Leicester. "There was evidence of activity in terms of response and disease stabilization rates and reduction in liver metastasis volume as well as Quality of Life scores in this group of patients . . . Rates of disease control are encouraging compared to existing data."

"We would suggest a phase III randomized controlled trial to assess the independent contribution of omega-3 lipids to this effect," they conclude.

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Study shows how omega-3 inhibits cancer cell growth

An article appearing in the Journal of Pharmacology and Experimental Therapeutics reports the discovery of Washington State University researchers of a mechanism for omega-3 fatty acids in reducing prostate cancer cell growth and metastasis. The findings stand in contrast with a widely publicized study that appeared in the Journal of the National Cancer Institute in 2013 which concluded that men who had higher serum omega-3 fatty acid levels had a greater risk of developing prostate cancer.

It is known that G protein-coupled receptors of the free fatty acid receptor family bind omega-3 fatty acids. The current study determined that activation of the receptor designated free fatty acid receptor 4 (FFA4) by the omega 3 fatty acid eicosapentaenoic acid (EPA) initiated signaling events that inhibit cancer cell proliferation in response to signaling induced by growth factors in human prostate cancer cell lines.

Although the mechanisms of omega 3 fatty acids in diabetes and inflammation have been the subject of research, "We're the first to show that they work this way in cancer," announced lead researcher Kathryn Meier, who is a professor of pharmacy at Washington State University Spokane. "The attention has mostly been on inflammation and diabetes but there has always been an interest in cancer, and we were the first to show this mechanism in any cancer cell at all. And we're using prostate cancer, which is the most controversial subject in omega 3s."

"This kind of knowledge could lead us to better treat or prevent cancer because now we know how it works," she noted.

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Health Concern

Pancreatic cancer

Pancreatic cancer is the fourth leading cause of cancer death in the United States and is responsible for an estimated 270,000 deaths worldwide each year (Ferlay 2010). Multiple factors, including a complex and poorly understood pathophysiology and difficulty in early detection and diagnosis make successful treatment of pancreatic cancer extremely challenging. Pancreatic cancer is typically not detected until it has already reached a locally advanced or metastatic stage due to the relative lack of symptoms in early disease. Current standard of care comprises surgery if the tumor is contained within the pancreas, followed by adjuvant chemotherapy and possibly radiation. However, if the cancer has spread, conventional treatment is limited, and long-term survival rates remain very low.

The rapidly accelerating use of specialized immunotherapies and innovative genetic analysis technology represent the next generation of novel medical treatments for pancreatic cancer. The ability to tailor treatment based upon the unique molecular biology of a patient's cancer promises to considerably improve a currently bleak outlook.

Weight loss in advanced pancreatic cancer patients (catabolic wasting or cachexia) is refractory to conventional nutritional support. However, it is well-established that supplementation with fish oil, rich in omega-3 fatty acids (EPA and DHA), reverses tumor-related weight loss (cachexia). Eicosapentaenoic acid (EPA) modulates the inflammatory response that contributes to weight loss in cancer and thus reverses cancer cachexia (Arshad 2011).

Omega-3 fatty acids, EPA and DHA, prevent pancreatic cancer progression and cause pancreatic tumor cell death by activating p53 (Wendel 2009) and blocking the activity of Ras (Strouch 2011), EGFR (Rogers 2010), COX-2 and 5-LOX (Swamy 2008), STAT3 (Hering 2007), and NF-kB (Ross 2003).

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