BARCELONA, SPAIN. Chemotherapy is associated with weight loss and decreased health-related quality of life (HRQOL). Spanish physicians report that providing patients undergoing chemotherapy with a nutritional supplement containing EPA (eicosapentaenoic acid), a main component of fish oil, is effective in preventing weight loss and deterioration of HRQOL. Their clinical trial included 11 patients with advanced (stage IV) colorectal cancer (CRC) who were going to receive chemotherapy (5-Fluorouracil + Oxaliplatin + Folinic acid or Capecitabine). The group was divided in half with 6 patients receiving standard nutritional counselling and 5 receiving standard nutritional counselling as well as a supplement containing 16 g protein, 6.1 g fat and 1 g EPA plus antioxidants. On average, the supplement group received 1.6 g/day of EPA. Height, weight and HRQOL were measured at baseline and after 12 weeks of treatment.
Although the sample size (11 patients) was too small to produce statistically significant differences between the two groups as far as overall HRQOL is concerned, there was a clear statistically significant difference in weight loss/gain between the two groups, with the supplement group gaining an average of 5 kg over the 12-week period as compared to an average loss of 1 kg in the control group. Both groups experienced a loss in physical functioning, but the loss was substantially greater in the control group. As far as social functioning is concerned, the supplement group experienced an average gain of 17 points, while the control group lost 14 points (on the GHS/QoL scale). Finally, the control group also experienced more fatigue and pain than did the supplement group and, while 4 of the 6 control patients experienced interruption in their chemotherapy schedule (due to toxicity) none of the patients in the supplement group did.
The researchers conclude that supplementation with EPA plus dietary counselling had a positive effect on weight maintenance, HRQOL and chemotherapy tolerability in advanced CRC patients. They recommend larger, randomized trials to confirm their findings.
Trabal, J, et al. Potential usefulness of an EPA-enriched nutritional supplement on chemotherapy tolerability in cancer patients without overt malnutrition. Nutricion Hospitalaria, Vol. 25, No. 5, September-October 2010, pp. 736- 40