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The effect of an oral nutritional supplement enriched with fish oil on weight-loss in patients with pancreatic cancer
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  • Published: 13 August 1999

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

  • M D Barber1,
  • J A Ross1,
  • A C Voss2,
  • M J Tisdale3 &
  • …
  • K C H Fearon1 

British Journal of Cancer volume 81, pages 80–86 (1999)Cite this article

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Summary

Previous studies have suggested that administration of oral eicosapentaenoic acid (EPA) will stabilize weight in patients with advanced pancreatic cancer. The aim of the present study was to determine if a combination of EPA with a conventional oral nutritional supplement could produce weight gain in these patients. Twenty patients with unresectable pancreatic adenocarcinoma were asked to consume two cans of a fish oil-enriched nutritional supplement per day in addition to their normal food intake. Each can contained 310 kcal, 16.1 g protein and 1.09 g EPA. Patients were assessed for weight, body composition, dietary intake, resting energy expenditure (REE) and performance 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 significant 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 significantly. Performance status and appetite were significantly improved at 3 weeks. In contrast to previous studies of oral conventional nutritional supplements in weight-losing cancer patients, this study suggests that an EPA-enriched supplement may reverse cachexia in advanced pancreatic cancer.

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  • 16 November 2011

    This paper was modified 12 months after initial publication to switch to Creative Commons licence terms, as noted at publication

References

  • Ahlgren, JD (1996). Epidemiology and risk factors in pancreatic cancer. Semin Oncol 23: 241–250.

    CAS  PubMed  Google Scholar 

  • Barber, MD, Wigmore, SJ, Ross, JA & Fearon, KCH (1997). Eicosapentaenoic acid attenuates cachexia associated with advanced pancreatic cancer. Prostaglandins Leukot Essent Fatty Acids 57: 204

    Google Scholar 

  • Beck, SA, Smith, KL & Tisdale, MJ (1991). Anticachectic and antitumour effect of eicosapentaenoic acid and its effect on protein turnover. Cancer Res 51: 6089–6093.

    CAS  PubMed  Google Scholar 

  • Cohn, SH, Vartsky, D, Vaswani, AN, Sawitsky, A, Rai, K, Gartenhaus, W, Yasumura, S & Ellis, KJ (1982). Changes in body composition of cancer patients following combined nutritional support. Nutr Cancer 4: 107–119.

    Article  CAS  Google Scholar 

  • DeWys, WD, Begg, C, Lavin, PT, Band, PR, Bennett, JM, Bertino, JR, Cohen, MH, Douglass, HO, Engstrom, PF, Ezdinli, EZ, Horton, J, Johnson, GJ, Moertel, CG, Oken, MM, Perlia, C, Rosenbaum, C, Silverstein, MN, Skeel, RT, Sponzo, RW & Tormey, DC (1980). Prognostic effect of weight loss prior to chemotherapy in cancer patients. Am J Med 69: 491–497.

    Article  CAS  Google Scholar 

  • Evans, WK, Nixon, DW, Daly, JM, Ellenberg, SS, Gardner, L, Wolfe, E, Shepherd, FA, Feld, R, Gralla, R, Fine, S, Kemeny, N, Jeejeebhoy, KN, Heymsfield, S & Hoffman, FA (1987). A randomised trial of oral nutritional support versus ad lib nutritional intake during chemotherapy for advanced colorectal and non-small-cell lung cancer. J Clin Oncol 5: 113–124.

    Article  CAS  Google Scholar 

  • Falconer, JS, Fearon, KCH, Plester, CE, Ross, JA & Carter, DC (1994a). Cytokines, the acute-phase response, and resting energy expenditure in cachectic patients with pancreatic cancer. Ann Surg 219: 325–331.

    Article  CAS  Google Scholar 

  • Falconer, JS, Ross, JA, Fearon, KCH, Hawkins, RA, O’Riordain, MG & Carter, DC (1994b). Effect of eicosapentaenoic acid and other fatty acids on the growth in vitro of human pancreatic cancer cell lines. Br J Cancer 69: 826–832.

    Article  CAS  Google Scholar 

  • Falconer, JS, Fearon, KCH, Ross, JA, Elton, R, Wigmore, SJ, Garden, OJ & Carter, DC (1995). Acute-phase protein response and survival duration of patients with pancreatic cancer. Cancer 75: 2077–2082.

    Article  CAS  Google Scholar 

  • Fearon, KCH, Falconer, JS, Ross, JA, Carter, DC, Hunter, JO, Reynolds, PD & Tuffnell, Q (1996). An open-label phase I/II dose escalation study of the treatment of pancreatic cancer using lithium gammalinolenate. Anticancer Res 16: 867–874.

    CAS  PubMed  Google Scholar 

  • Gogos, CA, Ginopoulos, P, Salsa, B, Apostolidou, E, Zoumbos, NC & Kalfarentzos, F (1998). Dietary omega-3 polyunsaturated fatty acids plus vitamin E restore immunodeficiency and prolong survival for severely ill patients with generalised malignancy. A randomised controlled trial. Cancer 82: 395–402.

    Article  CAS  Google Scholar 

  • Hannan, WJ, Cowan, SJ, Plester, CE, Fearon, KCH & DeBeaux, A (1995). Comparison of bio-impedence spectroscopy and multi-frequency bio-impedence analysis for the assessment of extracellular and total body water in surgical patients. Clin Sci 89: 651–658.

    Article  CAS  Google Scholar 

  • Heinrich, PC, Castell, JV & Andus, T (1990). Interleukin-6 and the acute phase response. Biochem J 265: 621–636.

    Article  CAS  Google Scholar 

  • Jelliffe, DB (1966). The assessment of the nutritional status of the community. WHO Monograph 53. WHO: Geneva

  • Jensen, MB, Hermann, AP, Hessov, I & Mosekilde, L (1997). Components of variance when assessing the reproducibility of body composition measurements using bio-impedence and the Hologic QDR-2000 DXA scanner. Clin Nutr 16: 61–65.

    Article  CAS  Google Scholar 

  • Lai, PBS, Ross, JA, Fearon, KCH, Anderson, JD & Carter, DC (1996). Cell cycle arrest and induction of apoptosis in pancreatic cancer cells exposed to eicosapentaenoic acid in vitro. Br J Cancer 74: 1375–1383.

    Article  CAS  Google Scholar 

  • Leaf, A & Weber, PC (1988). Cardiovascular effects of n-3 fatty acids. N Engl J Med 318: 549–557.

    Article  CAS  Google Scholar 

  • Loprinzi, CL, Schaid, DJ, Dose, AM, Burnham, NL & Jensen, MD (1993). Body-composition changes in patients who gain weight while receiving megestrol acetate. J Clin Onc 11: 152–154.

    Article  CAS  Google Scholar 

  • McMillan, DC, O’Gorman, P, Fearon, KCH & McArdle, CS (1997). A pilot study of megestrol acetate and ibuprofen in the treatment of cachexia in gastrointestinal cancer patients. Br J Cancer 76: 788–790.

    Article  CAS  Google Scholar 

  • McNamara, MJ, Alexander, HR & Norton, JA (1992). Cytokines and their role in the pathophysiology of cancer cachexia. JPEN J Parenter Enteral Nutr 16, suppl 50S–55S.

    Article  CAS  Google Scholar 

  • Meydani, SN, Lichtenstein, AH, Cornwall, S, Meydani, M, Goldin, BR, Rasmussen, H, Dinarello, CA & Schaefer, EJ (1993). Immunological effects of National Cholesterol Education Panel Step-2 diets with and without fish-derived n-3 fatty acid enrichment. J Clin Invest 92: 105–113.

    Article  CAS  Google Scholar 

  • Moldawer, LL & Copeland, EM (1997). Proinflammatory cytokines, nutritional support, and the cachexia syndrome. Interactions and therapeutic options. Cancer 79: 1828–1839.

    Article  CAS  Google Scholar 

  • Ovesen, L, Hannibal, J & Mortensen, EL (1993a). The interrelationship of weight loss, dietary intake, and quality of life in ambulatory patients with cancer of the lung, breast, and ovary. Nutr Cancer 19: 159–167.

    Article  CAS  Google Scholar 

  • Ovesen, L, Allingstrup, L, Hannibal, J & Mortensen EL Hansen, OP (1993b). Effect of dietary counseling on food intake, body weight, response rate, survival, and quality of life in cancer patients undergoing chemotherapy: a prospective, randomised study. J Clin Oncol 11: 2043–2049.

    Article  CAS  Google Scholar 

  • Perez, MM, Newcomer, AD, Moertel, CG, Go, VLW & DiMagno, EP (1990). Assessment of weight loss, food intake, fat metabolism, malabsorption, and treatment of pancreatic insufficiency in pancreatic cancer. Cancer 52: 346–352.

    Article  Google Scholar 

  • Shizgal, HM (1990). Validation of the measurement of body composition from whole body bioelectric impedence. Infusionstherapie 17 suppl 3, 67–74.

    PubMed  Google Scholar 

  • Simons, JPFHA, Aaronson, NK, Vansteenkiste, JF, ten Velde, GPM, Muller, MJ, Drenth, BM, Erdkamp, FLG, Cobben, EGM, Schoon, EJ, Smeets, JBE, Schouten, HC, Demedts, M, Hillen, HFP, Blijham, GH & Wouters, EFM (1996). Effects of medroxyprogesterone acetate on appetite, weight, and quality of life in advanced-stage non-hormone-sensitive cancer: A placebo-controlled multicenter study. J Clin Oncol 14: 1077–1084.

    Article  CAS  Google Scholar 

  • Simons, JPFHA, Schols, AMWJ, Hoefnagels, JMJ, Westerterp, KR, JF ten Velde, GPM & Wouters, EFM (1998). Effects of medroxyprogesterone acetate on food intake, body composition, and resting energy expenditure in patients with advanced nonhormone-sensitive cancer. Cancer 82: 553–560.

    Article  CAS  Google Scholar 

  • Tisdale, MJ (1996). Inhibition of lipolysis and muscle protein degradation by EPA in cancer cachexia. Nutrition 12: S31–33.

    Article  CAS  Google Scholar 

  • Todorov, P, Cariuk, P, McDevitt, T, Coles, B, Fearon, K & Tisdale, M (1996). Characterisation of a cancer cachectic factor. Nature 379: 739–742.

    Article  CAS  Google Scholar 

  • Wigmore, SJ, Ross, JA, Falconer, JS, Plester, CE, Tisdale, MJ, Carter, DC & Fearon, KCH (1996). The effect of polyunsaturated fatty acids on the progress of cachexia in patients with pancreatic cancer. Nutrition 12: S27–S30.

    Article  CAS  Google Scholar 

  • Wigmore, SJ, Plester, CE, Richardson, RA & Fearon, KCH (1997a). Changes in nutritional status associated with unresectable pancreatic cancer. Br J Cancer 75: 106–109.

    Article  CAS  Google Scholar 

  • Wigmore, SJ, Plester, CE, Ross, JA & Fearon, KCH (1997b). Contribution of anorexia and hypermetabolism to weight loss in anicteric patients with pancreatic cancer. Br J Surg 84: 196–197.

    Article  CAS  Google Scholar 

  • Wigmore, SJ, Fearon, KCH, Maingay, JP & Ross, JA (1997c). Down-regulation of the acute-phase response in patients with pancreatic cancer cachexia receiving oral eicosapentaenoic acid is mediated via suppression of interleukin-6. Clin Sci 92: 215–221.

    Article  CAS  Google Scholar 

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Author information

Authors and Affiliations

  1. University Department of Surgery, Royal Infirmary of Edinburgh, Edinburgh, EH8 9JA, UK

    M D Barber, J A Ross & K C H Fearon

  2. Ross Products Division, Abbot Laboratories, 625 Cleveland Avenue, Columbus, Ohio, 43215-1724, USA

    A C Voss

  3. Department of Pharmaceutical Sciences, Aston University, Birmingham, B4 7ET, UK

    M J Tisdale

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  2. J A Ross
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  3. A C Voss
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  4. M J Tisdale
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  5. K C H Fearon
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From twelve months after its original publication, this work is licensed under the Creative Commons Attribution-NonCommercial-Share Alike 3.0 Unported License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-sa/3.0/

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Barber, M., Ross, J., Voss, A. et al. The effect of an oral nutritional supplement enriched with fish oil on weight-loss in patients with pancreatic cancer. Br J Cancer 81, 80–86 (1999). https://doi.org/10.1038/sj.bjc.6690654

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  • Received: 03 September 1998

  • Revised: 11 February 1999

  • Accepted: 12 April 1999

  • Published: 13 August 1999

  • Issue date: 01 September 1999

  • DOI: https://doi.org/10.1038/sj.bjc.6690654

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Keywords

  • pancreatic cancer
  • cachexia
  • eicosapentaenoic acid
  • docosahexaenoic acid
  • fish oil
  • nutritional supplementation

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