
| Summaries of the latest research concerning fish oils and cancer |
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EPA improves cancer 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.
Fish oils may help prevent esophageal cancer Research has shown that colon cancer is associated with an increased expression of the COX-2 enzyme in the colon and that fish oil can reduce both the COX-2 level and the risk of colon cancer. There is also evidence that the COX-2 enzyme is upregulated in Barrett's esophagus and esophageal cancer. British researchers therefore reasoned that fish oil supplementation might also be beneficial in BE and thus, indirectly, lower the risk of esophageal cancer. Their clinical trial involved 46 patients with previously diagnosed BE. Twenty-seven of them were assigned to receive 3 EPA (eicosapentaenoic acid) capsules daily providing a total EPA intake of 1.5 grams a day with the remaining 19 patients serving as controls. Before the start of supplementation and at the end of the 6-month trial period, all participants underwent endoscopy during which appropriate biopsy samples were obtained. Analysis of the samples showed a significantly increased concentration of EPA and a significantly decreased level of COX-2 proteins in BE tissue in the supplement group, but not in the control group.
The researchers conclude that regular supplementation with relatively small doses of EPA results in significant
incorporation of metabolically active long-chain amoega-3 fatty acids into BE tissue and a concomitant, beneficial
decrease in COX-2.
Fatty fish reduces risk of kidney cancer in women
The authors comment that these results support the hypothesis that the lower risk of kidney cancer is possibly due to the increased intake of fish oil rich in the two marine omega-3 polyunsaturated fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) as well as vitamin D. They discuss the evidence for the biological plausibility of this hypothesis. The authors also point out that an explanation for the null results from earlier studies of the influence of fish consumption of cancer may have been the failure to distinguish fatty from not-fatty fish intake. As regards vitamin D, they discuss studies that found a connection between kidney cancer and vitamin D deficiency as measured by serum marker levels. This epidemiologic study, according to the authors, is the first to address this dietary association.
Fish oils in cancer prevention Researchers at Sweden’s famous Karolinska Institutet have just published a comprehensive review of the current knowledge regarding the role of PUFAs in carcinogenesis. They conclude that omega-3 PUFAs are protective against cancer progression, while omega-6 PUFAs, notably arachidonic acid and its derivatives, help promote the growth of cancer. They believe the n-3 PUFAs exert their beneficial effects in several different ways:
Free radicals and reactive oxygen species produced in cells may attack PUFAs resulting in the formation
of
more free radicals, specifically hydroperoxides. The hydroperoxides, in turn, may damage DNA ultimately
leading to cancer. These effects have indeed been observed in some in vitro experiments, but not
in
actual human beings. Many studies have shown that fish oils actually retard aging and suppress so-
called free
radical diseases such as atherosclerosis and cancer. Other studies have shown that a daily EPA + DHA
intake
in excess of 2.3 grams decreases the production of superoxide, a potent cancer promoter.
At least one in vitro and one animal experiment have observed that EPA + DHA kill human breast
cancer
cells via the formation of hydroperoxides, but that this effect is strongly inhibited by vitamin E. Thus, at
this point,
it is not entirely clear whether EPA + DHA exert part of their beneficial effect through an increase or a
decrease
in the production of free radicals and reactive oxygen species. The researchers recommend more work
in this
area, but emphasize that the major benefits of fish oils probably are associated with their ability to inhibit
the
synthesis of arachidonic acid-derived, pro-inflammatory eicosanoids. The Swedish researchers also
confirm that
fatty, cold-water fish are the best sources of EPA and DHA and that the conversion rate of alpha-linolenic
acid
(flaxseed oil) to EPA is very low, even in healthy humans – probably in the order of 2-5%. Editor’s comment: There would appear to be a growing body of evidence to the effect that long- chain omega-3 fatty acids, in particular EPA and DHA, help prevent the promotion and progression of certain cancers, notably hormone-dependent ones. Some of the mechanisms involved in this protective effect are well understood. While others, notably the role of free-radical formation, clearly need more work. Of some concern is the uncertainty surrounding vitamin E. Both vitamin E and fish oils have been found to help prevent hormone- dependent cancers, so taking both for cancer prevention is probably desirable. The situation is much less clear when it comes to slowing down an existing cancer and preventing it from spreading. Should one just rely on vitamin E (particularly the succinate form) or place one’s faith in fish oils, or is the combination of the two the best way to go? Clearly more research in this area is urgently required.
Fish consumption reduces lung cancer risk
Fish oils and the immune system
Their clinical trial involved 48 men and women aged 55 to 75 years. The participants were randomized to
receive one of six supplements for 12 weeks. The supplements were all provided in the form of capsules,
three of which were to be taken with each meal. The nine capsules (daily intake) contained either a total
of 2 g alpha-linolenic acid, 770 mg gamma-linolenic acid (from evening primrose oil), 680 mg arachidonic
acid, 720 mg docosahexaenoic acid (DHA), 720 mg eicosapentaenoic acid (EPA)+ 280 mg DHA (fish oil)
or a placebo (an 80:20 mix of palm and sunflower oils). All the participants had blood samples taken four
weeks before start of supplementation, immediately before start of supplementation, and then every four
weeks during the trial as well as after a four-week washout period. The researchers found no changes in
killer cell activity except in the group taking fish oil. Here they observed an average decline of 20 per cent
after 8 weeks and 48 per cent after 12 weeks. The decline was completely reversed after the washout
period. The fact that no decline was observed with pure DHA strongly suggests that EPA was
responsible. The researchers conclude that an excessive EPA intake could have adverse effects for
people at risk of viral infections and some cancers. Editor’s Note: The British researchers’
speculation about fish oils perhaps affecting the effectiveness of NK cells in killing cancer cells is at odds
with the results of many other studies. There are at least a dozen studies that show a clear protective
effect of fish or fish oil against breast, colon, and prostate cancer. NOTE: This study was partly funded by
Unilever. [54 references]
Docosahexaenoic acid halts melanoma VALHALLA, NEW YORK. The incidence of cutaneous malignant melanoma is growing rapidly among persons with fair skin. It is estimated that one in 75 Americans will develop melanoma within their lifetime. Melanoma has a pronounced tendency to spread to other organs (metastasis) and the 5-year survival rate for metastatic melanoma is less than 10%. There is growing evidence that diet can influence the risk of developing melanoma. It is now believed that a high intake of omega-6 fatty acids stimulates the growth of melanoma and other cancers whereas omega-3 fatty acids suppress the growth of cancer cells.
Researchers at the New York Medical College and the American Health Foundation have just released
the results of a laboratory experiment which clearly shows that docosahexaenoic acid (DHA), a main
component of fish oil, is highly effective in inhibiting the growth of human melanoma cells. The
researchers treated 12 different human metastatic melanoma cell cultures (in vitro) with DHA and found
that more than 50% of them stopped growing. They urge further testing of their findings in full-scale
clinical trials involving patients with melanoma. They conclude that “if DHA is capable of suppressing cell
and tumor growth and metastatic potential in in vivo models of melanoma, a clinical trial of DHA would be
warranted as an adjuvant to current surgical and chemotherapeutic interventions”.
Fish oils combat weight loss in cancer patients After three weeks the patients had gained an average (median) of 1 kg in weight and at seven weeks an average of 2 kg. A significant improvement in performance status and appetite was also noted after three weeks on the supplement. Other research has shown that EPA inhibits the growth of pancreatic cancer cells in vitro. It is therefore of interest to note that the average survival time among the patients was over eight months. This compares very favourably with the normal survival time of 4.1 months and is at least as good as the survival time that can be obtained with aggressive chemotherapy.
The researchers conclude that a fish oil-enriched nutritional supplement has the potential to be a safe and
effective means of preventing weight loss in cancer patients and may even increase survival time in
patients with cancer of the pancreas. NOTE: This study was partially funded by Abbott Laboratories, the
maker of the nutritional supplement.
Fish oils improve survival of cancer patients
Fat consumption and cancer The study compared cancer mortality rates in 24 European countries, Canada and the USA with fish consumption and the intake of animal fats. In countries where the animal fat intake was high the researchers found a clear inverse correlation between the ratio of fish fat to animal fat and the risk of developing breast cancer in women and colon cancer in both men and women. A similar correlation was found between cancer risk and the ratio of fish fat to total fat intake.
The researchers conclude that a 15% decrease in animal fat intake combined with a 3-fold increase in
fish oil intake could possibly reduce male colon cancer risk by as much as 30% in countries with a high
animal fat intake. A 3-fold increase in fish oil intake could be achieved by eating fish three times a week
or by taking two standard fish oil capsules daily.
Colon cancer progression associated with fatty acid status
The researchers conclude that there are significant changes in the levels of n-3 and n-6 fatty acids early
on in the sequence leading from benign polyps to colon cancer and speculate that these changes might
participate in the progression to colon cancer. They recommend further work to investigate the benefits
of long-term dietary manipulation in view of the finding that low-dose fish oil supplementation normalizes
the cell proliferation pattern in patients with sporadic polyps.
Fish oils help patients with pancreatic cancer
Researchers at the Royal Infirmary of Edinburgh have released the results of a study which clearly shows
that fish oil supplementation can halt and even reverse cachexia in patients with pancreatic cancer. The
study involved 18 patients with inoperable pancreatic cancer (9 had stage IV tumors). The patients were
started out on 2 grams/day of fish oils (containing 360 mg of eicosapentaenoic acid and 240 mg of
docosahexaenoic acid). The dose was subsequently increased by 2 grams/day every week until the
patients’ body tolerance was reached. The average final intake was 12 grams/day. Prior to entering the
trial the average (mean) weight loss among the patients was 2.9 kg (6.3 lbs) per month. After 3 months
of fish oil supplementation an average weight gain of 0.3 kg/month was observed among the patients.
Overall, 11 patients (61%) gained weight, 3 became weight-stable, and 4 continued to lose weight, but at
a significantly reduced rate. The concentration of eicosapentaenoic acid in plasma phospholipids
increased from 0 to 5.3% of total fatty acids after 1 month of supplementation while the concentration of
docosahexaenoic acid increased to 6.6% from a base level of 3.5%. The researchers conclude that fish
oil supplementation arrests weight loss in cancer patients with cachexia.
Fish consumption and colon cancer
Fish oil supplementation helps prevent colon cancer Their study involved 34 men and 26 women who had just undergone surgery to remove benign polyps from their colon. The patients were divided into 4 groups. Group 1 was supplemented with 1.4 grams of EPA and 1.1 grams of DHA per day, group 2 with 2.7 grams of EPA and 2.4 grams of DHA, group 3 with 4.1 grams of EPA and 3.6 grams of DHA while group 4 received placebo capsules containing mainly olive oil. Biopsy samples from the lower part of the colon lining and blood samples were taken and analyzed at the start of the trial and 30 days later at the end of the supplementation period. Overall, patients in the fish oil groups experienced a significant decline in the number of abnormal cells in their colon lining as compared to members of the placebo group. Further analysis showed that the reduction in the number of abnormal cells was limited to patients who had a large number of abnormal cells at the beginning of the trial. The researchers also noted a very significant increase in EPA and DHA levels and a significant drop in arachidonic acid level in the biopsy samples from the fish oil supplemented patients.
A separate 6-month trial involving 15 patients taking 1.4 grams per day of EPA and 1.1 grams per day of
DHA also showed a significant drop in the number of abnormal colon lining cells. The researchers
conclude that low-dose supplementation with fish oils inhibit the proliferation of abnormal cells (a
precursor to polyps) in patients at risk for colon cancer and that this effect can be maintained with long-
term treatment. They caution that it may be advisable to increase vitamin E intake during fish oil
administration.
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Additional References
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