Fish oil and treatment of cancer cachexia

Cancer cachexia is a syndrome characterized by high prevalence and multifactorial etiology. The pathophysiology of cancer-induced weight loss is mainly due to failure of food intake and to various metabolic abnormalities, including hypermetabolism. Multiple biologic pathways are involved in this process, including pro-inflammatory cytokines, neuroendocrine hormones and tumour specific factors such as proteolysis inducing factor (PIF). As a result, a protein and energy depletion is observed that is greater than what would be expected based on the simple decrease of food intake and is associated with marked reduction of lean body mass (LBM). Therapy requires a multi-model approach with control of reduced food intake and of the metabolic abnormalities. Combination treatment with nutritional support and modulation of metabolic/inflammation changes is promising. In this regard, n-3 fatty acids in dose of at least 1.5 g/day for a prolonged time to advanced cancer patients with weight loss, are associated with an improvement of clinical, biological and functional parameters and with amelioration of quality of life.