• Intervention
    Can the acute phase response in cancer patients can be altered by fatty acids?
    • Conclusion

      Four studies (two neutral quality time series, one neutral quality non-randomized trial, and one negative quality time series), published by the same group of researchers, evaluated acute-phase response as measured by serum CRP, in patients with pancreatic cancer and ongoing weight loss instructed to consume an omega-3 fatty acid enriched liquid nutritional supplement which provided a mean dose of 2.2g EPA daily. Three studies (two neural time series, one neutral rated non-randomized trial) indicated no change in APP over the treatment period of 7-12 weeks. The negative quality time series indicated a reduction in CRP concentration after four weeks of supplementation with 2g of EPA daily (p<0.002), however the change was no longer significant at 12 weeks. Further research is needed to clarify these results.

    • Grade: III
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
    • Search Plan and Results: Catabolic Process: Fatty Acids 2006
       
    Is there a relationship between the use of EPA as a fish oil supplement to the reduction of weight loss associated with pancreatic cancer?
    • Conclusion

      Two small time series (one neutral and one negative quality) had conflicting results on the effectiveness of EPA as fish oil supplement to reduce weight loss in pancreatic cancer patients. The dosage of EPA as a fish oil supplement and length of supplementation varied among the studies. Larger randomized controlled trials are needed. Sample size was small and there were inconsistencies across the studies.

    • Grade: III
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
    • Search Plan and Results: EPA/Omega 3 Fatty Acids and Symptoms/Complications 2005
       
    Is there a relationship between a patient's consumption of EPA-containing medical food supplement to the reduction of weight loss associated with pancreatic cancer?
    • Conclusion

      One large positive quality RCT showed weight stability in both the EPA group and the control group and were not significantly different in a trial of EPA-containing MFS (2 cans for 2.2g EPA per day) for eight weeks. This study was limited by patients not taking the recommended dosage of EPA-containing product. However, two small, non-randomized studies (one – quality non-placebo-controlled, non-blinded longitudinal study; one neutral quality time series) in which patients consumed an EPA-containing MFS (2 cans for 2.2g EPA per day) from three weeks to 7 weeks in length did result in weight stabilization or weight gain in patients with pancreatic cancer. More studies with better compliance and consistent length of EPA-medical food supplementation are needed.   

    • Grade: III
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
    • Search Plan and Results: EPA/Omega 3 Fatty Acids and Symptoms/Complications 2005
       
    Can lean body mass in pancreatic cancer patients be altered by fatty acids?
    • Conclusion

      Six studies (two neutral quality time series, one negative quality time series, three positive quality RCTs) evaluated the impact of omega-3 fatty acid supplementation on LBM in pancreatic cancer. One study, without a control group, indicated an increase in LBM (p=0.0047) after 7 weeks of supplementation with an omega-3 fatty acid-enhanced MFS which provided a mean dose of 2.09g EPA daily. Two large RCT of positive design with a dose of 1.5-1.65g EPA daily, one small RCT of positive design with a dose of 2.09g EPA daily, and two small timeseries (one negative and one neutral quality) with a dose of 2.0g EPA daily indicated no increase in LBM over the study period.

    • Grade: I
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
    • Search Plan and Results: Catabolic Process: Fatty Acids 2006