Review Articles

n-3 Fatty acids, cancer and cachexia: a systematic review of the literature

Ramón Colomera1 c1, José M. Moreno-Nogueiraa2, Pedro P. García-Lunaa3, Pilar García-Perisa4, Abelardo García-de-Lorenzoa5, Antonio Zarazagaa6, Luis Quecedoa7, Juan del Llanoa7, Luis Usána8 and César Casimiroa8

a1 Medical Oncology Service, Catalan Institute of Oncology, Girona, Spain

a2 Medical Oncology Service, Hospital Universitario Virgen del Rocío, Sevilla, Spain

a3 Clinical Nutrition Service, Hospital Universitario Virgen del Rocío, Sevilla, Spain

a4 Clinical Nutrition Service, Hospital Universitario Gregorio Marañón, Madrid, Spain

a5 Intensive Medicine Service, Hospital Universitario La Paz, Madrid, Spain

a6 Surgery Service, Hospital Universitario La Paz, Madrid, Spain

a7 Fundación Gaspar Casal, Madrid, Spain

a8 Medical Department, Abbott Laboratories, Madrid, Spain


Use of n-3 fatty acids (FA) has been reported to be beneficial for cancer patients. We performed a systematic review of the literature in order to issue recommendations on the clinical use of n-3 FA in the cancer setting. A systematic search was performed in MEDLINE, EMBASE, Cochrane and Healthstar databases. We selected clinical trials or prospective observational studies including patients with cancer and life expectancy >2 months, in which enteral supplements with n-3 FA were administered. Parameters evaluated individually were clinical (nutritional status, tolerance, survival and hospital stays), biochemical (inflammatory mediators), and functional (functional status, appetite and quality of life (QoL)). Seventeen studies met the inclusion criteria; eight were of high quality. The panel of experts established the following evidence: (1) oral supplements with n-3 FA benefit patients with advanced cancer and weight loss, and are indicated in tumours of the upper digestive tract and pancreas; (2) the advantages observed were: increased weight and appetite, improved QoL, and reduced post-surgical morbidity; (3) there is no defined pattern for combining different n-3 FA, and it is recommended to administer >1·5 g/day; and (4) better tolerance is obtained administering low-fat formulas for a period of at least 8 weeks. All the evidences were grade B but for ‘length of treatment’ and ‘advantage of survival’ it was grade C. Our findings suggest that administration of n-3 FA (EPA and DHA) in doses of at least 1·5 g/day for a prolonged period of time to patients with advanced cancer is associated with an improvement in clinical, biological and QoL parameters.

(Received March 08 2006)

(Revised October 25 2006)

(Accepted October 25 2006)


c1 *Corresponding author: Dr. Ramón Colomer, fax +34 972 206723, email


Abbreviations: FA, fatty acids; QoL, quality of life