Fish Oil & Evening Primrose Oil Supplementation Reduces Inflammatory Markers and Improves Polyunsaturated Fatty Acid Levels in Breast Cancer Patients Undergoing Chemotherapy

by | May 7, 2024 | 2023, Breast Cancer, Cancer, Essential Oils, Fish Oil Supplements, Polyunsaturated, Recent Articles

Written by Taylor Woosley, Science Writer. 12-week supplementation of a combination of fish oil and evening primrose oil (1000 mg EPA + DHA and 251 mg GLA daily) improved fatty acid profiles, as well as the n-6/n-3 PUFA ratio (p < 0.01), and significantly decreased IL-6 concentrations (p < 0.01) compared to the control group. 

breast cancerBreast cancer is the most diagnosed cancer in the world and is the leading cause of cancer mortality among females1. Chemotherapy is the primary treatment for most cancers and many cancer patients who undergo chemotherapy experience mild to severe side effects including nausea, vomiting, weakness, fatigue, and pain2. Chemotherapy has been implicated in inducing inflammation by disrupting normal cytokine regulation, as well as inducing monocytic migration to areas of inflammation both within the body and the central nervous system3.

Fish oil containing eicosapentaenoic acid (EPA) and docosahexaenoic acids (DHA) plays a crucial role in anti-cancer therapy of experimental models4. These omega-3 fatty acids aid in energy metabolism and have been shown to reduce levels of pro-inflammatory mediators5. Furthermore, evening primrose oil (EPO) contains high concentrations of linoleic acid and γ-linoleic acid which exert anti-cancer effects by altering the hypoxic microenvironment, mitochondria-mediated death, apoptosis, and anti-inflammatory pathways6.

Arsic et al. conducted a parallel, randomized, double-blind, placebo-controlled study to assess whether fish oil and EPO supplementation influence concentration of cytokines (IL-6, IL-8, IL-10, and TNF-α), nutritional status, and fatty acid profiles in breast cancer (BRC) patients receiving adjuvant chemotherapy. Subject inclusion consisted of postmenopausal women (aged 45 to 70 years) with BRC, stage IIa-IIIa, with ER+ and/or PR+ breast cancer, and human epidermal growth factor receptor 2 (HER2) negative, who had started adjuvant chemotherapy by anthracycline models. 32 subjects were assigned to either the intervention group receiving EPO and fish oil or to the control group who received mineral oil for a 12-week study. The intervention group consumed two omega-3 Cardio capsules and three EPO capsules daily, for a total of 1000 mg EPA + DHA and 251 mg GLA.

Primary outcomes included changes in nutritional status and level of interleukins. Secondary outcomes included changes in hematological and biochemical parameters and fatty acid profiles. Anthropometric measurements (weight, height, and BMI) were collected at baseline and end of study. Furthermore, fasted blood samples were obtained to assess for fasting serum glucose and lipid (triglycerides (TG), total cholesterol, high-density lipoprotein (HDL)- cholesterol low-density lipoprotein (LDL)-cholesterol) concentrations and hematological parameters at baseline and end of study.

29 participants were included in the final analysis. Two-factor analysis of variance for repeated measurements were utilized to compare values between baseline and end of study. Significant findings of the study are as follows:

  • Subjects in the intervention group of fish oil and EPO experienced significant changes in fatty acid profiles, resulting in increased plasma of n-3 polyunsaturated fatty acids (PUFAs), DHA, and total n-3 PUFA, along with a decrease in palmitoleic and oleic acid, as well as the n-6/n-3 PUFA ratio (p < 0.01).
  • After adjusting for baseline values, the intervention group showed significantly higher levels of DPA, DHA, n-3 PUFA, and total PUFA after comparing between groups at the end of the study.
  • Although IL-6 concentrations significantly decreased in both groups during chemotherapy, intergroup comparisons at the end of study adjusted for baseline values show a significantly lower concentration of IL-6 in the intervention group compared to the control (p < 0.01).

Results of the parallel, randomized, double-blind, placebo-controlled study show that supplementation with fish oil and evening primrose oil improved overall fatty acid profiles and decreased inflammatory markers such as IL-6 concentrations. Further research on omega-3 supplementation during chemotherapy is necessary to better comprehend results. Study limitations include the single center design of the study and the small subject size.

Source: Arsic, Aleksandra, Predrag Krstic, Marija Paunovic, Jasmina Nedovic, Vladimir Jakovljevic, and Vesna Vucic. “Anti-inflammatory effect of combining fish oil and evening primrose oil supplementation on breast cancer patients undergoing chemotherapy: a randomized placebo-controlled trial.” Scientific Reports 13, no. 1 (2023): 6449.

© The Author(s) 2023

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Posted May 7, 2024.

Taylor Woosley studied biology at Purdue University before becoming a 2016 graduate of Columbia College Chicago with a major in Writing. She currently resides in Glen Ellyn, IL.

References:

  1. Wilkinson L, Gathani T. Understanding breast cancer as a global health concern. The British journal of radiology. Feb 1 2022;95(1130):20211033. doi:10.1259/bjr.20211033
  2. Ferro Y, Maurotti S, Tarsitano MG, et al. Therapeutic Fasting in Reducing Chemotherapy Side Effects in Cancer Patients: A Systematic Review and Meta-Analysis. Nutrients. Jun 8 2023;15(12)doi:10.3390/nu15122666
  3. Brown T, Sykes D, Allen AR. Implications of Breast Cancer Chemotherapy-Induced Inflammation on the Gut, Liver, and Central Nervous System. Biomedicines. Feb 13 2021;9(2)doi:10.3390/biomedicines9020189
  4. Guo CH, Shih MY, Chung CH, et al. Fish Oil and Selenium with Doxorubicin Modulates Expression of Fatty Acid Receptors and Selenoproteins, and Targets Multiple Anti-Cancer Signaling in Triple-negative Breast Cancer Tumors. Int J Med Sci. 2022;19(14):2044-2057. doi:10.7150/ijms.75848
  5. Yoon SL, Grundmann O. Relevance of Dietary Supplement Use in Gastrointestinal-Cancer-Associated Cachexia. Nutrients. Jul 30 2023;15(15)doi:10.3390/nu15153391
  6. Abd-Alhaseeb MM, Massoud SM, Elsayed F, Omran GA, Salahuddin A. Evening Primrose Oil Enhances Tamoxifen’s Anticancer Activity against Breast Cancer Cells by Inducing Apoptosis, Inhibiting Angiogenesis, and Arresting the Cell Cycle. Molecules. Apr 7 2022;27(8)doi:10.3390/molecules27082391