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 All six of the fish oil supplements the researchers tested contained
a specific fatty acid that's been found to reduce the effectiveness
of chemotherapy in mice, the researchers report in JAMA Oncology.
People receiving chemotherapy should refrain from taking fish oil
supplements and discuss any supplement with their doctors, said Dr.
Emile Voest, the study’s lead author from the Netherlands Cancer
Institute in Amsterdam.
“I’m always discussing it with my patients,” he said. “Please have
an open relationship with me and tell me what you’re taking.”
He and his colleagues say omega-3 fatty acids are consumed by about
a fifth of Americans with cancer – usually through fish oil. Fish
oil is often sold in capsules for about $10 or $11 for 100 pills.
The researchers had previously found that even a small amount of two
fatty acids reduced the effectiveness of chemotherapy in mice with
cancer. These fatty acids may ultimately enable cancer cells to
repair themselves faster after chemotherapy, Voest said.
When his team looked for the two fatty acids in six fish oil
supplements, one was not detected but the fatty acid called
16:4(n-3) was ubiquitous.
The researchers also surveyed 400 people receiving treatment for
cancer in November 2011. Of 118 people who returned the surveys, 35
percent reported using nutritional supplements and 11 percent
reported using omega-3 fatty acid supplements.
In another part of the study, the researchers then had 30 volunteers
without cancer take 10 or 50 milliliters (mL) of the three fish oil
supplements. Levels of 16:4(n-3) peaked in their blood about four
hours after taking the 10 mL supplements; levels returned to normal
after about eight hours. Levels of the fatty acid remained elevated
longer among those taking 50 mL.
Furthermore, when 20 volunteers ate mackerel or herring, levels of
16:4(n-3) in their blood went up. Eating salmon or tuna had little
or no effect, however.
The researchers conclude that until more is known, people on
chemotherapy should avoid fish oil - and herring and mackerel - the
day before and after their treatments.
They note that the Dutch Cancer Society and the Dutch National
Working Group for Oncologic Dieticians recommend that people
receiving chemotherapy avoid fish oil around the time of treatment.
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“It’s an intriguing observation, which warrants further
investigation,” said Dr. Powel Brown, chairman of the Department of
Clinical Cancer Prevention at the University of Texas M.D. Anderson
Cancer Center in Houston.
“In general, when giving chemotherapy, we discourage the use of
additional supplements,” said Brown, who wasn’t involved with the
study. “It’s very well known that some supplements affect the
metabolism of chemotherapy.”
Voest said the study’s conclusions are a bit circumstantial, but it
would be very difficult to conduct a trial to confirm the findings.
For example, it would be unethical to randomly give patients fish
oil during chemotherapy to see if it makes their treatment less
effective.
People should be cautious about going overboard with avoiding all
omega-3 fatty acids, because they're an essential part of the diet
that the body can’t make on its own, said Stacy Kennedy, an expert
on oncology nutrition at the Dana-Farber Cancer Institute in Boston.
Flaxseed, chia seeds and walnuts are also sources of omega-3 fatty
acids.
“I think it’s important to have those detailed conversations with
your doctors and dieticians to weigh the risk and benefits of any
over-the-counter medication, supplements and powders,” said Kennedy,
who also wasn’t involved in the study.
SOURCE: http://bit.ly/1ClqxXP JAMA
Oncology, online April 2, 2015.
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