Omega-3 Fatty Acids
Also known by these names
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Key Points
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Omega-3 fatty acids are a type of polyunsaturated fatty acid (PUFA) found naturally in these foods and supplements:
The three main omega-3 fatty acids are docosahexaenoic acid (DHA), eicosapentaenoic acid (EPA) and alpha-linolenic acid (ALA). DHA and EPA generally show greater benefits in cancer, but are found only in animal sources. ALA from plant sources is converted to DHA and EPA in our bodies, but with a low conversion efficiency. ALA is not recommended as your sole source of omega-3s.2
Clinical Practice Guidelines
2013 evidence-based clinical practice guidelines from the American College of Chest Physicians recommended oral nutritional supplementation with omega-3 fatty acids to improve the nutritional status for lung cancer patients with sarcopenia (loss of muscle tissue).3
Treating the Cancer
Working against cancer growth or spread, improving survival, or working with other treatments or therapies to improve their anticancer action
Clinical Evidence
Breast Cancer
- Improved outcomes with DHA added to chemotherapy in a small trial of metastatic breast cancer patients4
Colorectal Cancer
- A diet rich in omega-3 fatty acids is associated with higher survival with colorectal cancer5
- Improved overall survival in patients undergoing liver resection surgery for colorectal cancer liver metastases taking eicosapentaenoic acid (EPA) supplements6
- ompared with a placebo, eicosapentaenoic acid (EPA) either with or without aspirin did not reduce the proportion of patients with at least one colorectal adenoma in patients with sporadic colorectal neoplasia.7
Prostate Cancer
A group of men with prostate cancer combining omega 3 supplements with a low-fat (15 percent of calories from fat) diet for four to six weeks before prostatectomy was compared to a control group consuming the standard American diet with 40 percent of calories from fat and no fish oil supplementation. At prostatectomy, the group supplement had smaller prostates (both benign and malignant components), lower proliferation index, and plasma that inhibited growth of prostate cancer cells in vitro more than the plasma from the control patients.8 Other effects in prostate cancer:
- Decreased prostate cancer proliferation and decreased prostate tissue omega-6:omega-3 ratios, but no change in serum insulin-like growth factor I (IGF-1) in a small study of men undergoing radical prostatectomy9
- Some evidence of decreased inflammatory markers in clinical trials10
- Increased resistance to chemotherapy; not recommended on the days surrounding chemotherapy11
Other Cancers
Conflicting interactions with chemotherapy have been reported:
- No adverse side effects and possible improved anthracycline-based chemotherapy outcome were found in a small uncontrolled trial of group patients with rapidly progressing visceral metastases.12
- Rise in plasma levels after supplementation in healthy volunteers to levels capable of causing chemoresistance to cisplatin in mice; use is not recommended on the days surrounding chemotherapy.13
Lab and Animal Evidence
Managing Side Effects and Promoting Wellness
Managing or relieving side effects or symptoms, reducing treatment toxicity, supporting quality of life or promoting general well-being
Results related to patient body weight and composition:
- Omega-3 fatty acid (EPA and DHA) capsules or supplements with EPA have been associated with weight stabilization, gain in lean body mass, and improvement in quality of life markers in patients losing weight as a result of advanced pancreatic and head and neck cancers.20
- The weight of patients with gastrointestinal cancer (anal, colorectal, esophageal, stomach) increased significantly with EPA supplementation.21 EPA and DHA ameliorated muscle loss and myosteatosis (the presence of intermuscular and intramuscular adipose tissue) in clinical studies.22
- In patients with colorectal cancer, EPA supplements increased weight and improved scores of health-related quality of life, with a trend toward fewer interruptions of chemotherapy treatment in a small study.23
- A small study involving cancer patients receiving chemotherapy after surgical tumor (mainly gastrointestinal) removal found that fish oil supplementation reduced weight loss and improved the function of blood neutrophils.24
- Omega-3 supplements improved outcomes, especially body composition, in patients undergoing chemotherapy and/or radiotherapy.25
High-dose EPA inhibited bone resorption in breast cancer survivors taking aromatase inhibitors.2627
Omega-3s reduced paclitaxel-induced peripheral neuropathy in a small clinical study of breast cancer patients.28
Dietary omega-3 fatty acids combined with guarana extract and a diet rich in whole foods, fruits and vegetables can treat cancer-related fatigue in patients with breast cancer.29
Nutritional supplementation with omega-3 fatty acids, arginine and nucleotides resulted in a marked improvement of immune functions in cancer patients undergoing surgery and a reduction in infectious complications, hospital stay and co-morbidities.30
Reducing Risk
Reducing the risk of developing cancer or the risk of recurrence
Clinical Evidence
Substantial data support the importance of omega-3 fatty acids for colorectal cancer prevention.31 A decreased risk colon cancer was found, primarily in men, from using fish oil supplements.32
Higher omega-6 to omega-3 ratios are associated with higher risk of breast cancer,33 while higher consumption of dietary marine omega-3 polyunsaturated fatty acids is associated with a lower risk of breast cancer.34 Higher levels from combined diet and supplements are associated with reduced risks of breast cancer.35 No impact of supplements on breast cancer recurrence and improved overall mortality in patients were found with early stage breast cancer, but marine omega-3s from food were associated with reduced risk of additional breast cancer events and all-cause mortality.36
Higher levels from combined diet and supplements are associated with reduced risks of breast cancer.37 No impact of supplements was found on breast cancer recurrence and improved overall mortality in patients with early stage breast cancer, but marine omega-3s (DHA and EPA) from food were associated with reduced risk of additional breast cancer events and all-cause mortality.38
Data on omega-3 fatty acid supplementation for prostate cancer prevention are inconclusive. A 2017 review of the literature showed no clear relationship between fish-derived omega-3 fatty acids and risk of prostate cancer,39 but a separate review found that consumption of omega-3 long-chain polyunsaturated fatty acids (LCPUFAs) and "an omega-6/omega-3 ratio of 2-4:1 are associated with a reduced risk of breast, prostate, colon and renal cancers."40
Lab and Animal Evidence
Optimizing Your Terrain
- Lowered the magnitude of inflammatory responses and modulated the immune response in patients undergoing radical colorectal cancer resectionL42
Cautions
A few cautions are noted. Please see the Memorial Sloan Kettering Cancer Center’s About Herbs website for information.
- High blood concentrations of omega-3s are associated with increased risk of prostate cancer (see the Foundation for Alternative and Integrative Medicine for an analysis of the study that found this).
- A type of omega-3 fatty acid, 16:4(n-3), can reduce the activity of the chemotherapy drug cisplatin.43
- A 2018 review conclusions:44
- Four grams of supplementation may impair clotting; patients may want to eliminate omega-3 supplements before and immediately after surgery.
- A few adverse reactions and interactions with prescription and other drugs have been observed.
Dosing
BCCT does not recommend therapies or doses, but only provides information for patients and providers to consider as part of a complete treatment plan. Patients should discuss therapies with their physicians, as contraindications, interactions and side effects must be evaluated. Levels of active ingredients of natural products can vary widely between and even within products. See Quality and Sources of Herbs, Supplements and Other Natural Products.
Dosage recommendations are available from these sources:
- Solutions 4 Health:
- Breast Cancer Wellness Plan
- Colorectal Cancer Wellness Plan
- Endometrial Cancer Wellness Plan
- Lung Cancer Wellness Plan
- Prostate Cancer Wellness Plan
- Natural Medicines Database (requires purchase)
- Also see the protocols listed below.
Integrative Programs, Protocols and Medical Systems
For more information about programs and protocols, see our Integrative Programs and Protocols page. |
- Programs and protocols
- Alschuler & Gazella complementary approaches45
- Block program46
- Breast cancer case study
- Lung cancer case study
- Prostate cancer case study
- Core diet plan
- Remission support diet
- Chemotherapy coupler
- Radiation therapy coupler
- Normalizing coagulation
- Blocking inflammation
- Blocking tumor-fueling enzymes
- Boosting immune surveillance
- Self-care program for stress chemistry and circadian rhythm
- Chang strategies47
- Lemole, Mehta & McKee protocols48
- MacDonald breast cancer program49
- McKinney protocols50
- Traditional systems
Non-cancer Uses of Omega-3 Fatty AcidsBCCT has not reviewed the effectiveness of this therapy for non-cancer uses.
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Written by Nancy Hepp, MS, and reviewed by Laura Pole, RN, MSN, OCNS; most recent update on October 22, 2019. Note: BCCT has not conducted an independent review of research of Omega-3 fatty acids. This summary draws from the Memorial Sloan Kettering Cancer Center’s About Herbs and other sources as noted.
More Information
- Memorial Sloan Kettering Cancer Center’s About Herbs website: Omega-3
- Deng G, Gubili J. Omega-3 Fatty Acids. ASCO Post. March 10, 2019.
- American Institute for Cancer Research website: more than 100 articles and scientific reports on omega-3 fatty acids and cancer
- TRC Natural Medicines website (subscription is required): in-depth information, ratings of effectiveness and safety and evaluation of specific omega-3 fatty acid products
- Consumer Labs: Product Review (subscription required): Fish Oil and Omega-3 and -7 Fatty Acids Supplement Review
- Moss Reports (purchase required): Select from the list of cancers down the left side of the page for a report describing uses of conventional, complementary, alternative and integrative therapies related to that cancer. Ralph Moss is among the most knowledgeable and balanced researchers of integrative cancer therapies. The cost of his Moss Reports is not negligible, but many patients find them of considerable value. Moss is also available for consultations.
- Harvard Health Publishing: Should you be taking an omega-3 supplement?
- Linus Pauling Institute, Oregon State University: Essential Fatty Acids
- Dawn Lemanne and Victoria Maizes: Advising Women Undergoing Treatment for Breast Cancer
- Block KI, Block PB, Gyllenhaal C: Integrative Treatment for Colorectal Cancer
- Keith Block and others: A Broad-Spectrum Integrative Design for Cancer Prevention and Therapy
- Raymond Chang, MD: Beyond the Magic Bullet: The Anti-Cancer Cocktail
- Donald I. Abrams, MD, and Andrew T. Weil, MD: Integrative Oncology, 2nd Edition
- Neil McKinney, BSc, ND: Naturopathic Oncology, 3rd Edition
- Ted Schettler, MD, MPH: The Ecology of Breast Cancer: The Promise of Prevention and the Hope for Healing
- Lise Alschuler, ND, FABNO, and Karolyn Gazella: The Definitive Guide to Cancer, 3rd Edition
- Keith I. Block, MD: Life over Cancer: The Block Center Program for Integrative Cancer Treatment
- Lorenzo Cohen and Alison Jefferies: Anticancer Living: Transform Your Life and Health with the Mix of Six
- Michael Lerner: Choices In Healing: Integrating the Best of Conventional and Complementary Approaches to Cancer
- Lone Star Medical Group: Natural Alternative Treatments
- National Cancer Institute: Office of Cancer Complementary and Alternative Medicine