title: Potential applications of fish oils rich in omega-3 polyunsaturated fatty acids in the management of gastrointestinal cancer.
abstract: Despite advances in chemotherapeutic agents and surgical approaches for its management, gastrointestinal cancer still accounts for 27% of new cancer cases and 35% of cancer related mortality worldwide. Omega-3 polyunsaturated fatty acids (PUFAs) specifically eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) have anti-inflammatory and anticancer activities and are used as immuno-nutrients.
  
  
  
  A literature search was conducted to identify primary research reporting on applications of the omega-3 PUFAs in gastrointestinal cancer.
  
  
  
  Reported laboratory studies indicate a clear role for omega-3 PUFAs in preventing cancer development at various stages including cancer cell proliferation, survival, angiogenesis, inflammation and metastasis. In clinical settings, omega-3 PUFAs have been reported to improve the immune response, maintain lean body mass, improve quality of life and improve overall survival in patients with colorectal and pancreatic cancer. In contrast to other GI cancers, there is a strong connection between inflammation and oesophageal cancer.
  
  
  
  Little work has been done exploring the role for omega-3 PUFAs in oesophageal cancer prevention and management. The authors are conducting a clinical trial investigating the use of parenteral omega-3 PUFAs supplementary to the standard of care (epirubicin, oxaliplatin and capecitabine palliative chemotherapy) in patients with advanced oesophagogastric cancer as a promising new therapeutic approach.
authors.affiliation: Department of Surgery, University Hospitals of Leicester, Leicester, LE1 5WW, United Kingdom. Electronic address: amar.eltweri@nhs.net.
authors.forename: A M
authors.initials: AM
authors.lastname: Eltweri
authors.affiliation: Department of Cancer Studies, University of Leicester, LE2 7LX, United Kingdom.
authors.forename: A L
authors.initials: AL
authors.lastname: Thomas
authors.affiliation: Department of Surgery, University Hospitals of Leicester, Leicester, LE1 5WW, United Kingdom.
authors.forename: M
authors.initials: M
authors.lastname: Metcalfe
authors.affiliation: Human Development & Health Academic Unit, Faculty of Medicine, University of Southampton, Southampton, United Kingdom; NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, United Kingdom.
authors.forename: P C
authors.initials: PC
authors.lastname: Calder
authors.affiliation: Department of Surgery, University Hospitals of Leicester, Leicester, LE1 5WW, United Kingdom.
authors.forename: A R
authors.initials: AR
authors.lastname: Dennison
authors.affiliation: Department of Surgery, University Hospitals of Leicester, Leicester, LE1 5WW, United Kingdom.
authors.forename: D J
authors.initials: DJ
authors.lastname: Bowrey
mesh_terms: D000818:Animals; D000893:Anti-Inflammatory Agents / Q000494:pharmacology; D000970:Antineoplastic Agents / Q000494:pharmacology; D049109:Cell Proliferation; D016208:Databases, Factual; D019468:Disease Management; D004195:Disease Models, Animal; D004281:Docosahexaenoic Acids / Q000494:pharmacology; D015118:Eicosapentaenoic Acid / Q000494:pharmacology; D019317:Evidence-Based Medicine; D015525:Fatty Acids, Omega-3 / Q000494:pharmacology*; D005395:Fish Oils / Q000494:pharmacology*; D005770:Gastrointestinal Neoplasms / Q000188:drug therapy*; D006801:Humans; D007249:Inflammation / Q000188:drug therapy; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic
chemical_list: D000893:Anti-Inflammatory Agents; D000970:Antineoplastic Agents; D015525:Fatty Acids, Omega-3; D005395:Fish Oils; D004281:Docosahexaenoic Acids; D015118:Eicosapentaenoic Acid
keywords: Cancer; Docosahexaenoic acid; Eicosapentaenoic acid; Fish oil; Gastrointestinal; Inflammation