Effects of omega-3 supplementation on psychological symptoms in men with prostate cancer: Secondary analysis of a double-blind placebo-controlled randomized trial.

Josée Savard, Hanane Moussa, Jean-François Pelletier, Pierre Julien, Louis Lacombe, Rabi Tiguert, Yves Caumartin, Thierry Dujardin, Paul Toren, Frédéric Pouliot, Michele Lodde, Yves Fradet, Karine Robitaille, Vincent Fradet

Journal: Cancer medicine 2024;12(19):20163-20176

PMID: 37787025

Free Full Text on PubMed Central View on PubMed

Plain Language Summary

This study investigated the effects of omega-3 supplementation on psychological symptoms in men with prostate cancer. Omega-3 polyunsaturated fatty acids, found in fish and some plant oils, have been linked to lower levels of depression in the general population, but their impact on cancer patients is less clear. The research compared the effects of a specific omega-3 supplement, eicosapentaenoic acid monoacylglyceride (MAG-EPA), with a placebo made from high oleic acid sunflower oil (HOSO) to see how they influenced depression and other symptoms such as anxiety, fear of cancer recurrence, fatigue, and insomnia.

The results showed that several psychological symptoms decreased significantly over time, mainly within the first months following the surgery. However, MAG-EPA did not produce greater reductions in any symptom compared to the placebo (HOSO).

In conclusion, psychological symptoms such as depression, anxiety, fatigue, insomnia, and fear of cancer recurrence improved over time after prostate cancer surgery. However, omega-3 supplementation did not provide any additional benefit compared with placebo. Healthcare professionals can use these findings to guide discussions with patients about the limited evidence for omega-3 supplements in improving psychological wellbeing after prostate cancer surgery and to consider other supportive care approaches where appropriate.

Abstract

BACKGROUND

In the general population, a higher omega-3 polyunsaturated fatty acids intake is associated with lower levels of several psychological symptoms, especially depression. However, the existing evidence in cancer is equivocal.

METHODS

This phase IIB double-blind, placebo-controlled trial was aimed at comparing the effects of eicosapentaenoic acid monoacylglyceride (MAG-EPA) supplementation and high oleic acid sunflower oil (HOSO; placebo) on depression levels (primary outcome) and other symptoms (anxiety, fear of cancer recurrence, fatigue, insomnia, perceived cognitive impairments; secondary outcomes). Participants, recruited in a prostate cancer clinic, were randomized to MAG-EPA (3.75 g daily; n = 65) or HOSO (3.75 g daily; n = 65) for 1 year post-radical prostatectomy (RP), starting 4-10 weeks before surgery. Patients completed self-report scales at baseline (before RP) and 3, 6, 9, and 12 months after: Hospital Anxiety and Depression Scale (HADS), Fear of Cancer Recurrence Inventory (FCRI), Insomnia Severity Index (ISI), Fatigue Symptom Inventory (FSI), and Functional Assessment of Cancer Therapy-Cognitive Function (FACT-Cog).

RESULTS

Analyses showed significant reductions in HADS-depression, HADS-anxiety, FCRI, ISI, FSI-number of days, and FACT-Cog-impact scores over time. A significant group-by-time interaction was obtained on FACT-Cog-Impact scores only; yet, the temporal change was significant in HOSO patients only.

CONCLUSIONS

Several symptoms significantly decreased over time, mainly within the first months of the study. However, MAG-EPA did not produce greater reductions than HOSO. Omega-3 supplementation does not seem to improve psychological symptoms of men treated with RP.

Address: School of Psychology, Université Laval, Québec, Canada.; CHU de Québec-Université Laval Research Center, Québec, Canada.; Université Laval Cancer Research Center, Québec, Canada.; Faculty of Medicine, Université Laval, Québec, Canada.; Institute of Nutrition and Functional Foods (INAF) and Nutrition, Health and Society (NUTRISS) center of Université Laval, Québec, Canada.

DOI: 10.1002/cam4.6598