Cachexia is a state of progressive function impairment involving obvious weight loss, muscle loss, poor appetite, fatigue, and weakness.
Cachexia can be caused by a variety of diseases, and cancer in particular. Cancer cells attack and break down people’s immune systems, and people suffer severe systematic dysfunction and are susceptible to cachexia.
A common treatment for cachexia in cancer is to provide cancer patients with necessary dairy elements and nutrients to support body function.
In addition to prescriptions from physicians, cancer patients often use vitamins, minerals, proteins, and other supplements to help cancer treatment. This is particularly true among advanced cancer patients who only receive palliative care and reply much on nutrition treatment.
The questions raise here: are vitamins, minerals, proteins, and other supplements helpful for cancer patients, and which ones can be truly useful?
A European Palliative Care Research Centre conducted a systematic review of the role of vitamins, minerals, proteins, and other supplements in the treatment of cachexia in cancer. The study was designed to examine whether supplements are useful to treat cachexia for cancer patients.
The review covered a wide range of cancer journals and publications, and it finally included 21 eligible studies out of 4214 pieces.
Magnesium is a common mineral for cancer patients. In a randomized controlled trial reviewed in the study, magnesium supplementation showed no significant effects on weight increase among 17 patients with advanced testicular cancer.
Vitamin supplements showed relatively promising effects and seem more likely to help reduce cachexia symptoms.
Vitamin D supplementation was found to improve muscle strength among 6 patients with advanced prostate cancer, though no such benefits were seen in weight increase.
Intravenous and oral vitamin C administration improved the outcomes of the Quality of Life Questionnaire among patients with different cancers. The questionnaire included different subscales including physical and cognitive function, appetite loss, fatigue, and nausea/vomiting.
Additionally, a combination of omega-3 fatty acids and vitamin E showed a significant increase in survival for patients with generalized solid tumors, despite this regimen didn’t exert statistically significant effects on body weight.
As for proteins and other dietary supplements, the results were mixed and were not clearly determined.
A combination of β-hydroxy-βmethylbutyrate (HMB), arginine, and glutamine showed an overall benefit in improving lean body mass, mood, weakness, and hematological parameters after 4-week treatment among 32 cachectic advanced solid tumors patients.
However, another study involving more participants found no significant difference in lean body mass after 8-week follow-ups.
Carnitine treatment showed an increase in body mass index (BMI) and increased overall survival and reduced hospitality. However, the result wasn’t valid enough because only 26 out of 72 participants completed the trial.
Supplement combinations appeared to be superior compared to a single agent.
L-carnitine alone showed no benefits while it showed better effects when used in combination with the other three supplements.
Similarly, a combination of antioxidants, vitamins, omega-3 fatty acids, medroxyprogesterone acetate, and celecoxib helped stabilize or increase weight, LBM, and appetite in a study with 39 cancer patients.
A combination regimen of various proteins and other supplements, including omega-3 fatty acids, glutamine, selenium, and CoQ10, and multiple probiotics and vitamins, was also found to effectively improve body weight in head and neck cancer patients.
Good perioperative supplementation is important for surgical patients, which can help prevent surgical infections and facilitate recovery.
Arginine and glutamine in combination with other supplements showed positive effects in the length of hospital stay, postoperative infections, BMI, and improved protein levels in perioperative treatment.
Supplement supplementation could produce some side effects and gastrointestinal problems were a major one reported in the studies.
Due to small-scale study samples and mixed results, the review could not directly determine the efficacy and safety of these supplements, and their effects on weight loss were also inconclusive.