A diet high in polyunsaturated fatty acids (PUFAs), especially omega 3s, has been shown to be negatively associated with cancer development. PUFAs differentially inhibit mammary tumor development by inflicting modifications to the morphology of cell membranes and influencing signaling pathways, gene expression, and apoptosis.
The human body is unable to synthesize the following PUFAs at a reasonable rate: omega-3 docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), and omega-6 arachidonic acid. Therefore, these PUFAs must be acquired through dietary sources. The recommended daily nutritional intake is 2,000 mg EPA+DHA, while therapeutic intake is 4,000-6,000 milligrams of EPA+DHA per day.
OMEGA-3 FATTY ACIDS AND THE TUMOR MICROENVIRONMENT
Omega-3 fatty acids support normal inflammation control by lowering COX 2, LOX5, PGE2, IL1, IL6, TNFa, and CRP. Increased inflammation contributes to cancer development, progression, and metastasis. It’s also linked to cancer-related pain, fatigue, depression, and cognitive impairment. In addition, increased inflammation is linked to cancer-related hypercoagulation and risk of thromboembolism. Supporting normal Inflammation control has a wide impact on the behavior of tumor cells, and on safety and quality of life for cancer patients and survivors.
Omega-3s promote expression of M1 type tumor-associated macrophages (TAMs). Type M1 TAMs promote tumor regression, inflammation control, and immune activation through promoting tumor infiltration by antigen-presenting dendritic cells and cytotoxic T cells. In addition, type M1 TAMs:
- Inhibit VEGF (vascular endothelial growth factor) and promote normal control of angiogenesis. VEGF promotes the development of new blood vessels to the tumor cells. Inhibition of VEGF and the development of capillaries inhibits tumor growth and progression as well as metastasis.
- Downregulate tumor-promoter protein kinase C isoenzymes. This group of enzymes links multiple cellular processes responsible for the regulation of tumorigenesis, cell cycle progression, and metastasis.
- Inhibit collagenase. This proteolytic enzyme breaks down the extracellular matrix (ECM) and allows invasion of tumor cells into tissues and blood vessels, leading to progression, invasion, and metastasis.
- Promote normal apoptosis signaling. Cancer cells lose the ability to initiate apoptosis, the normal process in which a cell recognizes itself as aberrant and self-destructs. The inhibition of normal apoptotic signaling in malignant cells is a hallmark of a tumor microenvironment that permits uncontrolled growth, persistence, and immortality due to the loss of normal regulation.
- Lower Bcl2 and Ras oncogenes. These genes inhibit normal apoptosis and promote tumor growth and progression.
- Act as a chemo-sensitizer. DHA has the potential to specifically chemo-sensitize tumors in several ways. First of all, tumor cells can be made more sensitive to chemotherapy than non-tumor cells when membrane lipids are enriched with DHA. Incorporating DHA during treatment may also reduce the adverse effects of chemotherapy. And DHA may improve the outcome of chemotherapy when highly incorporated into cell membranes.
- Act as a radio-sensitizer. By both promoting normal membrane structure and function and influencing the tumor microenvironment, DHA acts synergistically to potentiate the therapeutic effects of radiotherapy on tumor cells.
- Promote healthy 16-OH estrogen metabolism. Estrogen can be metabolized through multiple pathways. The promotion of 16-hydroxylation of estrogen produces estrogen metabolites that aren’t pro-carcinogenic. Omega-3s also promote healthy estrogen metabolism.
- Inhibit platelet aggregation and thrombin formation. Abnormal hyper-coagulation increased platelet aggregation and thrombus formation are hallmarks of the tumor microenvironment. Thus, control of platelet aggregation and thrombus formation reduces the risk of life-threatening and adverse thrombotic events. Forty percent of all cancer patients are at risk for the formation of thromboembolisms. Omega-3smay reduce this risk.
- Promote normal cell membrane functions and receptor binding. A healthy, flexible cell membrane built of omega-3 fatty acids promotes enhancement of all membrane functions, which normalizes and optimizes therapeutic physiology.
- Increase expression of the tumor-suppressor gene PTEN. More expression of tumor-suppressor genes leads to enhanced control over carcinogenesis, tumorigenesis, and metastatic progression.
- Inhibit multi-drug resistance. Tumor cells can quickly become resistant to therapeutic anti-neoplastic agents, thus decreasing and shortening the efficacy of treatments.
- Inhibit cachexia and preserve muscle mass and bone mass (inhibit proteolysis-inducing factor). Loss of bone mass (osteopenia) and loss of muscle mass (sarcopenia) are risk factors of aging and the cancer physiology. Maintaining bone mass and muscle mass is crucial to robust, healthy function and quality of life.
- Support normal mood regulation. Depression and anxiety are common in cancer patients. Support of balanced mood allows these patients to have deep and restful sleep, improved quality of life, and increased coping capacity and resilience in the face of stress.
HOW TO MEASURE OMEGA-3 FATTY ACID STATUS
Serum or plasma omega-3 fatty acid ratios are readily accessible and available from most medical clinical labs. However, I recommend the OmegaQuant Omega-3 Index for measuring omega-3 status.
This cost-effective test was developed by a world expert in omega-3s and human health: Bill Harris, PhD, founder of OmegaQuant. Using a finger-stick at-home collection method, the test assesses the fatty-acid composition of the red blood cell membrane—not plasma.
OmegaQuant’s Omega-3 Index is defined as the amount of EPA plus DHA in red blood cell membranes, expressed as the percent of total red blood cell membrane fatty acids. Omega-3 levels of 8-12 percent are associated with better overall health.
For an in-depth discussion of the OmegaQuant Omega-3 Index, listen to the Dr. Bill Harris interview on the The Peter Attia Drive Podcast #83 (December 9, 2019). You can find the podcast at peterattiamd.com/billharris/.
Nalini Chilkov, LAc, OMD, is the founder of the American Institute of Integrative Oncology Research and Education and. She’s the author of the best-seller 32 Ways to Outsmart Cancer, and is recognized as an authority and pioneer in the fields of integrative cancer care, cancer prevention, and immune enhancement. She has also lectured at UCLA and UC Irvine Schools of Medicine, and is a frequent expert resource to the media. Dr. Chilkov’s OutSmart Cancer system utilizes her more than 35 years of experience with thousands of patients, as well as her passion for training front-line clinicians worldwide to become skilled and confident in serving the health needs of patients whose lives have been touched by cancer. Her private practice is located in Santa Monica, California.