Integrative Cancer Therapies
April-June 2016: 1
–31
© The Author(s) 2016
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DOI: 10.1177/1534735416656052
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Review Article
Introduction
Prostate cancer (PrCa) accounts for almost one quarter of can-
cers diagnosed among men. In Canada, there are approxi-
mately 24
000
new cancer cases (24% of all new male cancer
cases) expected in 2015.
1
While 5-year survival rates have
dramatically improved, PrCa is still the third leading cause of
cancer death among men, with nearly 4000 deaths (10.1% of
all male cancer deaths) expected in 2015 in Canada.
1
However,
PrCa incidence and mortality varies 60-fold globally, with a
dramatic increase observed in immigrants moving from low-
to high-risk countries, suggesting that dietary and lifestyle
factors play a role in its etiology and pathogenesis.
2
With
Canadian men having approximately a 1 in 8 (12.8%) lifetime
probability of being diagnosed with prostate cancer, there is
strong interest in dietary and natural health product (NHP)
656052
ICT
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X
10.1177/1534735416656052Integrative Cancer Therapies
Aucoin et al
research-article
2016
1
Canadian College of Naturopathic Medicine, Toronto, Ontario, Canada
2
University of Toronto, Toronto, Ontario, Canada
3
Ottawa Hospital General Campus, Ottawa, Ontario, Canada
4
Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
5
McMaster University, Hamilton, Ontario, Canada
6
Ottawa Integrative Cancer Centre, Ottawa, Ontario, Canada
Corresponding Author:
Dugald Seely, Ottawa Integrative Cancer Centre, 29 Bayswater Avenue,
Ottawa, Ontario, K1Y 2E5 Canada.
Email: dseely@ccnm.edu
Fish-Derived Omega-3 Fatty Acids and
Prostate Cancer: A Systematic Review
Monique Aucoin, ND
1
, Kieran Cooley, ND
1
,
Christopher Knee, ND, MSc
1
, Heidi Fritz, ND, MA
1
,
Lynda G. Balneaves, RN, PhD
2
, Rodney Breau, MSc, MD, FRCSC
3
,
Dean Fergusson, MHA, PhD
4
, Becky Skidmore, MLS
1
,
Raimond Wong, MD, FRCSC
5
, and Dugald Seely, ND, MSc, FABNO
1,4,6
Abstract
Background
. The use of natural health products in prostate cancer (PrCa) is high despite a lack of evidence with respect
to safety and efficacy. Fish-derived omega-3 fatty acids possess anti-inflammatory effects and preclinical data suggest a
protective effect on PrCa incidence and progression; however, human studies have yielded conflicting results.
Methods
. A
search of OVID MEDLINE, Pre-MEDLINE, Embase, and the Allied and Complementary Medicine Database (AMED) was
completed for human interventional or observational data assessing the safety and efficacy of fish-derived omega-3 fatty
acids in the incidence and progression of PrCa.
Results
. Of 1776 citations screened, 54 publications reporting on 44 studies
were included for review and analysis: 4 reports of 3 randomized controlled trials, 1 nonrandomized clinical trial, 20
reports of 14 cohort studies, 26 reports of 23 case-control studies, and 3 case-cohort studies. The interventional studies
using fish oil supplements in patients with PrCa showed no impact on prostate-specific antigen levels; however, 2 studies
showed a decrease in inflammatory or other cancer markers. A small number of mild adverse events were reported
and interactions with other interventions were not assessed. Cohort and case-control studies assessing the relationship
between dietary fish intake and the risk of PrCa were equivocal. Cohort studies assessing the risk of PrCa mortality
suggested an association between higher intake of fish and decreased risk of prostate cancer–related death.
Conclusions
.
Current evidence is insufficient to suggest a relationship between fish-derived omega-3 fatty acid and risk of PrCa. An
association between higher omega-3 intake and decreased PrCa mortality may be present but more research is needed.
More intervention trials or observational studies with precisely measured exposure are needed to assess the impact of fish
oil supplements and dietary fish-derived omega-3 fatty acid intake on safety, PrCa incidence, treatment, and progression.
