Re-evaluating omega-3 (EPA/DHA) in cancer prevention and management.

PURPOSE OF REVIEW: This review summarizes the most recent evidence on the role of omega-3 polyunsaturated fatty acids (PUFAs) in oncology, focusing on cancer prevention, cachexia and body composition, treatment-related toxicities, and therapeutic response.

RECENT FINDINGS: Recent large-scale epidemiological and biomarker-based studies confirm a consistent, dose-dependent inverse association between eicosapentaenoic acid (EPA) and colorectal cancer risk, while evidence for docosahexaenoic acid (DHA) remains less consistent. Observational data reinforce the protective role of omega-3-rich dietary patterns, such as the Mediterranean and MIND diets, in reducing cancer risk. In clinical settings, omega-3 PUFA supplementation has shown modest but significant clinical benefits on body weight, inflammation, and quality of life in cancer cachexia, though effects on lean mass are variable. Promising data also support a reduction in severe oral mucositis during chemotherapy, whereas trials on chemotherapy-induced peripheral neuropathy and chemosensitization have produced inconclusive results, mainly due to heterogeneity in design and adherence.

SUMMARY: Omega-3 fatty acids exert measurable biological and clinical effects in oncology, however, their benefits appear context-dependent. Future studies should focus on standardized interventions, patient stratification based on molecular and inflammatory profiles, and integration within immunonutrition frameworks to enhance therapeutic precision and clinical outcomes.