Poster Presentation Cancer Survivorship Conference 2023

A scoping review on dietary supplements for malnutrition and malnutrition-related conditions in people with metastatic cancers (#121)

Jolyn Johal 1 , Chad Han 1 , Ria Joseph 1 , Zachary Munn 1 , Andi Agbejule 1 , Fiona Crawford-Williams 1 , Matthew Wallen 1 2 , Raymond Chan 1 , Nicolas Hart 1 3 4 5 6
  1. Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
  2. School of Science, Psychology and Sport, Federation University, Mount Helen, Victoria, Australia
  3. Cancer and Palliative Care Outcomes Centre, School of Nursing, Queensland University of Technology, Brisbane, Queensland, Australia
  4. Exercise Medicine Research Institute, School of Medicine and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia
  5. Institute of Health Research, The University of Notre Dame Australia, Fremantle, Western Australia, Australia
  6. Clinical Exercise Physiology, University of Technology Sydney, Sydney, New South Wales, Australia

Background: Cancer-associated malnutrition, resulting from cancer and/or its treatments, is prevalent in patients with metastatic cancers. Evidence suggests that dietary supplements play a role in managing malnutrition in cancer but the response to dietary supplements may differ between patients with metastatic as compared to non-metastatic cancers, as metastatic cancer cells are associated with notable genomic and phenotypic alterations.
Objective: This scoping review aims to identify dietary supplements studied in patients with metastatic cancers and malnutrition, their proposed effects, mechanisms, outcome measures, and tools used.
Methods: A systematic search was conducted across MEDLINE, EMBASE, CINAHL, and clinical trial registries.
Results: Of the initial 6535 records screened, a total of 48 studies were included, covering a range of dietary supplements— vitamins (n = 13), minerals (n = 5), antioxidants (apart from vitamins and minerals) (n = 7), proteins (n = 3), amino acids (n = 14), fatty acids (n = 18), fibre (n = 1), and others (n = 5). The list of dietary supplements found were Vitamin A/B1/B6/B9/B12/C/D/E, Calcium, Iron, Selenium, Carbocysteine, Curcumin, Lipoic acid, Lycopene, Quercetin, Lactoferrin, Whey Protein isolate, All essential amino acids, Arginine, Branched chain amino acids, Carnitine, Glutamine, Hydroxymethylbutyrate, Omega-3, Fibre, β-hydroxybutyrate, Co-enzyme Q10, Muscadine grape extract, Dietary nucleotides, Royal jelly. Of the 31 dietary supplements studied across cancer types, omega-3 (n=18) and carnitine (n=7) were investigated most often. Dietary supplements were provided orally in 45/48 (94%) of the studies. Types of cancers studied include – Breast, Gastrointestinal, Skin, Colorectal, Gynaecological, Renal, Pancreatic, Prostate, Head and neck, Lung. Proposed relevant attributes of dietary supplements included their antioxidant, anti-inflammatory, anti-cancer, and immunomodulatory properties.
Conclusion: Overall, the studies examining dietary supplements in patients with metastatic cancers were heterogeneous and dissimilar depending on cancer types. More randomised controlled trials are warranted as there was also a dearth of primary interventional studies in this area.