Energy Reversal Battle: Fat Emulsion Drip
Chemotherapy, radiotherapy, and immunotherapy deplete the body’s strength; fat emulsion infusion helps Hong Kong cancer patients rebuild their energy and autonomy in life.
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Introduction: How to Restore Energy After Treatments
For cancer patients in Hong Kong, the real battlefield is not only the tumor itself. Side effects from chemotherapy, radiotherapy, immunotherapy, and targeted therapy often “drain” the body faster than the tumor. Many people experience rapid weight loss, muscle wasting, decreased physical strength, and may even develop cancer cachexia.
In this situation, relying solely on daily diet or oral nutritional supplements is often insufficient. Medical teams may recommend parenteral nutrition (PN), one of whose core components is intravenous lipid emulsion (ILE). For patients, this is not just “dripping fat,” but directly delivering energy, immune modulation, and anti-inflammatory potential back into the body, helping them get through the most difficult moments.
(References: Wischmeyer, 2020; Pradelli et al., 2020)
What is Intravenous Lipid Emulsion?
Lipid emulsion is a parenteral nutrition formulation made from plant oil or fish oil, emulsified with lecithin as an emulsifier and glycerol as a stabilizer, then diluted with water into a milky-white liquid. It can be infused directly into veins, bypassing intestinal absorption.
Common lipid emulsion formulations include:
Soybean oil emulsion: Rich in ω-6 fatty acids (linoleic acid), providing essential fatty acids, but high ω-6 may promote inflammation. (Pradelli et al., 2020)
Medium-chain triglyceride (MCT) emulsion: Metabolized quickly, does not require bile salts or carnitine, suitable for patients needing rapid energy. (Waitzberg et al., 2006)
Olive oil emulsion: Rich in monounsaturated fatty acids (ω-9), metabolically neutral, reduces pro-inflammatory risk. (Calder, 2019)
Fish oil emulsion: Contains EPA and DHA (ω-3 fatty acids), with anti-inflammatory and immune-modulating effects, and in recent years considered an important component of “immunonutrition.” (Calder, 2022)
Different formulations correspond to different metabolic pathways and immunological effects.
Why Do Cancer Patients Need Lipid Emulsion?
Counteracting Cancer Cachexia
Cancer cachexia is a systemic metabolic disorder characterized by weight loss, muscle wasting, and increased energy expenditure. Supplementing only carbohydrates or protein is often insufficient. Lipid emulsion provides high energy density, preventing further weight loss. (Fearon et al., 2011)
Reducing Muscle Breakdown
When energy intake is insufficient, the body breaks down muscle protein for fuel. Intravenous lipids can partially replace energy sources, protecting muscle tissue and slowing sarcopenia progression. (Pradelli et al., 2020)
Providing Essential Fatty Acids
Humans cannot synthesize ω-6 and ω-3 fatty acids and must obtain them externally. Deficiency can cause dry skin, immune imbalance, and poor wound healing. Lipid emulsion helps maintain balance during treatment. (Calder, 2019)
Supporting Immunity and Anti-Inflammation
Fish-oil-based lipid emulsions containing EPA/DHA can reduce the release of inflammatory mediators and lower chronic inflammation caused by treatment, which is especially important for patients undergoing radiotherapy or immunotherapy. (Calder, 2022)
Potential Benefits: Patient Perspective
Reducing Treatment Side Effects
Some patients report decreased fatigue and improved mental status during chemotherapy after lipid emulsion supplementation. This is related to lipid emulsion’s role in lowering inflammation and improving energy metabolism. (Pradelli et al., 2020)
Improving Quality of Life
For patients in Hong Kong, being able to “move and eat” is more important than data. When lipid emulsion provides sufficient energy, some patients report faster recovery from treatments and improved autonomy in daily life. (Waitzberg et al., 2006)
Helping Complete Treatment
Many patients are forced to interrupt treatment due to side effects or insufficient energy. Lipid emulsion infusions help maintain strength and reduce the risk of stopping treatment because of exhaustion. (Wischmeyer, 2020)
Risks and Controversies
Infection Risk
Parenteral nutrition requires a central venous catheter, increasing the risk of infection. Poor care may lead to hospitalization due to catheter-related infections. (Pironi et al., 2020)
Hyperlipidemia and Liver Burden
If infusion rate or dose is too high, it may cause elevated blood lipids or liver function abnormalities. Patients with liver metastasis or impaired liver function need careful monitoring. (Waitzberg et al., 2006)
Fatty Acid Ratio Debate
Soybean oil emulsion: High in ω-6, criticized for potentially promoting inflammation and immune suppression. (Calder, 2019)
Fish oil emulsion: Some studies show anti-inflammatory effects, but whether it interferes with immunotherapy still requires more data. (Calder, 2022)
Clinical Cases and Research Data
Case 1: Gastrointestinal Cancer Patients
A European clinical study showed that postoperative gastrointestinal cancer patients receiving fish-oil-enriched lipid emulsion had lower infection rates and shorter hospital stays. (Pradelli et al., 2020)
Case 2: Chemotherapy in Breast Cancer Patients
Some studies indicate that supplementing with ω-3-containing lipid emulsions can improve chemotherapy tolerance and reduce inflammatory markers. (Calder, 2022)
Case 3: Local Experience in Hong Kong
In public hospitals in Hong Kong, some late-stage patients with severe cachexia and difficulty taking oral nutrition receive PN, with lipid emulsion as the main calorie source. Patients and families are often concerned about “feeding the tumor.” Doctors explain that the goal is not to “feed the tumor,” but to prevent energy deficiency that might force patients to abandon treatment. (Hong Kong Clinical Nutrition Experience, 2022)
Real Situation for Hong Kong Patients
Limitations of the Healthcare System
Public hospitals are understaffed, and nutrition support is often provided only in “emergency” situations. Many patients receive PN only after severe cachexia develops. Patients and families often feel information is insufficient and have limited understanding of the effects and risks of lipid emulsions.
Financial Pressure
Some patients turn to private healthcare for more proactive nutritional support, which can be expensive and a heavy burden on lower-income families.
Patient Voice
Many patients say: “I’m not afraid of the tumor; I’m afraid that treatment will make me unable to continue.” For them, lipid emulsion infusions symbolize the chance to “hold on a little longer.”
Future Outlook
Precision Nutrition
The future direction is no longer “one-size-fits-all,” but designing lipid emulsions based on tumor type, metabolic state, and immunotherapy approach.
Combination with Immunotherapy
Research is exploring whether ω-3 fatty acids can enhance immunotherapy effects or at least reduce side effects. This may become part of next-generation “nutritional adjuvant therapy.”
Hong Kong’s Role
As a city integrating Eastern and Western medicine, Hong Kong can promote comprehensive nutritional interventions in both public and private systems, making lipid emulsions not just a “last resort,” but part of a treatment strategy.
Conclusion: Energy Back in the Body is the Key to Keep Going
For cancer patients in Hong Kong, lipid emulsion infusions are not just “parenteral nutrition.” They are a way to regain strength to continue treatment, fight cachexia, maintain immunity, and improve quality of life.
However, it is not a panacea: professional monitoring is required to avoid infections and metabolic burden. More importantly, patients and families should receive full information, understanding why, how, and when to use it.
Fighting cancer is a long race. Whether lipid emulsion helps you “hold on longer” depends on precise medical decisions and patient self-awareness. True strength is not only the drug, but the courage regained when energy is restored and the patient can step out of the hospital back into life.
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References
- Calder, P. C. (2019). Rationale for using new lipid emulsions in parenteral nutrition and a review of the trials performed in adults. Proceedings of the Nutrition Society, 78(3), 366–376.
- Calder, P. C. (2022). Omega-3 fatty acids and cancer-related fatigue. Current Opinion in Clinical Nutrition & Metabolic Care, 25(4), 303–309.
- Fearon, K., Arends, J., & Baracos, V. (2011). Understanding the mechanisms and treatment options in cancer cachexia. Nature Reviews Clinical Oncology, 8(7), 444–454.
- Pradelli, L., Mayer, K., Muscaritoli, M., & Heller, A. R. (2020). n-3 fatty acid-enriched parenteral nutrition regimens in elective surgical and ICU patients: Meta-analysis. Critical Care, 24(1), 85.
- Pironi, L., Arends, J., Baxter, J., Bozzetti, F., & Forbes, A. (2020). ESPEN guideline on home parenteral nutrition. Clinical Nutrition, 39(6), 1645–1666.
- Waitzberg, D. L., Torrinhas, R. S., & Jacintho, T. M. (2006). New parenteral lipid emulsions for clinical use. JPEN Journal of Parenteral and Enteral Nutrition, 30(4), 351–367.
- Wischmeyer, P. E. (2020). Tailoring nutrition therapy to illness and recovery. Critical Care, 24(1), 35.