Observational Study on the Effectiveness of L-Arginine Plus Vitamin C in the Management of Cancer-related Fatigue

Background/Aim: Cancer-related fatigue is one of the most distressing symptoms reported by patients with neoplastic disease. L-Arginine has a positive effect on physical performance in healthy individuals, on fatigue in diseases other than cancer, and on immune response in patients with cancer. Patients and Methods: Forty-four patients with cancer undergoing medical treatment were treated orally with 1.66 g L-arginine and 500 mg of vitamin C b.i.d. Cancer-related fatigue and health-related quality of life were recorded before treatment and after 15 and 30 days of supplementation employing a visual analog scale and the European Organization for Research and Treatment of Cancer quality of life questionnaire (EORTC QLQ-C30) respectively. Results: Daily oral supplementation with L-arginine and vitamin C ameliorated cancer-related fatigue in a statistically significant manner. Health-related quality of life remained mostly unchanged despite patients having advanced cancer and being administered medical treatments including chemotherapy, immunotherapy and biological agents. No effect on appetite preservation was observed, except in a small percentage of patients. Conclusion: Our exploratory study suggests a positive effect of oral supplementation with L-arginine plus vitamin C on cancer-related fatigue without significant worsening of quality of life. Due to the heterogeneity of the patient sample, further studies are needed including more clinically homogenous groups of patients.