Clinical Research Directory

Inclusion Criteria: 1. Ability to give signed informed consent and willing and able to comply with the protocol. 2. Patients aged 18 years and above. 3. Patients with newly diagnosed, pathologically confirmed pancreatic ductal adenocarcinoma who will undergo neoadjuvant chemotherapy following formal MDT assessment at St Vincent's University Hospital, specifically FOLFIRINOX or Gemcitabine with Nab-Paclitaxel (and/or any additional therapy regimen approved by NCCP). 4. Patients have CT scan available and suitable for body composition analysis within 8 weeks prior to randomisation. 5. Patients have adequate upper limb dexterity to allow assessment of hand grip strength. Exclusion Criteria: 1. Patients who are unable to consume oral diet and require prolonged enteral and/or parenteral nutritional support. 2. Patient with any significant history of non-compliance to medical treatments or with inability to grant reliable informed consent. 3. Patients who can/will not consume fish and pork products due to allergy, intolerance, religious beliefs, or dietary preferences. 4. Patients with known blood clotting disorders, e.g antiphospholipid syndrome, factor V Leiden syndrome, haemophilia /any liver disease which has progressed to liver cirrhosis where prolonged fish oil supplementation is unsafe. 5. Patients with uncontrolled hypertension (BP \>180/110 mm Hg) which prohibits exercise. 6. Patients with muscle wasting disorders, e.g. paraplegia, motor neuron disease, Duchenne muscular dystrophy, multiple sclerosis. 7. Women who are pregnant or breastfeeding due to differing nutritional needs and macronutrient metabolism.