We did not find significant improvement in appetite, other
symptoms, nutritional status, or physical function after the
administration of fish oil for 2 weeks using a mean daily dose of
1.8 g of EPA and 1.2 g of DHA as compared with that of the
placebo in patients having advanced cancer. We also observed
no correlation between most subjective and objective outcomes
and dose in the fish oil group (Table 3). The absence of
significant benefits regarding symptoms or nutritional status
cannot be considered proof that such benefits do not exist.
However, the findings for appetite using our well-powered
sample size indicate that fish oil administered at a high dose had
no clinically relevant effects over the 2-week observation period.
Our power calculations were based on the detection of a
difference in appetite as a primary end point. Research on other
drugs for cachexia, such as megestrol acetate,24,27 thalidomide,29
and corticosteroids,30 have found that appetite is an earlier and
more sensitive variable than nutritional indices or weight gain.
Therefore, it is unlikely that improvement in nutritional indices