Our findings indicate that fish oil used as alternative or
complementary medicine at the study dose or even at much
higher doses is not useful in improving subjective and objective
manifestations of cancer anorexia/cachexia. One potential concern
would be the purchase and use of fish oil capsules of
patients out of the context of the study (A. Voss, personal
communication, 2002); this could result in a number of placebo
patients actually receiving fish oil without the knowledge of the
investigator. In fact, the blood levels of EPA and DHA in one of
our patients indicated that he was taking fish oil. However,
because of the low frequency of this event in our sample, it is
unlikely that use of over-the-counter fish oil had any effect on
the results of our study.