The use of an anabolic steroid (nandrolone decanoate) to improve nutritional status after esophageal resection for carcinoma

Anabolic steroids increase appetite and muscle mass. This randomized, doubl e-blind trial investigates any nutritional benefits of anabolic steroid in patients after surgery for esophageal cancer. Forty patients were recruited : 19 patients had five injections of 50 mg nandrolone decanoate and 21 pati ents received placebo over 3 months, starting 1 month after surgery. Measur ements of body weight, mid-arm muscle circumference (MAMC) and appetite wer e taken over a 6-month period. Nutrition was optimized by dietary advice an d by esophageal dilatation if required. Percent ideal weight, percent ideal MAMC and appetite score did not show significant differences between stero id and placebo groups, but there was a trend to an increase over 6 months f or percent ideal MAMC in the test group. With this protocol, we have experi enced minimal side-effects. However, we have not demonstrated any therapeut ic benefit with low-dose steroid. An increased dose schedule over a longer period might produce a significant response.