A diagnosis of any cancer can cause an overwhelming, stressful and emotional reaction. Making it even more daunting is trying to think of what to do first while simultaneously processing the reality of it all. WINGS OF HOPE offers the following resources to supplement your understanding of pancreatic cancer, diagnosis and treatment options and procedures, statistics and other information.
As the source of insulin that helps in the regulation of blood sugar and of enzymes that help break down fats, carbohydrates, and proteins, the pancreas is a key part of the digestive system.
So it’s not so surprising that cancer of the pancreas can bring with it significant nutritional challenges. Successfully addressing these challenges, however, brings multiple rewards: it can enable and enhance treatment, boost day-to-day well-being, and support healthy recovery.
When assembling a team to tackle your pancreatic cancer, a dietitian should be one of your first recruits, according to Maria Petzel, RD, CSO, LD, CNSC, a senior clinical dietitian at the MD Anderson Cancer Center. Ideally, he or she should have a CSO after their name, signifying they have received oncology nutrition certification, with more than 2,000 hours of clinical oncology experience under their belt. That experience comes in handy when assessing the needs of each patient, which differ from person to person, based on factors such as their body type, treatment history, surgical history, and amount of fat in their diet.
For pancreatic cancer patients it is important that the dietitian is well-educated in enzymes. Pancreatic enzymes help break down fats, proteins, and carbohydrates. A deficit of pancreatic enzymes can affect digestion, cause uncomfortable side effects, and weight loss. Symptoms of inadequate enzyme production include excessive gas, bloating, or indigestion after meals and changes in bowel movements such as light colored or yellow stools or stools that are frequent, floating, oily, or loose.
Fun Fact: A normally functioning pancreas secretes about eight cups of enzyme-containing pancreatic juice into the duodenum daily.
“Inadequate enzyme production can be fixed with pancreatic enzyme replacement therapy (supplementing with prescription enzymes), but it’s not a one-size-fits-all solution,” Petzel says. “Pancreatic cancer patients need to have someone on their healthcare team who can help individuals figure out what brand and dose works best to help minimize symptoms and get maximal digestion and absorption.”
Weight loss due to pancreatic cancer is common, but its causes can be complicated. Some are related to the tumor itself, in which case surgery, chemotherapy, or radiation treatment can help. Others, however, are a result of such treatment.
Nausea, loss of appetite, or the change in taste that often accompany chemo or radiation therapy can be combated through diet and pharmaceutical strategies. These are most successful when tailored to each patient, Petzel explains. One person’s diarrhea could be caused by fat malabsorption due to pancreatic enzyme insufficiency, while another may be suffering the effects of lactose intolerance, bacterial overgrowth, chemotherapy, or dumping syndrome from surgical resection. Enzyme replacement may solve the problem for some patients, while a low-fat, low-fiber, and/or dairy-free diet might do the trick for others.
Maintaining a healthy weight for pancreatic cancer patients can be critical to the success of their treatment. “We know that patients who are able to maintain weight are more likely to get their scheduled doses of treatment,” Petzel adds.
Here is some general advice Petzel offers for patients:
Additional nutritional advice can be found on the Academy of Nutrition and Dietetics Oncology Nutrition website. The American Institute for Cancer Research also provides some culinary inspiration in its recipe archives.
As research for the treatment of pancreas cancer develops, fewer patients are being treated with single-modality therapy. Instead, most patients are being treated with a combination of surgery, chemotherapy and/or radiation therapy. This often makes navigating the healthcare system difficult and overwhelming. In a traditional medical environment, patients are often seen by different specialists over the course of several weeks. The Pancreas and Biliary Multidisciplinary Clinic at the CU Cancer Center is designed so that patients are seen by our team of specialists over one day with the goal of having a treatment plan by the end of the visit. This multidisciplinary approach to care provides patients with the most up-to-date and evidence-based treatment to provide the best care for the highest chance of success and cure of disease.
- Cheryl Meguid, DNP, ACNP
Pancreas and Biliary Cancer Clinic Coordinator
To learn more about the Pancreas and Biliary Cancer Multidisciplinary Clinic or schedule an appointment:
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