Nutrition's Role In Managing Pancreatic Cancer Symptoms

When diagnosed with pancreatic cancer, one of the last things on a patient’s mind may be diet and nutrition, yet these are two key components that medical experts say can affect the outcome of treatment.

Patients with pancreatic cancer often experience weight loss, loss of appetite, fatigue, nausea, as well as back and belly pain. The cancer itself plays a large role in preventing patients from having a normal diet and nutrition.

During a live broadcast of CURE Connections, held during the Seventh Annual Ruesch Center Symposium: Fighting a Smarter War on Cancer on Dec. 3 in Washington, D.C., a panel that included an oncologist, a nurse, an oncology dietitian and a patient advocate discussed the importance of nutrition when trying to manage a long list of symptoms.

“These cancers are well-known to release hormones that we don’t fully understand that rob a patient of their appetite,” said Michael Pishvaian, M.D., Ph.D., director, Phase 1 Clinical Trials Program, Division of Hematology/Oncology, Georgetown Lombardi Comprehensive Cancer Center. “It makes them feel like they don’t want to eat or drink anything. It robs them of their calories even if they are very conscientious about getting enough nutrition in. It can even cause changes to taste, so a patient with pancreatic cancer will often complain about an abnormal taste sensation long before they even start chemotherapy.”

Pishvaian explained that the pancreas creates digestive enzymes that help digest food properly. When the cancer invades the pancreas, this disrupts proper digestion. The lack of digestion also leads to bacterial overgrowth lower down into the gastrointestinal (GI) tract and can cause a lot of discomfort, gassiness, bloating and diarrhea, he added.

There are ways to try to manage these symptoms before, during and after the cancer journey. The panel recommended patients make it a priority to meet with a dietician one-on-one. Some cancer centers already have a dietician in place.

“Often pancreatic cancer patients will undergo a surgery called a Whipple Procedure (pancreaticoduodenectomy), which can impair a patient’s ability to digest certain foods like fats, carbohydrates and proteins — particularly in fats,” said Rachel Wong, R.D., oncology dietician, Georgetown Lombardi Comprehensive Cancer Center.

She added, that this is where digestive enzymes, which help break down fats, proteins and carbohydrates, should be consumed with meals and snacks.

Patients should consume energy-dense nutritious foods such as quinoa, oatmeal and avocado, which all have healthy fats. As far as sugars go, they should continue to eat fruits, but stay away from simple sugars like candy bars.

It is also recommended that patients with pancreatic cancer eat small, frequent meals, eat slowly and also keep a diary of everything they are eating and drinking each day.

Patricia Reilly, a holistic health counselor, nutrition expert and patient advocate, says the best way a caregiver can be there for a loved one with pancreatic cancer is to help with nutrition. She became that person for her husband, who had pancreatic cancer.

“We recognized that he wanted to feel good every day. As a caregiver, I looked at the foods,” Reilly said. “I want my doctor to know about those clinical trials. I want him to be on top of that and let me create a team to support my husband in terms of what he’s eating for breakfast, lunch and dinner, again looking for nutrient-dense foods that will support him to be stronger so he will get to that clinical trial.”

The panel also opened up the discussion on marijuana and if there is a benefit there for patients with pancreatic cancer, which they agreed there is.

“We are seeing that their appetite goes up, their sense of well-being is greater and their pain levels are reduced,” said Pishvaian. “It is not a treatment for their cancer, but universally makes them feel better. Try things, see what works and stick with it.”