The pancreas produces hormones and enzymes that help digest food. If you have pancreatic cancer, the pancreas no longer functions properly. Substances are released into the body that affect your metabolism and appetite. This can cause problems with eating and drinking. For example:
- you may experience a low appetite.
- you eat or drink too little.
- your body cannot digest food properly.
- your smell and taste abilities change.
- you get diabetes and because of this you have to drink and urinate a lot.
These problems can lead to malnutrition. When you’re malnourished, your body doesn’t get enough energy, protein, and other nutrients from food and drink. This causes you to lose weight and weaken your muscles, while your need for energy (fuel) actually increases.
Eight out of ten people are malnourished when they are diagnosed with pancreatic cancer. Malnutrition also increases your risk of problems during surgery or chemotherapy. It also makes it more difficult to recover after surgery or chemotherapy.
If you have pancreatic cancer, a dietitian can help you eat the right type of food suitable for your condition. You’ll have an appointment with a dietitian if your doctors suspect you have pancreatic cancer. The dietitian will review your progress with you. They’ll look at things like:
- have you lost weight?
- how strong are your muscles?
- what do you eat?
- are you getting enough nutrients?
- are you already taking extra vitamins or minerals?
Energy and proteins
You are often advised to eat food that produces extra energy (calories) and protein to build strength. Eating food that contains enough energy and protein reduces muscle loss, improves fitness, and strengthens your immune system. This can help you to tolerate treatment better.
- You can get more energy and protein by spreading your meals throughout the day. Eat smaller portions more frequently, for example, every two hours.
- Examples of energy-rich products are: nuts, avocado, oily fish (such as salmon, mackerel and herring), olive oil, fattier types of meat and dairy products (such as cheese, whole milk and full-fat yoghurt).
- Examples of protein-rich products: fish, legumes, soy products, nuts, eggs, cheese, milk (products), chicken, meat and meat substitutes.
- If you have trouble drinking enough or are no longer able to get enough nutrients, it may be helpful to supplement your usual diet with medical nutrition. Consult with your doctor or dietitian to determine if this is a good option for you.
Pancreatic enzymes
The pancreas produces various enzymes that help you digest food. Pancreatic cancer or its treatment can impair this process. If the pancreas produces fewer enzymes, you may experience problems digesting food. This can include gas, bloating, intestinal cramps, or abdominal pain. You may also experience fatty diarrhea. This is loose, greasy, and sticky stool with a grayish/beige color and a strong odor.
If your pancreas doesn’t produce enough enzymes to digest fat and protein, you’ll receive capsules. These capsules are filled with granules containing pancreatic enzymes. Swallowing the capsules releases pancreatic enzymes into your small intestine. This improves the digestion and absorption of nutrients from food and drink. Pancreatic enzymes are primarily needed to digest dietary fats. They are also necessary for digesting proteins.
Insulin
The pancreas also produces the hormone insulin, which is necessary for digesting carbohydrates. Pancreatic cancer or its treatment can cause the pancreas to produce too little or no insulin. This leads to diabetes mellitus. By monitoring your diet in consultation with a dietitian, your blood tests, and taking insulin or other medications as needed, you can learn to manage this.
Vitamins
If you have fatty diarrhea, your doctor can check your blood levels of vitamins A, D, E and K. These vitamins are fat-soluble. Pancreatic cancer often makes it harder for your body to absorb fat. So you might not get enough vitamins into your body along with the fats.
If you have too little vitamin A, D, E and K in your blood, you may be advised to take extra vitamins.
Diets and supplements
Some people with cancer wish to supplement their hospital treatment with a special diet, supplement their diet with vitamins and minerals, or supplements. Scientific research has not yet demonstrated that a specific eating pattern or diet can positively influence the progression of cancer. For example, there is also no evidence that turmeric helps with pancreatic cancer.
Dietary supplements can sometimes be a helpful addition, but they can also be harmful if you consume too much of certain substances. Therefore, always consult your doctor or dietitian if you’re considering a special diet or taking nutritional supplements.
Nutrition and chemotherapy
Chemotherapy for pancreatic cancer can cause eating problems, as side effects such as poor appetite and nausea make eating difficult. These side effects are usually temporary. It’s important to always drink plenty of fluids. Fluids are needed to get rid of any harmful residues through the kidneys. Therefore, it’s recommended to drink 1.5 to 2 liters of fluids per day (2 liters = 10 glasses). A dietitian can advise you further during chemotherapy.
Nutrition around the surgery
If you will be undergoing surgery, paying extra attention to nutrition is crucial. If you have lost a lot of weight, you are more likely to experience problems afterward. Your dietitian will advise you on what to eat to be as strong as possible before surgery.
- After surgery, you can eat and drink whatever you want. Sometimes this is more difficult due to nausea, vomiting, diarrhea, impaired taste, or decreased appetite. Pain and anxiety can also affect your eating and drinking.
- It’s important to spread your meals throughout the day. Eat slowly and chew well.
- Your stomach may not be functioning properly and may stay full for longer. This can cause bloating and nausea. It may also make you unable to eat normally. If this continues for a few days, you may receive nutrition through an IV or a feeding tube. A feeding tube is a tube that runs from your nose to your small intestine, through which the nutrition flows.
- Once your stomach is working again, you can slowly start eating normally. Sometimes you’ll be given drinks with extra energy (calories) and protein.
- Sometimes the stomach empties too quickly after surgery. This can cause abdominal pain or diarrhea immediately after eating. You may also experience symptoms 1.5 to 2 hours after eating, such as sweating, tremors, palpitations, or a sudden feeling of hunger (to an extreme degree). These are dumping symptoms. If you experience these symptoms, your dietitian will advise you about eating and drinking.
- When you go home, your dietician will give you advice about your diet at home.
Nutrition at the end of your life
If the pancreatic cancer has spread or is in a difficult location, in most cases it can’t be cured. Even then, nutrition can still be important.
People with pancreatic cancer who are nearing the end of their lives often lose weight because they eat less. This can happen because they no longer feel like eating, feel full quickly, get nauseous easily, or suffer from (fatty) diarrhea.
You choose the food that makes you feel most comfortable and gives you the least symptoms. A dietitian can help you with this.