Written by Kayla Cooke, MS Student at Pace University

November 16 is World Pancreatic Cancer Day, created to spread awareness about this disease. Pancreatic cancer involves the uncontrolled growth of cells in the pancreas. This type of cancer is the tenth most common and its incidence rate has been growing by about 1% every year for men and women since the late 1990s.2,7 African American men are most susceptible to pancreatic cancer though many other groups are affected.4 Additionally, pancreatic cancer is common among older people with an average age of 70 at the time of diagnosis.4 It is a serious diagnosis since on average only 12.5% of people survive within five years of being diagnosed.7

Unfortunately, it is harder to diagnose pancreatic cancer early on which contributes to its average low survival rate.1 If pancreatic cancer is not diagnosed early, over time the cancer can spread to other parts of the body including blood, other tissues, and the lymphatic system complicating treatment.1 It is harder to detect pancreatic cancer in its earlier stages because there aren’t as many noticeable symptoms.1 When there are noticeable symptoms, they also resemble many other illnesses which can lead to misdiagnosis.1 Some signs of pancreatic cancer involve unexpected weight loss, jaundice, and abdominal and back pain caused by tumor pressure on nerves or nearby organs.1 Since this cancer can be hereditary (e.g. through passing down gene mutations), it is suggested that those with a strong family history or genetic predisposition to pancreatic cancer be annually screened.2,4 However, the US Preventive Services Task Force doesn’t recommend screening for this type of cancer for those who are asymptomatic.2

Along with having a strong family history of pancreatic cancer or pancreatitis, there are more controllable risk factors.1 These risk factors include history of smoking, excess weight, and existing diabetes or chronic pancreatitis.1 As a preventative measure, one can incorporate more daily physical activity to help maintain or achieve a healthy weight and reduce the risk for type 2 diabetes. This can be a simple lifestyle change such as doing a wall squat while scrolling through social media or leg raises while brushing teeth. Exercising muscles more frequently and intensely improves insulin sensitivity.3 For further information about diabetes including ways to reduce your risk, please refer to our April blog post.

Diabetes is a common comorbidity as the tail portion of the pancreas contains cells that produce insulin and glucagon (hormones that regulate blood sugar levels). Therefore certain pancreatic cancers can reduce one’s ability to produce these hormones which can lead to diabetes.6 With insulin resistance, dietary changes such as reducing added sugar are recommended to keep blood sugar levels stable.6

The type of pancreatic cancer treatment depends on the stage, patient health status, and whether the disease is reoccurring.1 Sometimes combined treatments such as surgery with chemotherapy or radiation can support survivorship.2 Aside from oral pain medications, if the pain is severe enough one may require medication injections around the affected area, have the nearby nerves cut, or undergo radiation to shrink the tumor.1 Pancreatic cancer treatment may affect the organ’s ability to produce enzymes which help with digestion.1 One can be prescribed

medication to replace these enzymes.1 Nutrition-based treatment includes eating softer (e.g. chopped or boiled) foods to support digestion.5 Fat digestion is especially affected by having reduced pancreatic enzymes, so it is recommended to limit fatty and greasy foods to reduce potential digestive issues.6 Overall, it's best to not eat foods that noticeably increase adverse symptoms such as diarrhea or vomiting.6

When undergoing pancreatic cancer and treatment it is important to consider healthful dietary changes to support strength and energy. Cancerous tumors in the pancreas release cytokines that reduce appetite and increase calorie use which can lead to weight loss.6 This weight loss can be compounded through treatment side effects, like nausea or vomiting. Therefore it is recommended to incorporate more calorie-dense foods to prevent weight loss as this can hinder the body’s ability to fight infection and handle the treatment.5 It’s also recommended to eat more lean protein-dense foods to help maintain muscle mass and strength.6 Being physically active during treatment can help promote appetite.5 Common nutrition recommendations for cancer patients undergoing treatment include eating small, frequent meals and not drinking fluids shortly before or during a meal to make it easier to consume more calories.5, 6 If diagnosed with pancreatic cancer and are undergoing treatment, it is best to consult a Registered Dietitian for specific nutritional needs and lifestyle changes to best support health and well-being.

References

1. Pancreatic Cancer Treatment (PDQ®)–Patient Version. National Cancer Institute. Published May 5, 2023. Accessed October 23, 2023. https://www.cancer.gov/types/pancreatic/patient/pancreatic-treatment-pdq#:~:text=Pancre atic%20cancer%20is%20a%20disease

2. Cancer Facts & Figures 2023. American Cancer Society; 2023:23. Accessed October 23, 2023.

https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/annua l-cancer-facts-and-figures/2023/2023-cancer-facts-and-figures.pdf

3. Simple Steps to Preventing Diabetes. Harvard T.H. Chan. Accessed October 23, 2023. https://www.hsph.harvard.edu/nutritionsource/disease-prevention/diabetes-prevention/pre venting-diabetes-full-story/#:~:text=Beyond%20individual%20behavior

4. Pancreatic Cancer Risk Factors. www.cancer.org. Published June 9, 2020. Accessed October 23, 2023.

https://www.cancer.org/cancer/types/pancreatic-cancer/causes-risks-prevention/risk-facto rs.html

5. Walsh C. Pancreatic Cancer Nutrition: 12 Pancreatic Diet Tips. John Hopkins Medicine. Accessed October 23, 2023.

https://www.hopkinsmedicine.org/health/conditions-and-diseases/pancreatic-cancer/pancr eatic-cancer-nutrition#:~:text=Patients%20with%20pancreatic%20cancer%20often

6. Whelan C. Can Diet Help Pancreatic Cancer? Healthline. Published July 20, 2023. Accessed October 23, 2023.

https://www.healthline.com/health/pancreatic-cancer/diet#enzymes-and-supplements

7. Cancer Stat Facts: Pancreatic Cancer. Surveillance, Epidemiology, and End Results Program (SEER). Accessed October 23, 2023. https://seer.cancer.gov/statfacts/html/pancreas.html