These dietary tips can stave off digestive problems, keep your weight and strength up, and improve your quality of life.
Nutrition is an essential part of cancer treatment. Enough calories and the right blend of nutrients helps keep your body strong and more resilient during treatment. Any type of cancer can cause weight loss and nutrient deficiencies, but that's especially true for pancreatic cancer.
"The pancreas is a very important part of the digestive system," explains Vincent Chung, MD, a professor in the department of medical oncology and therapeutics research at City of Hope in Duarte, California. This gland in your belly produces enzymes that aid in digestion. It also releases hormones that help regulate your blood sugar. A pancreatic tumor can cause nutrient deficiencies, blood sugar swings, and dramatic weight loss.
Learn more about the nutritional challenges people with pancreatic cancer face, as well as how to maintain your weight and avoid vitamin and mineral deficiencies during treatment.
Pancreatic cancer can affect digestion and health in several ways. These are some of the most common nutritional challenges affecting people with this type of cancer.
Digestion Difficulties
The pancreas produces digestive enzymes — proteins that help your body break down fats, sugars, and starches. Cancer interferes with its ability to make these enzymes.
"This dysfunction can lead to significant challenges in breaking down and absorbing essential nutrients, which can contribute to malnutrition," explains Renee E. Stubbins, PhD, an assistant professor of nutritional sciences in medicine at Houston Methodist Neal Cancer Center.
About 1 in 5 people with pancreatic cancer are eligible to have the Whipple procedure, a type of surgery that removes the widest part of the pancreas, the first part of the small intestine (duodenum), part of the bile duct, and the gallbladder. Anyone who has such a big part of their digestive system removed may no longer be able to make enough digestive enzymes, and will need to take pancreatic enzyme supplements afterward to help them digest food.
Weight Loss and Muscle Wasting
Impaired digestion, plus appetite loss and nausea from chemotherapy can lead to significant muscle and fat loss, which doctors call cachexia.
"People with pancreatic cancer will typically start to lose a lot of weight, and that really affects their overall well-being," says Dr. Chung.
Glucose Metabolism Issues
The pancreas produces insulin, a hormone that transports glucose (sugar) from the bloodstream into the cells for energy or storage. Pancreatic cancer disrupts insulin production, which could lead to high blood sugar or diabetes. Some experts believe that type 2 diabetes could be an early warning sign of pancreatic cancer.
People undergoing treatment for pancreatic cancer have increased nutritional needs, says Rachael Williams, RDN, a clinical dietitian at Moffitt Cancer Center in Tampa, Florida.
"Consuming adequate calories can help prevent unintentional weight loss,” she says.
Everyone with pancreatic cancer has different nutritional needs. That's why it's important to work with a registered dietitian, and ideally one who is certified in oncology, who can tailor an eating plan for you.
"A personalized approach is vital, as it directly addresses the individual's nutritional requirements and treatment goals," says Dr. Stubbins.
Experts also recommend these strategies to avoid weight loss and muscle wasting during treatment.
Choose High-Calorie, Nutrient Dense Foods
Your diet should include protein in every meal (chicken, fish, eggs), healthy fats (peanut butter, olive oil), and high-calorie drinks (milkshakes, smoothies) to help you add weight and preserve muscle.
Eat Smaller Meals
If you have nausea from chemotherapy or you feel full quickly after eating, eat small portions of food every two to three hours instead of three big meals, suggests Williams. She also recommends ginger cookies or candies to combat nausea.
Drink Enough Fluids
Vomiting and diarrhea, as well as high blood sugar, can lead to dehydration. Chung recommends drinking at least 64 ounces of fluid — about 8 glasses — each day, and not just water.
"If you drink water alone, that dilutes the electrolytes in your body." Instead, he suggests adding coconut water or a sports drink to replenish electrolytes. Juice and protein shakes are other good beverage options.
All these foods are an essential part of a nutritionally balanced diet for people with pancreatic cancer:
Protein Because this nutrient helps repair the cells that cancer damages, your protein needs increase during treatment. Good sources include chicken, fish, eggs, nuts, seeds, beans, and tofu.
Healthy Fats Unsaturated fats give you extra calories and help your body absorb more nutrients. Good sources include avocados, fatty fish like salmon, olives and olive oil, nut butters, and seeds.
Good Carbs Fruits and vegetables are loaded with nutrients, while complex carbs provide your body with fiber. You may need to cut back on foods with insoluble fiber like vegetables and wheat if you have diarrhea because it could make this side effect worse. Soluble fiber (oat bran, barley, nuts, seeds, beans) shouldn't bother you. Good sources include berries, apples, oranges, broccoli, onions, kale, quinoa, barley, and farro.
Tips for Better Digestion
Pancreatic enzymes are essential for digestion. If your pancreas no longer makes these enzymes, you'll need to take supplements — what doctors refer to as pancreatic exocrine replacement therapy (PERT).
Pancreatic enzyme supplements are available over-the-counter, but because they're not regulated by the U.S. Food and Drug Administration (FDA), you're safer taking a prescription product. Some people will only need to take pancreatic enzymes temporarily, but if you've had the Whipple procedure you may need to stay on them for life.
Another way to manage digestive issues is to eat foods that are soft and easy for your body to break down, such as:
Oatmeal
Hard-boiled eggs
Yogurt
Cottage cheese
Chicken and rice soup
If you’re being treated for pancreatic cancer, you should limit or avoid these foods.
Sugary and processed foods: Not only are cookies, snack chips, and candy low in nutrition, they also wreak havoc on your blood sugar levels. "Because you have a tumor in your pancreas, that will impair insulin production, and you may have wild blood sugar swings," says Chung.
Greasy and fatty foods: Burgers, pizza, and fried chicken are hard to digest and can worsen diarrhea. High-fiber, spicy, and sugar-free foods are also difficult for your compromised digestive system to handle.
Raw fruits and vegetables: Chemotherapy suppresses your immune system. A weakened immune system offers little defense against E. coli and other bacteria that can hide in raw produce. Consuming foods containing these germs could lead to a life-threatening infection. Wash all fruits and vegetables thoroughly before eating them, and cook them if you can. Avoid buffets, and heat foods to the appropriate temperature, suggests Williams.
Caffeine and alcohol: Both of these can increase your risk of dehydration. You're much safer drinking water and other uncaffeinated and nonalcoholic beverages.
If your diet isn't providing enough calories and nutrients, it might need a boost.
"Nutritional supplements can be very helpful for patients trying to obtain adequate calories and protein during treatment," says Stubbins. She recommends brands like Boost, Ensure, Orgain, and Premier Protein.
As for nutrition that comes in the form of pills or gummies, Williams doesn't recommend them.
"Most supplements have not been appropriately studied in conjunction with cancer treatments," she says.
There's a chance that herbal remedies or other supplements could interfere with your cancer medications or cause harmful side effects. Check with your oncologist before taking any supplement.
If you can't get enough nutrients from foods and you're at risk for malnutrition, or you've had surgery that's preventing you from absorbing enough nutrients, your oncologist may recommend getting nutrition more directly. Enteral nutrition delivers nutrients and calories directly to your GI tract through a feeding tube. Parenteral nutrition delivers them through a vein.
A feeding tube won't prevent you from eating food. As long as you can safely eat, the tube will be a supplement to your normal diet. It's also not forever.
"Feeding tubes are not necessarily permanent fixtures,” Williams explains. “Often they're used temporarily to ensure adequate nutrition, and removed once a patient can sustain themselves on an oral diet."
Pancreatic cancer can affect your body’s digestion and blood sugar metabolism. You'll need to be more mindful about the types of foods you eat.
To keep up your weight, muscle mass, and nutrition during treatment, it's important to get enough calories, protein, healthy fats, and complex carbs in your diet.
A dietitian who specializes in oncology nutrition can help you create a personalized nutritional plan that factors in your specific dietary needs and food preferences.
