PANCREATIC CANCER: A PERSONALISED NUTRITION PLAN

Proper nutrition applies to both the healthy population and those already affected by disease.
The recommendations of the World Cancer Research Fund are a valid and balanced guide to maintaining a healthy lifestyle and preventing oncological diseases without having to resort to “extreme” diets.

Recommending a correct diet to those already affected by an oncological pathology is difficult, and all the more difficult in case of pancreatic cancer. In the latter case, it is necessary to take into account the location of the tumor and the treatments (surgeries and oncological treatments) that the patient is undergoing.
The two main functions of the pancreas are exocrine and endocrine. The state of exocrine and endocrine insufficiency can be caused by the disease itself and/or surgery.
The symptoms of exocrine insufficiency include substantial weight loss and steatorrhea (high content of undigested fats in the stool), while endocrine failure is manifested with the onset of diabetes mellitus. Patients who lose more than 5-10% of their weight and whose biochemical parameters (inflammation indices, albumin levels, etc.) are altered, need an artificial nutritional supplement and/or to postpone surgery to avoid postoperative complications.

The diet of the patient who is operated for pancreatic cancer must take into account his/her reduced food (especially fatty food) absorption capacity due to a reduced production or non-production of pancreatic enzymes.  This can result in diarrhea, cramps, feeling of swelling, loss of appetite and weight, nausea and vomiting.  The latter is also caused by medical cancer treatments.  Understanding this mechanism helps to better aid the choice of the foods we will indicate to you.

The World Cancer Research Fund recommends 5 servings of non-starchy fruits and vegetables per day. Cooked vegetables are more digestible than raw. Berries, citrus fruits, green leafy vegetables and cruciferous vegetables are recommended because they are rich in antioxidants.  Since the diet must maintain low blood sugar levels and consumption of dietary sources of energy, it is recommended to eat complex carbohydrates (beans, lentils, oats, quinoa, brown rice). Other healthy energy resources are monounsaturated and polyunsaturated fats (olive oil, peanuts, avocados). The oncologist   will have to integrate the prescribed diet with vitamin B and pancreatic enzymes, which as already stated, are often no longer produced due to patient’s malabsorption syndrome.

From the description above, it is evident that the management of this pathology requires nutritional screening and a multidisciplinary approach for the patient from the moment of diagnosis and for the entire course of the disease.

In the Hospitals of Gallarate and Busto Arsizio, the Unit of Oncology organized a specially designed path as part of a project called N.I.O. (Nutrition in Oncology), which provides nutritional screening and counselling for all cancer patients under treatment to support them during the oncological medical therapy.