Pancreatic Cancer  
               Patient 
               Nutrition  
               Guide
                                                  
                                                                                                                                                                                                                                               Contents
                                                                                                                                                                                                                                               Managing your nutrition                                                                                                                 4
                                                                                                                                                                                                                                               How can a dietitian help me?                                                                                                            4
                                                                                                                                                                                                                                               How does pancreatic cancer affect your diet                                                                                             6 
                                                                                                                                                                                                                                               and nutrition?
                                                                                                                                                                                                                                               How does the pancreas work?                                                                                                             7
                                                                                                                                                                                                                                               Your nutrition after surgery                                                                                                            8
                                                                                                                                                                                                                                               Nutrition and chemotherapy                                                                                                              9
                                                                                                                                                                                                                                               Diabetes and your nutrition                                                                                                          10
                                                                                                                                                                                                                                               Managing your diabetes                                                                                                               11
                                                                                                                                                                                                                                               Using nutrition to manage your symptoms                                                                                              12 
                                                                                                                                                                                                                                               and side effects 
                                                                                                                                                                                                                                                    Nausea and vomiting                                                                                                             12 
                                                                                                                                                                                                                                                    Changes in bowel habits                                                                                                         12 
                                                                                                                                                                                                                                                    Loss of appetite                                                                                                                14 
                                                                                                                                                                                                                                                    Changes in your taste and smell                                                                                                 15 
                                                                                                                                                                                                                                                    Mouth ulcers                                                                                                                    17 
                                                                                                                                                                                                                                                    Dry mouth                                                                                                                       17 
                                                                                                                                                                                                                                                    Low immunity                                                                                                                    17 
                                                                                                                                                                                                                                                    Dumping syndrome                                                                                                                18
                                                                                                                                                                                                                                               Using Pancreatic Enzyme Replacement Therapy (PERT)                                                                                   19 
                                                                                                                                                                                                                                               to help with malabsorption 
                                                                                                                                                                                                                                               How can I improve my nutritional intake?                                                                                             20
                                                                                                                                                                                                                                               Where does the fuel come from in food?                                                                                               20 
                                                                                                                                                                                                                                                    Try using the ‘adding principle’                                                                                                21 
                                                                                                                                                                                                                                                    Quick and easy meal ideas for high energy, high protein eating                                                                  22 
                                                                                                                                                                                                                                                    Nourishing snack ideas                                                                                                          23 
                                                                                                                                                                                                                                                    Can nutritional supplements help with my dietary issues?                                                                        23 
                                                                                                                                                                                                                                                    How to use supplement drinks and powders                                                                                        24 
                                                                                                                                                                                                                                                    Common supplements                                                                                                              24
                  Contact us                                                                                                                                                                                                                   Tips to increase or maintain your weight                                                                                             25
                  Jreissati Family Pancreatic Centre at Epworth
                  Phone  03 9426 8880                                                                                                                                                                                                          References 26
                  Email EHJreissatiCentre@epworth.org.au 
                  www.epworth.org.au/jreissaticentre                                                                                                                                                                                           Bibliography 26
                  2  | Jreissati Family Pancreatic Centre at Epworth                                                                                                                                                                                                                                                                                             Pancreatic Cancer Patient Nutrition Guide  |  3
        Managing  
        your nutrition 
        Being diagnosed with pancreatic                                                             It’s important to remember that your     Dietitians have the knowledge 
        cancer is an emotional time for                                                             diagnosis is unique to you. You may      and experience to help you get the 
        you and your family. It presents                                                            not suffer from any symptoms or side     most out of the food you eat. It’s 
        many challenges, and it will impact                                                         effects. But if you do, there are ways   recommended that you consult with a 
        many aspects of your life. Your                                                             that you can manage your well-being      dietitian, as dietitians can help you to:
        treatment can cause some of your                                                            during your treatment. This will help     >  manage dietary issues resulting 
        biggest challenges. For example, it                                                         to make sure you feel as well as you         from symptoms of cancer or  
        can cause your symptoms to worsen,                                                          can and assist your recovery.                its treatment
        leaving you feeling tired and unwell. 
        Poor nutrition can also lead to you                                                         How can a dietitian help me?              >  create an individualised diet 
        being unable to tolerate cancer                                                             Pancreatic cancer can cause diet             plan and provide nutritional 
        treatments and affect your ability                                                          and nutrition-related problems.              counselling and education
        to participate in clinical trials.                                                          This happens because cancer and its 
        By managing your nutrition, you                                                                                                       >  manage your diabetes
        can help relieve your physical                                                              treatment can affect how your body        >  help you to gain or maintain  
        symptoms. Managing your                                                                     breaks down and absorbs nutrients            your weight
        nutrition can also improve                                                                  from the food you eat. Additionally, 
        your emotional well-being.                                                                  side effects of the disease can cause     >  improve your quality of life
                                                                                                    loss of appetite, resulting in you eating 
                                                                                                    less food. This can lead to weight loss   >  assist in answering questions 
                                                                                                    and not getting enough nutrition             related to nutrition and cancer 
                                                                                                    out of the food you eat.                     misinformation.
        4  | Jreissati Family Pancreatic Centre at Epworth                                                                                         Pancreatic Cancer Patient Nutrition Guide  |  5
         How does pancreatic cancer                                                                             How does the pancreas work?
         affect your diet and nutrition?
         Pancreatic cancer causes changes              Patients experiencing symptoms                           The pancreas is a large, tongue-shaped        The pancreas has two main functions 
         in how your pancreas works. These             will often suffer from weight loss.                      gland. It is a part of your digestive         within your body:
         changes occur because the disease             According to a recent study, almost                      system, along with your stomach, liver, 
         affects the body’s ability to digest          85% of people with pancreatic cancer                     gall bladder and intestines (often called       >  it produces substances (called 
         and absorb nutrients from the food            suffer from weight loss at the time                      the small and large bowel).                       enzymes) that help us break down 
         you eat. Treatments and surgery               of their diagnosis. Weight loss is a                     The pancreas has three different                  (digest) the food that we eat
         can also cause further changes to             serious problem as it can impact the                     sections:                                       >  it produces hormones (chemicals 
         how your pancreas works. Especially           effectiveness of your treatment and                                                                        that send messages to other parts 
         treatments that fully or partially            draw out your recovery. By managing                        >  the head – the wide end of the               of the body) to control our blood 
         remove your pancreas.                         your symptoms, you have a greater                             pancreas on the right side of                sugar levels (using a hormone 
         As a result of these changes,                 likelihood of maintaining your weight,                        your body                                    called insulin).
         patients may experience the                   which will help your recovery. 
         following symptoms:                           The best way to maintain your weight                       >  the body – the middle section  
                                                       is to make sure you get the most                              of the pancreas 
           >  nausea and vomiting                      nutrition out of your diet as possible.                    >  the tail – the thin end of the 
           >  changes in bowel habits                  Some ways to do that include:                                 pancreas on the left side of  
                                                                                                                     your body.
           >  loss of appetite                           >  eating smaller meals more often 
           >  changes in your taste and smell              during the day
           >  mouth ulcers                               >  eating a variety of foods to get  
                                                           a range of different nutrients                                                                                                       stomach
           >  dry mouth                                  >  choosing foods that are high in                                                                gallbladder    cystic 
           >  low immunity                                 protein as they can help your body                                                                              duct
                                                           repair and recover                                                                                               common  
           >  dumping syndrome.                                                                                                                                             bile duct
                                                         >  try to stay physically active if                                              pancreas                         pancreatic 
                                                                                                                                                                             duct
                                                           possible as this will help boost                                                           duodenal 
                                                           your appetite.                                                                           minor papilla
                                                                                                                                                     duodenal                                  tail of the 
                                                       Please be aware that side effects can                                                       major papilla                               pancreas
                                                       affect people differently. It’s important                                                                                 pancreas
                                                       to know there are many ways to                                                                 head of the 
                                                       manage side effects to improve                                                                  pancreas
                                                                                                                                                                 duodenum
                                                       how you are feeling.                                                                                                   Anatomy of the pancreas
         6  | Jreissati Family Pancreatic Centre at Epworth                                                                                                          Pancreatic Cancer Patient Nutrition Guide  |  7