Managing diet and weight loss with tips from a dietitian

|
7 May 2020

Hello, we are Lynne and Emma, specialist pancreatic cancer nurses, here to help those with pancreatic cancer navigate symptoms as best as possible throughout the pandemic. In this week’s blog we wanted to give you some more detailed information on one of the commonest issues – diet, weight loss and diabetes.

Diet problems

Having pancreatic cancer can cause problems with your diet. It can affect what you eat and how well you digest your food. The pancreas produces enzymes to help break down food so all the nutrients are absorbed into your body. Pancreatic cancer can reduce the amount of these enzymes and cause problems with digestion. This is called malabsorption and it can be managed with pancreatic enzyme replacement therapy (PERT). You may have heard of Creon, which is a type of PERT. If you are someone who has had surgery to remove all or part of the pancreas, this may also affect the number of enzymes that the pancreas makes. The pancreas also produces hormones such as insulin and glucagon to control blood sugar levels in the body. Pancreatic cancer can reduce the amount of hormones, which can cause diabetes.

It is common for people with pancreatic cancer to get symptoms caused by problems digesting such as:

  • poor appetite and weight loss
  • indigestion
  • tummy pain
  • bloating
  • runny poo (diarrhoea).

Read more about these and other diet symptoms.

Pancreatic enzyme replacement therapy (PERT) is a capsule you take orally with your food that helps to replace the enzymes that your pancreas would normally make. They help you to digest your food and absorb all the calories and nutrients. Taking PERT can help manage dietary symptoms and make a big difference to how you feel. Most people with pancreatic cancer will benefit from taking PERT.

We asked Lindsay Carnie, Specialist Oncology Research Dietitian at The Christie in Manchester for her tips on taking PERT

“If you are taking PERT, it is important to take them with all meals, snacks and milky drinks including oral nutritional supplements. If you are taking more than one capsule take half with the first mouthful of food or drink and then take the rest throughout the meal or drink

If you are struggling to remember to take your enzymes, try leaving a note on our fridge or cupboard, or set a reminder on your phone for around mealtimes. Don’t forget to have them with you when leaving the house, but don’t keep them in your trouser pocket or a warm glove compartment as this may stop them from working properly.”

If you are experiencing any symptoms related to diet or require advice about PERT, don’t let the situation with COVID-19 prevent you from getting the help you need. If you have a dietitian involved in your care give them a call. Your medical team or GP will also be able to give you advice and support.

Weight loss

Losing weight is a common symptom of pancreatic cancer. It can affect how you deal with the symptoms of cancer and your treatment but it can also be very upsetting and affect how you feel generally.

Finding out what is causing your weight loss is really important. If you have a dietitian they should be able to advise you on this and offer you support. You could also go to your hospital team or GP for advice. You should get advice on how to make changes to your diet so you can get more calories and protein. You may be offered nutritional supplements which are often drinks or powders. These have extra calories, protein and vitamins in them.

If you have lost weight quickly, you may notice you have lost some of the strength in your muscles, having more protein in your diet and doing gentle physical activity can help rebuild this muscle strength which can help you to feel better and have more energy.

A word of warning – there is a lot of bogus advice online, making claims that certain types of diets or supplements can help people with cancer. More often than not these claims are not scientific, with no evidence to support them. If you have pancreatic cancer it’s important not to cut anything out of your diet, or take any supplements, without speaking to your dietitian, hospital team or GP first.

Lindsay suggested this to help deal with the impact of coronavirus on problems with diet

“If you are being asked to ‘shield’ by the government you may be finding food shopping difficult. Asking family, friends or neighbours to help with food shopping is a good idea. It may be a good idea to have some staples in the house as a back-up if you are worried about when you will next get fresh food. Staples could include tinned or frozen foods, ready meals and UHT or powdered milk.”

Diabetes

Diabetes is a condition where the amount of sugar in your blood (blood sugar level) is too high; this is called hyperglycaemia. The pancreas plays an important role in controlling your blood sugar level so having pancreatic cancer can cause diabetes, such as following surgery and can also make managing diabetes difficult. You should be in touch with your diabetes nurse for advice. You may need to monitor your blood sugar level regularly, and take tablets or have insulin injections to control your diabetes. If you do not have a diabetes nurse please contact your dietitian, hospital team or GP for advice and support.

Symptoms of diabetes include:

  • feeling thirsty
  • wanting to urinate frequently (more so at night)
  • tiredness
  • weight loss
  • blurred vision.

If you have these symptoms please get in touch with your medical team or GP for advice and support.

If you have diabetes you are being asked to adopt social distancing practices. Although everyone in the country is being asked to do this, it’s particularly important for you as you may be at more risk of getting ill from coronavirus. If you have diabetes and you have symptoms of coronavirus, such as a raised temperature and/or persistent cough, you should contact your diabetes nurse, hospital team or GP for advice about your diabetes medicine. Diabetes UK have more information about diabetes and coronavirus, including what to do if you have symptoms of coronavirus.

There are different types of diabetes, and information on the internet about changing your diet may not be right for you because of your pancreatic cancer. If you have lost weight or are struggling to eat, you may need more calories in your diet to help you put weight back on. This may include eating foods that increase your blood sugar level. Your diabetes will need to be managed around this.

Lindsay gives some further advice on diet and diabetes

“The main focus at this time should be to stop you from losing more weight as this can affect whether you can have treatment or how you tolerate it. You should try to have a little and often approach to eating aiming for a high calorie, high protein diet. Your diabetes should be managed around what you are able to eat. Please speak with your dietitian, diabetes nurse or hospital team if you have any concerns.”

Managing diabetes if you have pancreatic cancer can be difficult and confusing. If you have any questions, speak to your dietitian, diabetes nurse or hospital team. You can also speak to our specialist nurses on our free Support Line. We also have information on our website about managing diabetes if you have pancreatic cancer.

If you have any concerns about your treatment, or questions about pancreatic cancer or coronavirus, you can of course speak to one of our nurse specialists on the Support Line.

Remember – you are not alone. Pancreatic Cancer UK is here to support you through this particularly challenging time. We’ll be back next week with more information but until then, stay safe.

Lynne & Emma