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Whatever the stage of pancreatic cancer your patient is at, they will face issues with nutrition. Maintaining a healthy body weight is difficult for patients suffering from malabsorption, vomiting or loss of appetite.
Your patient should be referred to a dietitian to assist in managing their condition.
Pancreatic cancer is strongly associated with cachexia and management of this requires a multidisciplinary approach including nutritional, dietary, physical, psychological and pharmacological support and regular review.
Patients with pancreatic cancer will often need to take pancreatic enzymes (PERT) to manage their condition, these are normally in the form of high doses of Creon®, Nutrizym® or Pancrease® (though other medications are available). This will most often be prescribed in secondary care, but you may need to make adjustments to the dose as the patient discovers what is right for them.
*Jewish or Muslim patients may need to be counselled that Creon is acceptable to their religion and the chief rabbi and the London Central Mosque Trust have approved PERT for use in patients where no alternative is available.
Patients technique with PERT will need to be monitored as patients adjust and learn about their medication, how doses vary depending on the meal and medication storage instructions. Though many patients are the experts in their own needs and medications, many miss this guidance.
You can refer patients to our online page which answers questions such as:
Pancreatic Cancer Action produces information for patients specific to diet and nutrition.
A booklet for “diet and nutrition” and a separate recipe book to assist patients in eating well with pancreatic cancer can help patients to understand what they should be eating and how to fortify or add extra nourishment to meals.
Both booklets can be viewed online or ordered free of charge to the UK.