Having cancer of the pancreas will affect your eating and drinking habits, whatever your stage of cancer or treatment. Many people with pancreatic cancer lose weight. The pancreas is not only close to the stomach and bowel, it produces insulin and enzymes which help to digest food.
If you've had all or part of your pancreas removed, you may need to take insulin or tablets to regulate your blood sugar. You may also need to take enzyme supplements when you eat to help your digestion.
If you are on insulin or tablets to regulate your blood sugar, your doctor will ask you to check your urine for sugar. Too much sugar in the urine indicates that the sugar balance of your body is not yet right.
If you are on insulin, you will probably also have to test your blood sugar levels. You will have to prick your finger and squeeze a drop of blood onto a test strip. This will show how much sugar is in your blood. You will then know how much insulin to take.
It takes time to get used to doing these tests. You will be shown how to do it before you leave hospital.
You may also have a nurse to visit you at home to help you and answer your questions.
Digestive enzymes help your body to break down and absorb fats and proteins. Without enough enzymes, you may have diarrhoea or your poo (stools) may float, look pale and smell offensive. This is due to the undigested fat in the stool.
It might be difficult to put on weight as you are unable to absorb the nutrients from your food. If your pancreas is not working properly due to the cancer or you've had all or part of your pancreas removed, you may need to take enzyme supplements to reduce these effects.
Types of enzyme supplements
There are several different types of enzyme supplement. Creon is the most commonly used. The dose depends on:
- how well the remaining part of your pancreas is working
- your diet
You might need to take more enzymes if you are about to eat a large or fatty meal.
How to take them
You swallow the enzyme capsules whole, immediately before your meal. If you find it difficult to swallow capsules, you can open them and mix the granules in soft acidic foods that are at room temperature and easy to swallow. This can include apple sauce or mashed banana.
You must not chew or crush the granules. Have a drink of water afterwards to make sure none of the granules stay in your mouth as they can irritate the lining and cause mouth ulcers.
Your dietician will give you a diet plan to suit you and advise you on taking the supplements. It can take a bit of time to get the right dose of enzymes for you.
Snacks and small meals
You may find it easier to have lots of small meals through the day, rather than sticking to the traditional three meals a day.
It is a good idea to have plenty of nutritious snacks to hand that you can have whenever you feel like eating. If you can manage it, it's best to choose full fat versions of yoghurts and puddings, so that you get the most calories.
You could try:
- yoghurts or fromage frais
- other soft puddings such as trifle or chocolate mousse
- dried fruit
- stewed or fresh fruit (bananas are high in calories)
- instant soups (make up with milk to boost calories)
- milky drinks
Some of these ideas may not suit your digestion but they might be worth a try. If in doubt, check with your dietitian.
Try to think of quick ways of having the things you like to eat. If possible, get someone to prepare your favourite foods in advance and freeze them in small portions. A microwave makes defrosting and heating easier and quicker.
If you have diarrhoea after pancreatic surgery, it is probably related to difficulty digesting fat. Avoid very high fibre foods (such as cereal and dried fruit) for a time as these may make things worse. Tell your doctor, nurse or dietitian.
You may need some medicines to control your symptoms. If you're taking enzyme supplements, your dietitian may need to alter the dose. They can also suggest some changes to your diet that may help.
If you are finding it hard to eat, there are plenty of nutritional supplements available on prescription. Some are powders you sprinkle on your food and some are drinks that are complete meals in themselves.
Sipping a supplement between meals throughout the day can really boost your calorie intake. Again, ask your doctor or dietitian.