Weight loss in pancreatic cancer patients should be treated as aggressively as the cancer itself, says a new article published in The Oncologist from the Supportive Care Committee on behalf of the Pancreatic Cancer Action Network’s (PanCAN) Precision PromiseSM consortium.
Establishing best practices, the article outlines a comprehensive approach for slowing or reversing weight loss in pancreatic cancer patients. The authors categorize weight loss into three causes: anorexia, malabsorption and cachexia, and provide recommendations for assessment and intervention for each cause.
An estimated 85 percent of pancreatic cancer patients suffer from cancer cachexia, a condition that causes patients to lose significant muscle mass and weight. Also, side effects of treatment, such as mouth sores or digestive problems, can make eating less appealing and lead to anorexia-related weight loss in patients. And if the cancer, or surgery to remove it, hinders the normal functions of the pancreas, patients can become malnourished and lose weight, as they’re unable to digest food properly.
Recommendations outlined by the paper’s authors include regular weight screenings, nutritional counseling with registered dietitians (as appropriate) and exercise. The authors also recommend patients be provided with pancreatic enzyme replacement therapy. When prescribed and taken properly, pancreatic enzymes are proving to be especially helpful to pancreatic cancer patients.
All these tactics must be tailored specifically to each patient. And together, they make up the first comprehensive approach for treating weight loss in pancreatic cancer — a devastating problem.
“These symptoms take much more from patients than weight,” said Lola Rahib, PhD, an article coauthor and the associate director of scientific initiatives at PanCAN. “They significantly lower patients’ quality of life, ability to handle treatment and can impact both short and long-term survival.”
Rahib continued, “The framework and recommendations set in this paper will make it easier for clinicians to classify, understand and treat pancreatic cancer associated weight loss. Further, it provides valuable insight for researchers as they investigate this problem and develop related clinical trials and improved treatments.”
Such a complex problem can only be addressed from multiple angles, which is why the team of pancreatic cancer experts behind the article specializes in diverse fields like medicine, science and nutrition.
In addition to Rahib, these coauthors include Andrew E. Hendifar, MD, at Cedars-Sinai Medical Center, Maria Petzel, RD, CSO, LD, CNSC, at MD Anderson Cancer Center, Teresa A. Zimmers, PhD, at Indiana University School of Medicine, Crystal S. Denlinger, MD, at Fox Chase Cancer Center at Temple Health, Vincent J. Picozzi, MD, at Virginia Mason Medical Center and Lynn M. Matrisian, PhD, MBA, PanCAN’s chief science officer.
Together, they form the Supportive Care Committee of Precision Promise, an adaptive clinical trial platform for pancreatic cancer patients set to launch in 2019.
The committee aims to establish best supportive care practices by fostering research and disseminating results. This is their first article, and they will continue to examine other issues related to pancreatic cancer (pain, depression, diabetes, etc.) and publish findings.
Seeing healthcare professionals who focus on symptom management and supportive (palliative) care improves outcomes and is critical for patients’ quality of life. PanCAN strongly recommends that symptom management and supportive (palliative) care should be provided early in your diagnosis as well as during and after treatment.