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Editor’s note: The “Research Spotlight” series is written by Dr. Anna Berkenblit, PanCAN’s Chief Scientific and Medical Officer. Each month, Dr. Berkenblit shares her insights into the latest news and research in pancreatic cancer. Follow Dr. Berkenblit on X and LinkedIn.
March is National Nutrition Month, and considerations about diet and nutrition are especially important for people facing pancreatic cancer. The two major functions of the pancreas are to help break down food to use it for energy and to regulate sugar levels. When the pancreas isn’t functioning properly — due to disease, surgery or other treatments — the digestion of food and regulation of blood sugar can be affected. In regard to regulation of blood sugar, diabetes can serve as both a risk factor (if longstanding) or a symptom (if new-onset) of pancreatic cancer.
Pancreatic ductal adenocarcinoma, the most common type of pancreatic cancer, primarily impacts the exocrine function of the pancreas, which controls the production and secretion of enzymes to digest food. If the pancreas isn’t producing or secreting enzymes properly, a condition known as exocrine pancreatic insufficiency (EPI) can result. Most patients who have surgery for pancreatic cancer and many patients with advanced pancreatic cancer develop EPI.
Patients with EPI may experience symptoms like weight loss, diarrhea, indigestion and cramping after meals. Having EPI can worsen a person’s quality of life and even impact survival. The prescription of pancreatic enzyme replacement therapy (PERT) can alleviate symptoms caused by EPI and improve outcomes for patients.
While this sounds straightforward, the diagnosis and management of EPI and the prescription and use of PERT can be complicated in a clinical setting. That’s why the Canopy Cancer Collective Learning Health Network, with support from PanCAN, convened an Expert Working Group composed of dietitians, nurse practitioners and other advanced practice providers. Through Working Group discussions and interviews with patients and caregivers, the team, which included two PanCAN colleagues, developed 15 consensus statements that were compiled into a white paper.
The white paper introduces the first-ever national consensus statements on identifying EPI and EPI/PERT management in patients with pancreatic cancer in the U.S.
The statements cover topics ranging from the identification and definitive diagnosis of EPI, dosing and timing of PERT and how to monitor patients who are using PERT long-term. Work from PanCAN years ago showed that many patients with pancreatic cancer were not being tested for EPI, not being prescribed PERT and not taking PERT properly. The guidelines included in the white paper aim to reduce challenges like these that persist today.
Our partnership with the Canopy Cancer Collective is a way to amplify both organizations’ efforts and reach. Filling the gap in the U.S. biomedical literature with the white paper and a planned peer-reviewed manuscript will help increase awareness about EPI across healthcare specialties and institutions. Most importantly, this collaborative work provides the opportunity for patients to get the appropriate diagnoses, treatments and care that will lead to better quality of life and potentially longer survival.
