The pancreas, a vital organ located behind the stomach, plays a crucial role in digestion and blood sugar regulation. Pancreatic cancer, characterized by the uncontrolled growth of cells within the pancreas, poses a significant health challenge. While the disease is often diagnosed at a late stage and is difficult to treat, dietary and lifestyle modifications can play a crucial role in prevention and management. This article explores the connection between diet and pancreatic cancer, offering insights into foods that may help reduce the risk and support recovery.
Understanding the Pancreas and Pancreatic Cancer
The pancreas has two primary functions:
- Digestion: Exocrine cells within the pancreas produce enzymes that break down food.
- Blood sugar regulation: Endocrine cells produce insulin and glucagon, hormones that regulate blood sugar levels.
Pancreatic cancer can develop in either the exocrine or endocrine cells, leading to different types of tumors with varying symptoms and treatments. Exocrine tumors, particularly adenocarcinomas, are the most common, accounting for around 95% of cases. Endocrine tumors, also known as neuroendocrine or islet cell tumors, are less frequent.
Pancreatic cancer can disrupt digestion and blood sugar control, making dietary choices crucial for managing symptoms, supporting recovery, and optimizing overall health.
The Role of Diet in Pancreatic Cancer Prevention
Obesity and Inflammation
Obesity is a well-established risk factor for several cancers, including pancreatic cancer. A large case-controlled study in the USA linked obesity to a 50-60% increased risk of developing pancreatic cancer, particularly among African-Americans and women. Obesity leads to chronic inflammation, which can promote carcinogenesis. Decreasing body fat is crucial for minimizing cancer risk and recurrence.
Read also: Managing Pancreatic Cancer with Diet
The Anti-Inflammatory Diet (AID)
An anti-inflammatory diet (AID), primarily plant-based, is often recommended for cancer patients. This diet emphasizes whole foods and limits processed items. Recent research in Nature suggests that an AID may improve prognosis in breast cancer patients.
Specific Foods and Nutrients
- Fruits and Vegetables: A diet rich in fruits and vegetables, especially vegetables, is associated with a reduced risk of pancreatic cancer. UCSF researchers found that eating lots of fruits and vegetables - particularly vegetables-is associated with about a 50 percent reduction in the risk of developing pancreatic cancer. The vegetables most strongly associated with increased protection were onions, garlic, beans, yellow vegetables (such as carrots, yams, sweet potatoes, corn and yellow squash), dark leafy vegetables and cruciferous vegetables. Light-green vegetables, tomatoes and tomato products showed weaker protective benefits. Fruits were found to be protective but significantly less so than vegetables, with citrus fruits and citrus juices most protective. The 50 percent reduced risk was associated with eating at last five servings per day of the protective vegetables or vegetables and fruit, compared to those who ate two servings a day or less. And eating nine servings per day of vegetables and fruit combined also was associated with about a 50 percent reduced pancreatic cancer risk compared with eating less than five servings per day. A case-controlled study from the EPIC cohort study showed an inverse relationship between plasma levels of beta-carotene (citrus fruits and leafy green vegetables), zeaxantin (corn, paprika and wolfberries) and alpha-tocopherol (green vegetables and tomatoes) and the risk of pancreatic cancer.
- Cruciferous Vegetables: Isothiocyanates found in cruciferous vegetables like cauliflower and broccoli have been shown to inhibit pancreatic cancer cell growth in vitro and in animal studies.
- Nuts: A prospective study on 75,680 women found that eating 28 grams of nuts at least twice a week was associated with a decreased risk of pancreatic cancer. This may be due to better glycemic control, decreased ingestion of animal products, or inherent properties of nuts.
- Green Tea: Green tea contains catechins, which possess anti-tumor activity. While data specific to pancreatic cancer is inconclusive, the potential to reduce the risk of cancers as a whole makes it worthwhile. Aim for at least 5 cups of organic green tea daily, removing caffeine by briefly dipping the tea in boiling water before steeping.
- Fiber-Rich Foods: The foods you choose can help you reduce many of the most challenging symptoms associated with your diagnosis. Calorie-dense, healthy foods can also help you stay energized, focused, and better able to take cancer on and win. Talk to your doctor and dietitian about what foods are best for you to eat.
Supplements
Several supplements are often recommended for pancreatic cancer prevention and recurrence:
- Vitamin D3: Vitamin D deficiency is associated with an increased risk of pancreatic cancer. Vitamin D decreases the proliferation of cancer cells and inhibits pancreatic cancer invasion and metastasis.
- Fish Oil: Supplementation with fish oil may reduce the risk of developing certain cancers, including pancreatic cancer. Aim for at least 2,000 mg of EPA + DHA daily.
- Curcumin: Curcumin has anti-inflammatory properties. It has been shown to be potentially advantageous in pancreatic cancer cell lines treated with gemcitabine-based chemotherapy.
- Melatonin: Melatonin supplementation may have a protective effect against carcinogenesis and may even induce apoptosis. A dose of 20 mg one hour before bedtime is often recommended.
- Asian Mushrooms: Extracts from Asian mushrooms have shown anti-tumor activity in pancreatic cancer cell lines in experimental models.
- Probiotics: Probiotics may decrease the risk of developing cancers in general and digestive cancers in particular
Foods to Limit or Avoid
Certain foods may exacerbate symptoms or increase the risk of pancreatic cancer recurrence:
- Red and Processed Meats: These hard-to-digest foods have been cited as possible causes of cancer.
- Greasy, Fatty, or Fried Foods: High-fat foods can increase uncomfortable symptoms, such as diarrhea and gas.
- Alcohol: Heavy drinking may increase pancreatic cancer risk or worsen symptoms.
- Sugar and Refined Carbohydrates: Many people with pancreatic cancer have difficulty digesting simple carbohydrates and sugary foods or drinks. These foods also represent empty, non-nutritious calories.
- Processed Foods: Eating highly-processed packaged foods like chips, pastries, microwave meals, and processed meats may be associated with an increased risk of developing cancer.
Dietary Considerations During and After Pancreatic Cancer Treatment
Pancreatic cancer and its treatments can significantly impact digestion, nutrient absorption, and blood sugar control. Here are some dietary considerations for managing these challenges:
Managing Digestive Issues
- Pancreatic Enzyme Insufficiency: If the pancreas doesn't produce enough enzymes, digesting food, especially fat, becomes difficult. This can lead to diarrhea, cramping, bloating, and gas. Supplemental pancreatic enzymes, taken before meals, can help improve digestion.
- Small, Frequent Meals: Eating small, frequent meals can help combat fatigue and weight loss.
- Easy-to-Digest Foods: Choose foods that are chopped, soft, or boiled for easier digestion, particularly those that are high in nutrients and calories.
- Hydration: Maintain hydration by drinking clear beverages like water, juice, electrolyte replacement beverages or broth.
Preventing Weight Loss
- Protein-Rich Foods: Protein is essential for immune function, tissue repair, and preventing muscle loss. Easy-to-digest protein sources include eggs, nut butter, tofu, fish, and poultry.
- Healthy Fats: Healthy mono- and polyunsaturated fats provide energy and help the body absorb nutrients. Good sources include olive oil, nuts, nut butters, and avocados.
- Nutritional Supplements: If tolerating food is challenging, nutritional supplements like shakes, protein powders, and vitamins can help meet daily nutritional needs.
Regulating Blood Sugar
- Complex Carbohydrates: Complex carbohydrates rich in fiber don’t spike blood sugar levels as quickly as simple carbs do. Good choices include potatoes, beans, lentils, oatmeal, quinoa, and brown rice.
- Balanced Meals and Snacks: Eat balanced meals and snacks that pair foods from multiple food groups (complex carbs, lean protein, veggies, healthy fats) to help with blood sugar control.
- Low-Sugar Options: Choose foods low in added sugar and high in fiber, such as plant-based foods. Fruits, vegetables, and legumes are good choices. Stay away from processed foods with lots of trans and saturated fat, and added sugar.
Addressing Common Side Effects
- Diarrhea: Discuss possible causes with your healthcare team for appropriate treatment. There are different causes of diarrhea such as fat malabsorption due to pancreatic enzyme insufficiency, lactose intolerance, bacterial overgrowth, chemotherapy and/or dumping syndrome from surgical resection.
- Nausea: Talk to your doctor about prescription medications and alternative approaches to managing nausea.
Sticking to a Pancreatic Cancer Diet
After treatment, there will be a new normal eating routine for you. This is different for everyone.
Read also: Overview of Metabolic Diets in Cancer Research
- Strive for a plant-based diet: This will take time as your body heals from treatment. Begin by adding easy-to-digest plant-based foods like oats, barley, bananas, applesauce, pears, peaches, turnips, sweet potatoes, carrots and asparagus. Over time, increase your intake of different plant-based foods and test your tolerance.
- Choose a mostly plant-based diet including vegetables, fruit, whole grains, legumes, and lentils and avoid highly processed foods with added gar and fats.
- When choosing dairy products, consider reduced-fat or nonfat choices.
- Limiting red meat to 1/3 or less of your plate can help reduce intake of saturated fat. When choosing red meat (beef, pork or lamb), choose lean cuts like sirloin, loin, round and 95% lean ground meat. Avoiding high fat processed meats like bacon, salami, salami, sausage and hot dogs can significantly reduce fat intake.
- Go easy on condiments like mayonnaise, honey mustard, salad dressing or queso- type dips. Instead choose salsa, mustard, vinegars or hummus. When choosing desserts, opt for fruit-based desserts and/or smaller portions.
- Evaluating beverage choices can help reduce added sugar and fat consumption. Many specialty coffee, chai tea, dairy-based frozen drinks, or smoothies contain a lot of sugar and some added fat.
The Importance of Physical Activity
In addition to a healthy diet, regular exercise is crucial for maintaining overall health and reducing cancer risk. Aim for at least 30 minutes of moderate-intensity physical activity per day.
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