Physical HealthTaha tinana
Seeking information about the pancreas and pancreatic cancer can feel overwhelming or frightening, especially if you’re unsure about what’s ahead for you or a loved one. Having the right information can help lessen some of these feelings. Here you will find reliable information about the pancreas and pancreatic cancer along with diagnosis, symptoms, risks, treatment, side effects, diet and nutrition and some useful websites to visit.
Nau mai rā, rarau mai rā ki tēnei whārangi mō ngā kōrero e pā ana ki te mate pukupuku repetaiaki huka
About the pancreas
Mō te repetaiaki huka
The pancreas is a large gland that sits behind the stomach in the back of the abdomen. It is part of the digestive system. The pancreas produces enzymes and hormones that help digest and absorb the food we eat. The pancreas is shaped a bit like a tadpole. It is often described as having a head, body, and tail.
Click here to learn more about the pancreas | Pāwhirihia ki kōnei mo ngā kōrero āpiti.
The pancreas is about 15cm (6 inches) long and is surrounded by several large and important organs and blood vessels. The head of the pancreas is closely attached to the duodenum (the top part of the small intestine).
The pancreas has two key functions as part of the digestive system.
It produces the hormone insulin that controls the level of sugar in the blood
It produces pancreatic enzymes that aid in the chemical breakdown of food so nutrients can be absorbed in the intestine
These enzymes flow down the pancreatic duct into the small intestine.
The common bile duct that carries the bile from the liver also passes through the head of the pancreas to empty in the duodenum. The large blood vessels that carry blood to the liver, intestines, kidneys, and lower part of the body can all be in contact with the pancreas.
What is pancreatic cancer? | He aha tēnei mea te mate pukupuku repetaiaki huka?
Pancreatic cancer occurs when abnormal cells in the pancreas grow out of control. Pancreatic cancer can occur in the head, body, or tail of the pancreas but is most common in the head of the pancreas.
Pancreatic cancers are divided into two main types – exocrine tumours and endocrine tumours:
Exocrine tumours or adenocarcinomas | Pukupuku repe
Exocrine tumours start in the cells that make enzymes to help digestion (exocrine cells) in the inner lining of the pancreatic ducts. 95% of pancreatic cancers are classified as exocrine tumours and about 90% of these are called pancreatic ductal adenocarcinomas (PDAC).
Endocrine tumours or neuroendocrine tumours or NETs | Pukupuku taiaki
Endocrine tumours start in the hormone producing cells and account for only 5% of all pancreatic cancers and are treated differently to exocrine tumours. For more information on endocrine tumours, please visit the Neuroendocrine Cancer New Zealand.
Symptoms & Risks
Tohumate & Tūraru
Common symptoms of pancreatic cancer | Ngā tohumate tōkau o te mate pukupuku repetaiaki huka
Unexplained symptoms can be worrying for anyone. Here you will find information about some common symptoms of pancreatic cancer and how to manage them. It is important to note that having one or more of these symptoms does not necessarily mean that you have cancer, but if you have new or persistent symptoms that are out of the ordinary for you, it’s really important that you contact your GP to get checked out.
Pancreatic cancer can be difficult to detect due to the location of the pancreas. Symptoms are often vague and can be similar to other medical conditions.
The symptoms that people experience because of pancreatic cancer depend on the location of the tumour and the tumour type.
Click here to learn more about the symptoms of pancreatic cancer.
Managing symptoms | Whakahaere i ngā tohumate
You might notice that things change for you physically and emotionally following your diagnosis and you may have even noticed some of these symptoms prior to diagnosis. Understanding them can help you to prepare for them mentally and manage them if they do appear. If you do experience any of these symptoms, let your healthcare team know when you next see them. If they are extreme, or you are worried about them, get in touch with your healthcare team sooner.
Click on the links below to learn about some ways you can manage these changes or symptoms | Pāwhirihia te momo tohumate mō ētahi atu mōhiohio.
Changes in diet | Ngā panonitanga o te whiringa Kai
If you are diagnosed with pancreatic cancer you may find that you develop Pancreatic Exocrine Insufficiency (PIE). This means that your pancreas can’t produce enough enzymes to digest your food properly and your body can’t absorb enough nutrients, proteins and vitamins from your food. In severe cases, this will mean that you lose weight and run low on certain vitamins, particularly fat-soluble vitamins (A, D, E & K). You should be screened with faecal elastase testing and those with low levels can be prescribed pancreatic enzymes.
Pancreatic Enzyme Replacement Therapy (PERT) replaces the enzymes that your pancreas would normally make and helps you break down your food. Most people with pancreatic cancer require PERT.
Many people find that sorting out symptoms related to their diet makes the biggest difference to how they feel. Ask your doctor or nurse for a referral to a dietitian.
Nausea | Whakapairuaki
Feeling sick (nauseous) is another common symptom. You may be prescribed anti-sickness medication, or you could try home remedies such as ginger, peppermint, or acupressure bracelets.
Fatigue | Ruha
You are bound to feel tired or exhausted sometimes, so be kind to yourself. Make sure you rest and prioritise what you want or need to do. Give yourself permission to accept offers of help for chores that feel overwhelming. Although you might not feel like it, gentle exercise such as stretching, or a short walk can help combat fatigue.
Intimacy | Mateoha
People of all genders can lose interest in sexual activity during cancer treatment, at least for a time. Although it can feel awkward, talking to your partner about what you find intimate, or soothing can help. There are many ways to be intimate, such as cuddling or gentle touch, or using warmth and comforting language. Your GP may be able to assist with medication or a referral to see a sex and relationship therapist.
Stress, pain, and anxiety | Kohuki, Mamae, Anipā
Simple relaxation techniques can help you cope with stress, pain, and anxiety. Having a warm bath, deep breathing or listening to soothing music are easy things to do at home. You might want to try complementary therapies like reflexology or aromatherapy massage. Talking to others can also help. There are many cancer-specific psychologists available to you in New Zealand – ask your oncologist, nurse, or GP for a referral.
Keep perspective | Kia whakataurite
Each individual will feel and react differently to treatment. What might work for someone else may not always work for you. Acknowledge that not every day will be as easy to manage as the last, and that every day may be different. Focus on what you know works for you and be very gentle with yourself.
Keeping active | Kia kori
Physical activity can also make you feel better, though how much activity will depend on how well you feel. Even a walk round the block or 10 minutes of stretching each day can help.
Risks of developing pancreatic cancer | Ngā tūraru whakawhanake mate pukupuku repetaiaki huka
Risk factors are things that increase the chances of developing cancer. There are some known risk factors that can increase the chance of pancreatic cancer developing. Having a risk factor does not automatically mean that you will develop pancreatic cancer, but they do increase the likelihood of it happening.
Knowing your risk factors and talking about them with your doctor may help you make more informed lifestyle and health care choices.
Some risk factors are environmental and within your control which is why it is important to understand what they are.
Risk factors that cannot be controlled
These risk factors can include:
a history of diabetes
chronic pancreatitis
older age
male gender
family history
inherited syndromes.
Societal and environmental risk factors that can be controlled | Ngā pūtake tūraru-ā-porihanga, ā-taiao whai here
These risk factors can include:
smoking
obesity
workplace exposure to certain chemicals.
Diagnosis
Tautohunga
Diagnosing Pancreatic Cancer | Te tautohunga mate pukupuku repetaiaki huka
Being diagnosed with cancer can be a scary time for anyone. Here you will find information to help you understand some of the terms you might have heard.
In order to diagnose pancreatic cancer, your cancer specialist will do a range of tests. There might be one test or a mix of tests, some of which are explained below.
Biopsy | Tipako Pītautau
A biopsy is when a small sample of tissue is taken to check under a microscope. The biopsy can be taken at the time of the EUS or laparoscopy.
Click here for a diagram of a biopsy.
Blood Tests | Whakamātau toto
Blood tests are usually taken first to check your blood count and see if your liver and kidneys are working well. Blood tests can also detect tumour markers (chemical substances) that some cancers produce. It is important to note that not all cancers produce these tumour markers, and some other illnesses also produce these markers and so blood tests are often undertaken in combination with other tests. If your levels are elevated, it might be useful to follow up over time, however, comparing with other people with cancer is unhelpful.
Ultrasound | Oro Ikeike
Ultrasound scans use a microphone (probe) that gives off sound waves to provide an image on a computer of the inside of your body. Some gel is put on your tummy and the probe is moved over the gel with a little pressure. Sometimes you may have a contrast dye injection before your scan that will help to show any growths clearly.
Click here for an example of an ultrasound.
Computed tomography (CT) scan | Matawaitanga-ā-rorohiko
A computerised tomography scan (CT scan) combines a series of x-ray images that are taken from different angles around the body. You will lie on a motorised bed that passes through a doughnut-shaped tube. It is important that you lay still for good quality images to be taken, and so a strap and/or pillows may be used to help with this. It isn’t painful and usually takes about 1 hour in an outpatient setting.
To prepare for the scan, you may be asked to:
stop eating or drinking for 4 hours before your scan
take off some or all of your clothing and wear a hospital gown for the scan
remove all objects such as jewellery, piercings, dentures, and glasses as they will interfere with the picture quality.
A CT scan uses small amounts of radiation. This is greater than the amount you would get during a simple x-ray, however, it is still a small amount and so the risk to your health is very low. The low dose of radiation you are exposed to during a CT scan has not been shown to cause harm.
Click here for an example of a CT Scan.
Magnetic resonance imaging (MRI) | Whakaahua ponguru autō
An MRI scan uses magnetic fields and radio waves to produce a detailed picture of the body. You will lie on a bed that moves into a tube. It is important that you lay still for good quality images to be taken. It isn’t painful and usually takes between 15 and 90 minutes in an outpatient setting. An MRI scan is very noisy and so you may be given headphones to wear. For those who do not like small spaces it may cause some anxiety. If this is the case, speak to your doctor before your MRI as they may be able to provide you with some relaxation tips or medicine to help you feel calmer.
To prepare for the scan | Hei whakarite i mua i te whakaata roto:
you may be asked to stop eating a few hours before the scan but will be informed beforehand if this is the case
take off some or all of your clothing and wear a hospital gown for the scan
remove all metal objects such as hair clips and piercings and possibly medical patches if you wear one as they may contain metal.
It is important to tell the radiology staff about any metal you have in your body including possible metal fragments in your eye and metal foreign bodies. Objects that have been implanted in your body need to be discussed ahead of the MRI scan as they may cause harm or be damaged. These include pacemakers, aneurysm clips, heart valve replacements, neurostimulators, cochlear implants, magnetic dental implants, and drug infusion pumps.
Click here for an example of an MRI.
Laparoscopy | Poka mātai papatoiake
A laparoscopy is a type of surgical procedure that allows a surgeon to access the inside of the abdomen (tummy) without having to make large incisions (cuts) in the skin. This procedure is also known as keyhole surgery or minimally invasive surgery. The specialist puts a small tube with a camera on the end (laparoscope), through the cut, into your abdomen which relays images to a television monitor. It can also be used to take biopsies and remove damaged/diseased tissue.
It is done under general anaesthetic (you will be asleep) and usually you can leave hospital the same day or the next day.
The advantages of laparoscopy over traditional open surgery are:
a shorter hospital stay and faster recovery time
less pain and bleeding after the operation
reduced scarring.
Laparoscopy is a common procedure and serious complications are rare. Minor complications occur for about 1-2 in every 100 people which may include infection or bleeding around the site.
Click here for an example of a Laparoscopy.
Positron emission tomography (PET) | Matawaitanga-ā-rorohiko whakarau pūngao
A PET scan uses a special type of camera that detects radioactive material. A small amount of radioactive material is injected into your arm about 1 hour before the scan which will travel and accumulate in areas of the body where there is higher metabolic activity i.e., where there is disease occurring. The body is then scanned to show where the radioactive material is accumulating.
Allergic reactions can occur due to the radioactive material but are extremely rare.
Similar to the CT scan, you will lie on a motorised bed that passes through a doughnut shaped tube. Sometimes the CT scan and PET scan are combined in the same machine and both types of images are taken at the same time. It is important that you lay still on the bed for good quality images to be taken and so a strap and/or pillows may be used to help with this. It isn’t painful and the whole procedure usually takes about 2 hours in an outpatient setting.
After the procedure you naturally pass the radioactive material out of your body in your urine.
To prepare for the scan you may be asked to | Hei whakarite i mua i te whakaata roto ka pātaihia pea i ēnei pātai:
avoid strenuous exercise for a couple of days before
stop eating 4 hours before your scan.
Click here for an example of a PET scan. *Source: Mediplus.in
Endoscopic retrograde cholangiopancreatography (ERCP) | Tūkanga tiro oranga whēkau huri kōaro
An ERCP is when a long thin flexible tube with a camera on the end is passed through your mouth and stomach to be able to see any issues occurring in the pancreas, bile ducts, gallbladder, or liver. A dye is also injected and x-rays are used to be able to see if there are any blockages in the bile ducts. You will be given a sedative and anaesthetic throat spray to numb your throat and a mouth guard is then put into your mouth before the tube is inserted.
The procedure usually occurs in hospital and if there are no issues found you can usually go home the same day. If any blockages found, you may have to stay in hospital for stents (small tubes) to be inserted into the bile ducts to open them up.
The procedure usually takes 30-60 minutes, and you will have to stay in hospital for about 4 hours afterwards until the sedative has worn off. Due to the effects of the sedative, you will need someone to drive you home and stay with you for the rest of the day.
in preparation for the procedure, you may be asked to:
refrain from eating for 6-8 hours beforehand
remove your clothes and put on a hospital gown.
Click here for a diagram of an ERCP.
Endoscopic ultrasound (EUS) | Oro Ikeike Tiro Oranga Whekau
An endoscopic ultrasound uses a flexible tube with a camera on it (called an ‘endoscope’) which is inserted into the mouth and oesophagus (food pipe). It uses sound waves to create images. Sometimes, there is a small needle on the end that can take fluid or tissue samples (a biopsy) that can be analysed later by the lab.
An EUS can help a doctor see a tumour’s location and size, check whether the cancer has spread to other nearby areas of the body. The images provided by this internal ultrasound have been shown to be helpful in determining whether a tumour can be removed with surgery.
During an upper EUS test, you lie on your left side. A healthcare provider:
gives you an IV sedative to help you relax
sprays your throat with a numbing medicine
places a plastic mouthguard in your mouth. The mouthguard protects your teeth and prevents you from biting down on the endoscope
inserts the ultrasound endoscope through your mouth and into the oesophagus
you shouldn’t feel any pain and you will be able to breathe as usual
when the images and/or biopsy have been taken, the healthcare provider gently removes the endoscope and stops anaesthesia. You slowly wake up in a recovery room.
An EUS takes about 1 hour and occurs in an outpatient setting. As you will receive a sedative you will need to take someone with you who can drive you home and stay with you for the remainder of the day.
To prepare for your EUS you may be asked to:
adjust the dosage of your medications such as blood thinners or insulin as recommended by your provider
not eat or drink for a set period of time before the test.
take off your clothes on your upper body and change into a hospital gown.
Endoscopic ultrasounds are a very safe procedure, but sometimes minor complications may occur. These include:
Sore throat
A small amount of bleeding if a biopsy has been taken
Bloating – as air is sometimes pumped through the endoscope during the procedure
Small tear in the throat – from insertion of the endoscope
Fluid on the lungs – if fluid from your mouth went into the lungs during your procedure
Shortness of breath – due to the effects of the sedative
It's important to acknowledge that some of these tests can be confronting or sometimes frightening. Taking a friend or whānau member with you can help ease anxiety. Be encouraged to tell staff if you need extra reassurance during the test, you'll find some very compassionate people working in healthcare.
Waiting to have tests carried out | E tāria ana kia whakamātauhia
Even if you have been given an urgent referral for a particular scan or investigation you may have to wait several days or possibly weeks for your appointment. This can be frustrating and worrying, especially if you are already feeling unwell.
Several weeks of testing to confirm a diagnosis or awaiting appointments is relatively common and is unlikely to alter overall outcomes. Cancer growth is considered to be negligible over a period of weeks, and this waiting period is unlikely to cause you harm if your symptoms are stable.
If your symptoms get worse or you start to feel more unwell while you are waiting, it is a good idea to get in touch with your GP or specialist if you already have one. If you cannot get in contact with them, you may need to present to the closest emergency department if your symptoms cannot be controlled at home.
How long will I have to wait for my test results | Ka hia te roa e tatari ai kia puta ngā kitenga whakamātautau?
Depending on which tests you have had it may take from a few days to a few weeks for the results to come through. Waiting for test results can be an anxious time.
It is a good idea to ask how long you may have to wait when you go for tests. If you think you have been waiting too long, then contact your GP or a specialist to follow up on the progress of your results. Usually, the doctor who does the test will write a report and send it to your specialist. If your GP sent you for the test, the results will be sent to the GP clinic.
You will need an appointment with your specialist or GP to discuss the test results and how they might affect your treatment. Usually, your specialist will discuss your results and plan your subsequent care.
All these tests will give the specialist more information about the cancer such as where it is, if it is growing, and if it has spread. This is called staging. Staging helps to work out the best treatment plan for you.
Pancreatic cancer stages | Ngā tūātupu mate pukupuku repetaiaki huka
You may have heard people talk about the stages of cancer. Staging provides an indication of the size of the cancer and if it has spread to other areas of the body and contributes to the treatment planning.
There are two ways in which the stage of cancer can be described. One uses numbers (stage 1, 2 etc) and the other uses letters and numbers (T1, N0, M0 etc) also known as TNM (Tumour-Nodes-Metastases) staging. The cancer may be described in one or both ways by your healthcare team.
Click here to learn more about the stages of cancer | Pāwhirihia kia whai mōhiotanga mō ngā tūātupu mate pukupuku.
TNM (Tumour-Nodes-Metastases) staging | Te Tūātuputanga Pukupuku, Tīpona, Hora-mate
The TNM gives a number according to tumour size (T), how many lymph nodes are affected (N), and how far the cancer has spread, or metastasised, to distant parts of the body (M). This may be expressed as, for example, T1, N0, M0. This information is used to help decide the best treatment.
T1 | The tumour is only in the pancreas and is 2cm or less in size | |
T2 | The tumour is only in the pancreas and is more than 2cm but less than 4cm in size | |
T3 | The tumour greater than 4cm in size or has spread to the duodenum or bile duct | |
T4 | The tumour has spread to nearby tissue | |
N1 | The tumour has spread into 1-3 lymph nodes | |
N2 | The tumour has spread into 4 or more lymph nodes | |
M1 | Distant metastasis |
Staging using numbers | Te tūātuputanga mahinga tau
Stage 1 | The cancer is only in the pancreas |
Stage 2 | The cancer is usually larger and may have started to grow into the duodenum, bile duct or tissues around the pancreas or there may be cancer in the lymph nodes near the pancreas |
Stage 3 | The cancer is growing outside the pancreas into nearby major blood vessels or nerves but has not spread to other parts of the body |
Stage 4 | The cancer has spread to other parts of the body such as the lungs or liver (metastatic cancer) |
Prognosis (Life expectancy) | Matapaenga (Te wā ora)
Like any cancer there are many things that can impact on survival rates, so it is best to talk to your cancer specialist for guidance about your own care and outcomes. Remember, even with a diagnosis, no one can know for certain how long anyone will live. Estimates of life expectancy are based on historical data, however treatments are becoming more effective over time which changes these estimates.
Prognosis is usually improved the earlier the cancer is detected. Your doctor will be able to give you the best idea of prognosis.
Often, statistics talk about survival rates which are taken from an average of other patients. These are usually described in 1, 5 and 10-year survival rates. A 10-year survival rate is the proportion (or percent) of people who have not died 10 years after having cancer, however many people live much longer than this.
Click here to view pancreatic cancer statistics related to morbidity (number of diagnoses) and mortality (survival rate) | Pāwhirihia ki kōnei kia tirohia ētahi tauanga mō te Mate Pukupuku Repetaiaki Huka. Remember that everyone is different, and statistics are only a guide.
In general, pancreatic endocrine tumours tend to have a better prognosis than exocrine tumours (PDAC) which can be very aggressive and difficult to treat.
Each year, 758 people are diagnosed with pancreatic cancer. That is equivalent to about 15 people for every 100,000. This rate is increasing year on year.
Unfortunately, although pancreatic exocrine cancer treatments are becoming more effective, pancreatic exocrine cancer has a poor long-term survival rate and it is the third most common cause of cancer death as it is usually diagnosed once it has spread.
Pancreatic exocrine cancer generally has an overall survival rate of 20.4% at one year, 6.5% at 5 years and 6.6% at 10 years.
Around 537 New Zealanders die from pancreatic cancer each year.
If diagnosed early, pancreatic cancer can be cured. Prompt investigation of symptoms is important to ensure pancreatic cancer is diagnosed and treated as early as possible.
Currently there is no screening programme for pancreatic cancer and so the need to come together to improve diagnosis outcomes is growing more urgent.
Ministry of Health data shows a 40 percent increase in rates of pancreatic cancer in the two decades to 2017. Additionally, incidence is higher among men than women in New Zealand, and 80% higher among Māori than non-Māori.
Remember that everyone is different, and statistics are only a guide.
Seeking a second opinion | E rapu ana i te whakaaro kē atu
Following diagnosis, some people choose to request a second opinion because they want to have peace of mind that they have explored all options and opinions available to them before starting treatment.
If you would like to know more about your care team and how to seek a second opinion, click here.
Treatment
Ngā momo rongoā
Treatment options | Ngā kōwhiringa rongoā
There are a number of treatment options available, and it may feel confusing and unsettling not knowing which will be the best for you.
Treatment of pancreatic cancer depends on its location, the stage of the cancer (how advanced it is at the time of diagnosis), and whether the person is otherwise medically fit.
The choice of treatments will be discussed with you and your whānau and your preferences will be considered. Your treatment will be discussed by a multidisciplinary team (MDT), which means that experts in different areas of cancer treatment (e.g., surgeons, gastroenterologists, radiologists, oncologists, and nurses) come together to share their expertise in order to provide the best patient care.
It is also important to note that more than one treatment may be needed to get the best results.
See below to read more about the treatment options. | Tirohia atu ētahi kōwhiringa rongoā ki raro nei.
*Not all the options below will be applicable to everyone's situation. Some treatments listed may not be funded and would require the patient to pay directly. It is important to discuss all your options with your specialist team.
Surgery | Poka tinana
In a small number of cases, the tumour can be surgically removed (cut out). If surgery is not an option, there are other types of treatment which may limit the growth of the cancer and/or improve your quality of life.
If the cancer is obstructing the bile duct and cannot be removed surgically, a stent (plastic or metal tube) can be inserted to maintain the flow of bile and prevent jaundice.
The only curative treatment for pancreatic cancer is surgery. If diagnosed early and there are no obvious signs of spread to other organs, pancreatic cancer can be removed by surgery. Unfortunately, no other therapies can cure pancreatic cancer.
Most surgeries attempting to cure pancreatic cancer are concentrated on tumours that start in the head of the organ. This surgery is called a pancreaticoduodenectomy and is commonly known as the Whipple's procedure. The Whipple's procedure involves the removal of:
head of the pancreas
lymph nodes near the pancreas
gallbladder
part of the common bile duct
part of the stomach
duodenum (first part of the small intestine)
a small portion of the jejunum (second part of the small intestine)
Click here to view a diagram of the surgery | Pāwhirihia ki kōnei kia tirohia ngā hoahoa o te poka tinana.
If the cancer is in the tail or body of the pancreas, a distal pancreatectomy may be performed where the tail, some of the body and sometimes the spleen are removed.
If there are signs of cancer throughout the whole pancreas, a total pancreatectomy may be performed where the whole pancreas is removed. In this case, the body is unable to produce insulin and so the patient will have diabetes and will need insulin injections to regulate blood sugar levels.
Radiation Therapy | Haumanu iraruke
Radiation therapy may be used in conjunction with surgery and/or chemotherapy. Radiation therapy uses x-rays to kill cancer cells and stop the cancer growing. It can be given for all stages of cancer.
External beam radiation therapy | Haumanu Iraruke pūhihi rāwaho
Getting radiation therapy is similar to getting an X-Ray but the radiation is stronger. It is a painless procedure which involves lying on a table and a large machine rotating around you. It is directed at the tumour to try to kill the tumour or stop the cancer cells growing without damaging the healthy tissue nearby. Radiotherapy is usually performed in an outpatient clinic. It usually takes place everyday Monday to Friday and lasts for about 10-20 minutes. Your treatment team will be able to tell you how many weeks you will need radiotherapy for.
A newer kind of radiotherapy available to treat pancreatic cancer called OncoSil, is available for people who meet specific treatment criteria. It is currently only available in Waikato (2022).
Radiation is placed directly into the tumour via stomach and bowel using an endoscope.
OncoSil is not funded in New Zealand but you may still wish to ask your treatment team if it is suitable for you.
Click here for an example of external beam radiation therapy | Pāwhirihia ki kōnei kia tirohia te hoahoa Haumanu Iraruke pūhihi rāwaho
Chemotherapy | Haumanu matū
Chemotherapy can be used for all pancreatic cancer patients.
If a patient is diagnosed with resectable pancreatic cancer, chemotherapy is often used after surgery to reduce the risk of the tumour reoccurring.
If a patient is diagnosed with borderline resectable pancreatic cancer, chemotherapy is used to reduce the size of the tumor to increase the chance of surgery.
For patients who are not able to undergo surgery, chemotherapy is used to slow the growth of the tumour and help lengthen life expectancy. Chemotherapy uses drugs to kill cancer cells and stop the cancer growing and dividing.
Chemotherapy is a drug which is administered either by swallowing tablets; through an injection; or through infusion which is a small tube that is inserted into a vein. The drug works by moving through the blood stream to kill the cancer cells. Unfortunately, some healthy cells can also be harmed leading to side effects. Chemotherapy can be given alone or in combination with other therapies such as targeted therapy, surgery, or radiation. It is usually administered in an outpatient clinic and sometimes a hospital stay is needed if the doctor wants to monitor you following treatment.
Click here to view an example of chemotherapy infusion | Pāwhirihia ki kōnei kia tirohia te hoahoa Whāuru Haumanu Matū.
Targeted therapy | Haumanu heipū
Targeted therapy uses drugs to attack specific features of cancer cells and stop the cancer growing. It may be used if surgery is not an option, or the cancer has spread.
Targeted therapy involves blocking the processes that change normal cells into cancer cells. As the therapy treats only the cancer cells, healthy cells are not affected, and fewer side effects occur. Targeted therapies can be delivered intravenously, injected directly into tumors or via oral tablets.
Click here to view a diagram of targeted therapy | Pāwhirihia ki kōnei kia tirohia te hoahoa Haumanu Heipū
Clinical trials | Whakamātau haumanu
You may be eligible to take part in a clinical trial, which is a type of research study that investigates new or specialised therapies or treatments. While you are discussing therapy options with your care team, it is a good idea to ask about clinical trials that may be suitable for your condition and discuss whether participating may be right for you.
Being involved in a clinical trial may be beneficial in that you may access the latest treatments before they become generally available. Additionally, clinical trial participation is often associated with closer monitoring of your care and condition and potentially improved outcomes.
Clinical trials are free, and travel and accommodation (if needed) are provided.
Click here to learn more about clinical trials | Pāwhirihia ki kōnei kia tirohia tētahi tauira o te whāuru haumanu matū.
Palliative care | Pairuri
A specialist may refer a patient to palliative care services, but this doesn’t always mean end-of-life care. Today people can be referred to these services much earlier if they’re living with cancer. Palliative care can help one to live as well as possible including managing pain and symptoms. This care may be at home, in a hospital or at another location one prefers. Additional supportive care (treatment or services that support you through a cancer experience) are also available.
Traditional Māori Healing | Rongoā Māori
Rongoā Māori is a body of knowledge that takes a holistic view to wellbeing and treatment. In particular, it focuses on hinengaro (mind), wairua (soul), mauri (life essence), ngā atua (Gods) and te taiao (the environment).
There are many providers who are able to provide rongoā services. Your Māori Health team at the hospital will be able to connect you with one nearest to where you live.
See the below websites for more information on rongoā Māori
Other complementary therapies
Complementary therapies are treatments that are used alongside standard treatments. They are often used to boost the immune system, relieve symptoms, and enhance the effectiveness of standard treatments.
Speak to your doctor if you intend to use complementary therapies to ensure that they will work well alongside your treatment.
Some examples of complementary therapies are:
acupuncture
meditation and mindfulness
music therapy
massage
aromatherapy
naturopathy
tai chi
pilates
visualisation or Guided Imagery
spirituality.
Click here to find out more about complementary therapies
Side Effects from Treatment
Ngā mate āpiti
Side effects of pancreatic cancer treatment | Ngā mate āpiti o te rongoā mate pukupuku repetaiaki huka
As with any medical treatment, you may experience side effects from your cancer treatment. This is perfectly normal and can be a sign that the treatment is working, although it may feel unpleasant. Side effects vary from person to person and depend on the type of treatment, the part of the body treated, and the length and dose of treatment. Most side effects are temporary and go away after treatment ends. Below you can find information on some common side effects of treatments and how you can manage them to improve your daily well-being.
You may experience side effects other than those discussed here.
If you experience side effects, it may be helpful to keep a diary and share it with your healthcare team know when you next see them. If the symptoms feel extreme or are worrying you, get in contact with your oncology team sooner.
Why cancer and cancer treatments cause side effects | Ko te take e whai mate āpiti ai te mate pukupuku, me ngā rongoā mate pukupuku hoki
Pancreatic cancer and cancer treatments change how the pancreas functions. You may notice some changes or side effects, but everyone is different.
Pancreatic cancer may impact | Kei pāngia te mate pukupuku repetaiaki huka :
nutritional requirements and what you need to eat
how much you eat
appetite
your ability to digest and absorb foods
blood sugar control
ability to maintain the weight and muscle mass
your energy levels and general wellbeing.
Common side effects of pancreatic cancer treatments | Ngā māte āpiti tōkau o ngā rongoā mate pukupuku repetaiakihuka
Click on each treatment to learn more about the side effects of that treatment | Pāwhirihia i ia momo rongoā kia tirohia i ngā mate āpiti e hāngai ana
Surgery | Poka tinana
Some side effects of surgery are due to the anaesthesia and should fade shortly after the surgery. These include:
nausea | whakapairuaki
vomiting | whakaruaki
dizziness | takaānini
agitation | pōkeka
Other side effects are due to the surgical procedure itself which should subside shortly after surgery. These include:
fatigue | ruha
pain at the site of the surgery | mamae wāhi poka
Some additional side effects may present due to the disruption to your digestive system as a result of the surgery and could take weeks or months to recover from.
These include:
diarrhoea and malabsorption | kotere me whākapi miti
weight loss | heke taumaha
loss of appetite | minangaro
feeling full quickly | pūnaunau wawe
Chemotherapy and biological therapies | Haumanu matū, koiora
Chemotherapy treatment kills cancer cells, but in the process, damages normal healthy cells which causes side effects. These side effects vary from person to person and depend on the type of treatment, the part of the body treated, and the length and dose of treatment. Below are some common side effects of this.
nausea and vomiting | whakapairuaki & Whakaruaki
loss of appetite | minangaro
feeling full quickly | pūnaunau wawe
diarrhoea and constipation | kotere me te kōroke
fatigue | ruha
weight loss | heke taumaha
sore mouth or throat | mamae o te waha/ korokoro
taste changes | panonitana rongo tawara
hair loss | whakahewa
dry or itchy skin | kiri mangeo
foggy brain.
Some chemotherapy side effects can be life threatening therefore it is important to go to contact your oncology team or go to your nearest emergency department immediately if you experience any of the following and let them know that you are undergoing chemotherapy treatment. These include:
fever or chills
pain in your chest or difficulty breathing
diarrhoea
vomiting that is not eased with anti-sickness medication
bleeding from the gums or nose that doesn’t stop
vain or blood present when passing urine.
Radiation therapy | Haumanu iraruke
Radiation therapy is used to kill cancer cells, but it can also kill some healthy cells near to the cancer site too. Although radiation therapy itself does not hurt, you may experience some symptoms afterwards due to the affect the radiation has on the healthy cells. These symptoms may include:
nausea and vomiting | whakapairuaki & ruaki
loss of appetite | minangaro
feeling full quickly | pūnaunau wawe
diarrhoea and constipation | kotere & kōreke
fatigue | ruha
similar to a sunburn - at the radiation site | mamae tīkākā
weight loss | heke taumaha
Managing symptoms and side effects | Whakahaere tohumate me ngā mate āpiti
Click on the symptoms below to find information on how to manage symptoms and side effects | Pāwhirihia i ia momo tohumate mō ngā mōhiohio kia whakahaere ai ngā tohumate me ngā mate āpiti
Fatigue | Ruha
A common side effect of treatment is feeling constant tiredness (fatigue). Treatment or the cancer itself can reduce the number of red blood cells in your body, resulting in anaemia, which can make you feel very tired.
Tips to manage fatigue | Ngā kupu āwhina mō te whakahaere i te ruha:
Use your energy wisely
plan ahead for when you feel too tired to cook
shop online for groceries
bulk cook meals you can store in the freezer
cook when you have more energy
ask and accept offers of help with shopping and cooking from whānau and friends
use home delivery services such as Meals on Wheels or other companies that bring pre-prepared food to you. You can ask for help to access these via your social worker
keep snacks handy in your bag or car.
Activity can help with fatigue
regular, gentle exercise can help improve fatigue and your appetite
activity can mean many things – walking, stretching, even vacuuming!
set small goals. Set a timer for five minutes and see what you can manage in this time
eat with others.
Loss of appetite | Kore hiakai
It can be discouraging to lose your appetite. You may lose your appetite because of the effects of cancer itself, the treatment, or other side effects, such as feeling sick, not enjoying the smell of food, or feeling upset. To help you can:
eat small amounts often, e.g., every 2–3 hours. Keeping to a regular eating pattern rather than waiting until you are hungry will mean your body gets the nourishment it needs to
use a smaller plate – a big plate of food may put you off
eat what you feel like when you feel like it. Have cereal for dinner or a main meal at lunch
include a variety of foods in your diet
sip fluids throughout the day
replace water, tea and coffee with drinks or soups that add energy (kilojoules/calories), such as milk, milkshake, smoothies, replacement drinks or soup
relax dietary restrictions – maintaining your weight or regaining weight you have lost is more important than avoiding full-fat and other high-energy foods
gentle physical activity can stimulate appetite – take a short walk around the block
eat with others
keep snacks handy e.g., in your bag or car so you can eat on the go
talk to your dietitian about liquid meal replacements that might be easier to digest.
Taste or smell changes | Rongo kakara me te hā
Some treatments such as chemotherapy can change the way food and/or drink taste or smell. It may taste bland or metallic.
Tips on managing changes in taste include:
add extra flavour to food if it tastes bland – like fresh herbs, lemon, lime, ginger, garlic, soy sauce, honey, chilli, or pepper
experiment with different food, as your tastes may change
if meat tastes bad during treatment, replace it with other protein sources like cheese, eggs, nuts, dairy foods, baked beans, lentils, or chickpeas
add small amounts of sugar to food if it tastes bitter or salty
use a straw when drinking
change from using metal cutlery to plastic or bamboo cutlery.
Tips on managing changes in smell include | Ngā kupu āwhina mō te whakahaere i ngā panoni rongo kakara:
eat cold food or food at room temperature (hot food smells more)
reheat pre-prepared meals in the microwave so the cooking smell doesn’t put you off
stay out of the kitchen, if possible, when food is being prepared
ask family or friends to cook
use the exhaust fan, open the kitchen window, or cook outside to help reduce cooking smells.
Nausea and vomiting | Whakapairuaki me te ruaki
Feeling sick and vomiting are often side effects of cancer, its treatment, or some medicines. They often occur together, but not always.
Nausea | Whakapairuaki
Nausea is stomach discomfort and the sensation of wanting to vomit. Nausea can be a precursor to vomiting the contents of the stomach and may be caused by treatment, stress, food odours, gas in the gastrointestinal tract, motion sickness or even the thought of having treatment.
Tips on how to cope with nausea | Ngā kupu āwhina ki te morimori i te whakapairuaki:
have a light snack before treatment and wait a few hours before eating again
eat small meals 5–6 times during the day. Going without food for long periods can make nausea worse
snack on dry or bland foods, e.g., crackers, toast, dry cereals, bread sticks or pretzels
choose cold foods or foods at room temperature instead of hot, fried, greasy, or spicy foods
eat and drink slowly and chew your food well
try foods with ginger, e.g., ginger biscuits, or ginger beer
avoid foods that are overly sweet, fatty, fried, spicy, or oily, or that have strong smells
brush teeth regularly to help reduce unpleasant tastes that may make you feel nauseated
do not eat your favourite food when feeling nauseated to avoid developing a permanent dislike
suck on hard lollies – flavoured with ginger, peppermint, or lemon
try ginger food and drink items, such as candied ginger, ginger beer, ginger ale, or ginger tea. Talk to your dietitian doctor or pharmacist about ginger supplements
take anti-nausea medicines as prescribed. Let the doctor know if the medicines don’t seem to be working.
Vomiting | Ruaki
Vomiting is the forcible emptying (“throwing up”) of stomach contents through the mouth. Vomiting can follow nausea and may be caused by treatment, stress, food odours, gas in the gastrointestinal tract, motion sickness or even the thought of having treatment.
Vomiting is more serious than nausea. Vomiting can cause dehydration and increase the risk of malnutrition. See a doctor if you are vomiting for more than one day, especially if you cannot keep water down as you may become dehydrated.
Tips on how to cope with vomiting | Ngā kupu āwhina ki te morimori i te ruaki:
Take small sips of water or clear liquids, such as ginger ale, soda water or sports drinks like Gatorade or Hydrolyte. Dilute sweet drinks. If you feel like a fizzy drink, open it, and let it sit for 10 minutes or so, and drink it when it’s a bit flat
sucking on crushed ice cubes or an ice block can be soothing
once you can keep clear liquids down try some different drinks, such as consommé and clear broths, weak tea, herbal tea, fruit drinks, beef, and chicken stocks
have small, frequent meals and snacks throughout the day
introduce bland, starchy foods, such as plain biscuits, bread or toast with honey or jam, peanut butter, rice, yoghurt, or fruit. Attempt small, frequent servings at first
consume a little bit more each time until you are eating a well-balanced diet.
Chewing and swallowing | Ngaungau me te horomi
After treatment chewing and swallowing may be difficult and painful. Surgery, radiotherapy, and chemotherapy can cause temporary problems. People with dentures who have lost weight may also find their teeth become loose, which can make eating difficult.
Signs that you are having problems with chewing and swallowing include taking longer to chew and swallow, coughing or choking while eating or drinking, or food sticking in your mouth or throat like a ball.
Tips on chewing and swallowing | Ngā kupu āwhina mō te ngaungau me te horomi:
change how you prepare your food by chopping food up into smaller pieces or pureeing
let your doctor know that you are having issues and get a referral to see a speech pathologist and dietitian
a speech pathologist can monitor your ability to swallow and suggest modifications to the texture of your food once your ability to swallow and chew begins to improve. A dietitian can ensure you are meeting your nutritional needs.
Mouth changes | Ngā panonitanga o te waha
Some chemotherapy drugs and some pain medicines can make your mouth dry, cause mouth ulcers, or change the amount of saliva in your mouth. A dry mouth can increase the risk of tooth decay and infections such as oral thrush, which will make eating harder.
Ulcers may also be present in your digestive tract, causing discomfort in the stomach or bowel and diarrhoea.
Tips to lessen discomfort with mouth sores | Ngā kupu āwhina ki te whakamauru i ngā harehare waha:
suck on ice cubes
eat soft foods – stews, soups, scrambled eggs, and smoothies
cold foods and fluids may be more comfortable than hot ones
avoid ‘coarse’ foods that can irritate your mouth, such as crackers, toast, nuts, and seeds
avoid spicy or very hot foods
use a straw and direct liquids away from the areas where mouth sores are most painful
talk to your doctor about medication or mouth washes to help manage the pain and allow you to eat more comfortably.
Tips to relieve a dry mouth | Ngā kupu āwhina ki te whakamauru i te waha maroke:
suck on ice cubes
keep your mouth clean with regular mouthwashes to prevent infections
gargle with 1⁄2 tsp salt or 1 tsp bicarbonate of soda in a glass of water
choose an alcohol-free mouthwash to avoid irritating your mouth further
use a soft toothbrush when cleaning your teeth
ask your dentist or health care team about suitable mouth rinses or oral lubricants
limit alcohol and coffee as these are dehydrating fluids and avoid smoking
avoid ‘coarse’ foods that can irritate your mouth, such as crackers, toast, nuts, and seeds
avoid spicy or very hot foods
soften food by dipping it into milk, soup, tea, or coffee
moisten with sauce, gravy, cream, custard
sip fluids with meals and throughout the day
chew sugar-free gum to stimulate the flow of saliva.
Changes in bowels- constipation and diarrhoea | Ngā panonitanga o ngā kōpiro
Living with cancer and its treatments can result in changes to your bowel habits. This could be differences in the appearance, consistency, and/or the smell of your stools.
Constipation | Kōroke
This is when your bowel motions are infrequent and difficult to pass. It can be caused by different factors including regularly taking opioid medicines; having a diet low in fibre; not getting enough exercise; not having enough fluids to drink (dehydration); or having a low overall food intake.
Tips on how to manage constipation | Ngā kupu āwhina mō te whakahaere kōroke:
soften stools by drinking 8–10 glasses of fluid a day, e.g., water, herbal tea, milk-based drinks, soup, prune juice
eat foods high in fibre, e.g., wholegrain breads, cereals, or pasta; raw and unpeeled fruits and vegetables; nuts and seeds; legumes and pulses
if you are increasing the amount of fibre in your diet, increase fluids to prevent the extra fibre making constipation worse
ask your doctor about using a laxative, stool softener and/or fibre supplement
exercise – check with your doctor, exercise physiologist or physiotherapist about the amount and type of exercise that is right for you.
Diarrhoea | Kotere
This means your bowel motions are watery, urgent, and frequent. You may also get abdominal cramping, wind, and pain. Frequent loose stools can occur because you are not digesting food or absorbing nutrients properly. Cancer treatment, medicines, infections, reactions to certain foods and anxiety can all cause diarrhoea.
Diarrhoea can result in dehydration, so it’s important to stay hydrated by drinking extra fluids. Every time you have a loose bowel movement you should drink an extra cup of non-caffeinated fluid. If you have diarrhoea for several days, see your doctor so he/she can determine the cause and help to manage your diarrhoea. Your doctor may decide to prescribe you anti-diarrhoea or over-the-counter medication.
Tips on how to manage diarrhoea | Ngā kupu āwhina mō te whakahaere kōtere:
drink plenty of fluids to avoid becoming dehydrated. Water and diluted cordials are better than high-sugar drinks, alcohol, or caffeinated fluids – remember signs of dehydration are smaller amounts of dark urine
choose low-fibre foods, e.g., bananas, mashed potato, rice, pasta, white bread, oats, steamed chicken without the skin, white fish
avoid foods that increase bowel activity, e.g., spicy, fatty, or oily foods, caffeine, alcohol, or artificial sweeteners
try soy milk or lactose-free milk if you develop a temporary intolerance to milk (lactose)
don’t eat too many raw fruit and vegetable skins and wholegrain cereals as they may make diarrhoea worse
avoid foods and drinks that are high in sugar, such as cordial, soft drinks and lollies
avoid foods sweetened with artificial sweeteners such as sorbitol, mannitol, and xylitol. These are often marketed as ‘sugar-free’
it may also help to eat small, frequent meals throughout the day, rather than three large meals
Heartburn (Indigestion) | Tokopā
Some cancers and treatments can cause heartburn, which is a burning sensation in the upper chest, oesophagus and/or throat. It is caused by the contents of the stomach coming back up into the oesophagus (reflux).
Heartburn may make you feel too uncomfortable to eat much, which could lead to weight loss. If the tips below do not relieve heartburn, let your doctor know as medication may help to prevent or manage these side effects.
Tips to manage heartburn | Ngā kupu āwhina mō te whakahaere tokopā:
avoid large meals; try to eat 3 small meals and 3 small snacks throughout the day
eat slowly and take the time to enjoy your meal
avoid wearing tight clothing while eating, especially belts
sip fluids between meals, rather than drinking large amounts at mealtimes
limit or avoid foods that may make heartburn worse, e.g., chocolate, highly seasoned spicy foods, high-fat foods (e.g., fried food, pastries, cream, butter, and oils), tomato and tomato products, citrus fruits, coffee (including decaf), strong tea, soft drinks, and alcohol
straight after eating, sit upright for at least 30 minutes and avoid lying down or activities that involve bending over (e.g., gardening).
Peripheral neuropathy | Pūtau Iotaiaki mōwaho:
Peripheral neuropathy is caused by damage to the peripheral nerves. These are the nerves in the body outside the brain or spinal cord. Peripheral neuropathy may be caused by cancer, cancer treatments or other health problems. It most commonly affects the hands and feet. Peripheral neuropathy caused by cancer treatment will get better over time with proper treatment and care.
The most common symptoms of peripheral neuropathy can include | Ngā kōrero tōkau mō te Pūtau Iotaiaki Mōwaho:
tingling, burning, numbness or pain in the hands or feet
difficulty doing up buttons and picking up small items
loss of feeling especially in the hands and feet
problems with balance or walking, and clumsiness
be safe. If you notice changes in your walking, stance, fine and gross motor skills, or balance speak to your doctor as soon as possible and ask for a referral to an occupational therapist, exercise physiologist or physiotherapist
Tips to manage peripheral neuropathy | Ngā kupu āwhina mō te whakahaere Pūtau Iotaiaki Mōwaho:
use a night light so that you don’t trip or bang into anything if you need to go to the toilet at night
keep clutter and rugs off the floors
have clear paths to the toilet and bedroom
use handrails where possible
use nonslip mats in the shower and bathroom
be careful on slippery and wet floors
do not walk around bare footed as you may not notice if you stand on something that could damage your feet
wear shoes and slippers that fit well
use a walking stick if you need to
wear gloves when washing up, cleaning and gardening
test water temperature with your elbow
take care when cutting food and opening cans or jars
keep your skin moisturised to prevent cracking
check your hands and feet daily for signs of injury, rubbing, redness or infection
ask for help if you need it, e.g., to do up buttons and shoes
find clothes and shoes that are easy to put on and take off
avoid driving if symptoms are severe.
Alerting your healthcare team of side effects | Whakaohititia tō rōpu tiaki hauora ki ngā mate āpiti
Your health care team wants to hear about your side effects. Your questions and concerns are important. Do not be afraid to share them. Ask your health care team who you should contact if you feel that your side effects need assessing right away.
Treatment changes | Ngā pānonitanga maimoa
Occasionally, if you have severe side effects, your doctor may discuss delaying or changing your treatment to prevent further discomfort.
Start a symptom diary | Tīmatahia he rātaka tohumate
Keeping track of your symptoms can help you and your cancer care team to manage them better.
Know who to contact if you have a problem | Me mōhio hoki ki te whakapā atu ki a wai mēnā he raru tāu
Ask your doctor or nurse:
when you should call for help or advice
who you should contact
how to contact them (including at night or weekends).
Keep this information where you can easily find it.
Our partners at the Pancare Foundation have created a webinar to help patients manage these side effects and help you navigate each day and experience greater quality of life. Pancare's experts share their knowledge surrounding common side effects such as nausea, peripheral neuropathy, fatigue, mouth sores, abdominal discomfort and more. Practical ways to manage these side effects are explored along with information regarding the support and care available for you and your family.
*NB - The PanSupport service mentioned is not available to patients in New Zealand
Diet & Nutrition
Whiringa kai me te taioranga
Why is diet and nutrition important? | He aha e whaitikanga ai te whiringa kai me te taioranga?
You may be feeling that some things are out of your control, however there are a number of actions that you can take to make sure your body is in the best condition to cope with, and heal from, the symptoms and side effects of the cancer and cancer treatments.
Below you will find detail about why diet and nutrition can make a big difference to the healing process and how you feel.
You can view our webinar all about the diet and nutrition in pancreatic cancer here.
Why does pancreatic cancer affect nutrition? |He aha e whakaaweawe ai te mate pukupuku repetaiaki huka i te taioranga?
Pancreatic cancer, and cancer treatments place extra demands on your body. They can also cause you to lose your appetite and energy, putting you at an increased risk of malnutrition. It is important to ensure that your body is receiving the right nutrition before, during and after treatment to be able to cope with these extra demands.
Your food choices when you have cancer and are undergoing treatment may be very different from what you are used to eating.
The main goal is to try to keep your weight constant, maintain muscle strength, maintain a healthy weight, and have more energy, all of which help your body to heal properly, improve your quality of life and give you the energy to cope with all the new challenges treatment may bring.
Pancreatic cancer and the treatments for pancreatic cancer may impact | Ka pāngia pea e te mate pukupuku repe me ngā maimoatanga o te mate pukupuku kōpiro:
your nutritional requirements and what you need to eat
how much you eat
your appetite
your ability to digest food
your ability to maintain your weight and muscle mass
your energy levels and general wellbeing.
Good nutrition can help to | He mea āwhina te taioranga pai ki te:
manage the side effects of treatment
speed up recovery after treatment
heal wounds and rebuild damaged tissues after surgery, radiotherapy, chemotherapy, or other treatment
improve the body’s immune system and ability to fight infections.
Overall, try to make food choices that provide you with enough | Nā reira, me ngana ki te whiriwhiri i ngā kai ka whakaratoa ki a koe:
calories (to maintain your weight)
protein (to help rebuild tissues that cancer treatment may harm)
nutrients such as vitamins and minerals
fluids (essential for your body’s functioning).
Exercise can also help with appetite and digestion issues related to treatment.
Nutritional tips during treatment | He kupu āwhina taioranga e koke ai te maimoatanga
Click here to learn more about nutritional tips during treatment | Pāwhirihia ki kōnei mō ētahi atu whakamōhiotanga
To maintain good nutrition | Kia mau roa ki te taioranga pai:
you may need more energy (kilojoules/calories)
eat small, frequent meals or snacks, rather than three large meals a day
ask for a referral to a dietitian – discuss eating issues, weight issues, muscle loss
do some light physical activity, such as walking, to improve appetite and mood, reduce fatigue, help digestion, and prevent constipation
check with your doctor or dietitian before taking vitamin or mineral supplements or making other changes to your diet
relax dietary restrictions, e.g., choose full-cream rather than low-fat milk
consider using nutritional supplements if you cannot eat enough – discuss options with your doctor, palliative care specialist or dietitian.
Nutritional tips following surgery | Ngā kōrero āwhina taioranga whai muri i te pokanga
Click here to learn more about nutritional tips following surgery | Pāwhirihia ki kōnei mō ētahi atu kupu āwhina taioranga
Surgeries used to treat cancer may result in a variety of side effects, including weight loss and diarrhoea. The side effects usually only last for a short period of time, but you may have to make some changes to your diet to ensure that you are getting enough nutrition and maintaining your weight.
Your body needs good nutrition after surgery, and it is an important part of your recovery process. If you are struggling to eat or drink, the hospital may prescribe nutrition supplements, or recommend tube feeding, to help you to maintain weight and provide you with the nutrients you need for speedy recovery.
Tips on maintaining weight after surgery | Ngā kupu āwhina ki te whakataki taumaha whai muri i te pokanga:
monitor your weight – weigh yourself once or twice a week to monitor for any weight loss
if you are losing weight, tell your doctor and get a referral to see a dietitian
eat small, frequent meals after surgery so your digestive system only has to deal with a small amount of food at a time.
We recognise that dietary changes have a huge impact on everyone with cancer. It can take a while to get used to changes to your diet and lifestyle but finding ways to manage your diet and symptoms can help you feel more in control. It can also be helpful to speak to your dietitian, doctor or nurse.
Nutritional tips to prevent Dumping Syndrome | Kupu āwhina taioranga kia aukati i te mate tātuku kōpiro
Click here to learn more about nutritional tips to prevent Dumping Syndrome | Pāwhirihia ki kōnei mō ngā kōrero āpiti
Whipple procedure includes removal of the lower part of the stomach. This may include the valve, or sphincter, that helps control the flow of food from the stomach to the small intestine. Removal of this valve can result in a condition called Dumping syndrome.
Dumping syndrome can occur when food moves from the stomach into the small bowel too quickly.
Symptoms of dumping syndrome (1-3 hours after eating):
nausea
cramps and diarrhoea approximately 10-30 minutes after eating or sweating
dizziness.
Tips to prevent Dumping Syndrome include:
avoid large meals
avoid sugary drinks and sweets
choose meals high in protein to slow the digestion of carbohydrates
keep drinks separate to meals.
We recognise that dietary changes have a huge impact on everyone with cancer. It can take a while to get used to changes to your diet and lifestyle but finding ways to manage your diet and symptoms can help you feel more in control. It can also be helpful to speak to your dietitian, doctor or nurse.
Malabsorption and pancreatic enzyme replacement therapy | Haumanu whākapi miti hē me te repetaiaki huka pūmua whākōkī
Click here to learn more about malabsorption and pancreatic enzyme replacement therapy | Pāwhirihia ki kōnei mō ētahi atu kupu āwhina
Changes to the pancreas, from either the cancer or the treatment, can mean that the body does not produce enough, or any, pancreatic enzymes. This can lead to poor digestion and absorption of food and is known as pancreatic exocrine insufficiency (PEI).
Symptoms of malabsorption:
floating, pale, foul-smelling stools
more frequent or loose bowel movements
bloating or pain
excess flatulence (farting)
stools that are oily in appearance
stools that are difficult to flush and stick to the toilet bowl
not gaining weight or losing weight, even if you feel you are eating enough
fatigue and weakness.
Your doctor or dietician should be consulted if you are experiencing any of these symptoms. They may recommend taking pancreatic enzymes which ensure that nutrients break down and can be absorbed by the body.
We recognise that dietary changes have a huge impact on everyone with cancer. It can take a while to get used to changes to your diet and lifestyle but finding ways to manage your diet and symptoms can help you feel more in control. It can also be helpful to speak to your dietitian, doctor or nurse.
Download the Pancreatic Enzyme Replacement Therapy (PERT) Patient Information and Clinician Letter.
Living well with cancer
Kia ora pai ai
Learn more about living with cancer.
Read about other people’s cancer journeys see our personal journeys page.
