Pancreatic cancer and diet

Category: Blog

There is a fantastic amount of research being published on the role of pancreatic cancer and diet. Let’s get to it.

In November 2018, researchers wrote in the journal Anticancer research (1) about the ketogenic diet (a high-fat, adequate-protein, low-carbohydrate diet,) and its potential use  in Pancreatobiliary Cancer patients. Here is what the research team wrote:

“High-carbohydrate diets are generally provided to post-pancreatectomy cancer patients. (The) Low energy density of this diet may obstruct proper energy intake and recovery. This study aimed to assess the effects of high-fat, high-energy ketogenic diet in these patients.”

What the researchers were saying in the simplest of terms is that a high-carbohydrate diet may be exactly the WRONG diet for pancreatic cancer patients. It robs these patients of energy, ability to gain weight, and to recover from surgery.

Here is the study results:

  • After pancreatectomy (surgery to remove all or part of the pancreas, 9 patients were provided with general diet while 10 were served a ketogenic diet. Meal compliance, energy intake rate, meal satisfaction and presence of complications were monitored throughout the patient’s hospital stay.
  • Findings:
    • Meal compliance, energy intake rate and meal satisfaction score were higher in ketogenic diet. The results: Post-pancreatectomy cancer patients who consumed a ketogenic diet had a higher energy intake and body cell mass (BCM), in other words they gained body mass.
    • These results suggest the potential use of a ketogenic diet as an adjuvant anti-cancer therapy.

Now that is just one suggestion to diet. At the Magaziner Center for Wellness we assess the individual patient’s body composition to help guide them to better nutritional choices. There are many suggestions as to what type of diet one may follow. This would be based on our particular emphasis on an anti-inflammatory diet and lifestyle, and biologic agents that quiet the inflammatory pathways since inflammation has been found to foster the growth of cancer cells.

In the journal Nutrients (2), researchers at North Dakota State University offered this:

Pancreatic cancer is the fourth most common cause of cancer-related deaths with a dismal average five-year survival rate of six percent. Progress has been made in understanding how pancreatic cancer develops and progresses. Evidence is mounting which demonstrates that diet and nutrition are key factors in carcinogenesis (the formation of cancer). In particular, diets low in folate and high in fruits, vegetables, red/processed meat, and saturated fat have been identified as pancreatic cancer risk factors.

 Are fruits and vegetables bad?

Doctors in the Czech Republic have published findings (3) trying to solve the role of diet in the development of Pancreatic cancer.

Some foods they tested provided a very strong protective effect from pancreatic cancer. they included:

  • pickled cabbage
  • broccoli
  • cooked onion
  • tomatoes
  • raw carrot
  • cooked carrot
    • Cooked vegetables were beneficial: “statistically significant protective associations were found in consumption of more than three portions of cooked vegetables per week”
  • and high consumption of citrus fruit.

Conflicting evidence and confusion

When it comes to cancer, dietary choices become very confusing. This is why we have to look at the individual patient situation before we would make dietary recommendations. You just read about what to avoid, now other research suggests some of those things may not be that bad after all.

Another study published in the journal Anticancer research (4) suggests this:

Fruits (particularly citrus) and vegetable consumption may be beneficial. The consumption of whole grains has been shown to reduce pancreatic cancer risk and fortification of whole grains with folate may confer further protection. Red meat, cooked at high temperatures, should be avoided, and replaced with poultry or fish. Total fat should be reduced. The use of curcumin and other flavonoids should be encouraged in the diet. There is no evidence for benefit from vitamin D supplementation. There may be benefit for dietary folate.

The role of inflammation

In a recent report, doctors confirm a strong association between pancreatic cancer and inflammatory stimuli or conditions such as cigarette smoking and diabetes, suggesting that inflammation may play a key role in pancreatic cancer.

Studies of dietary patterns and cancer outcomes also suggest that diet might influence an individual’s risk of pancreatic cancer by influencing the inflammation response. In this report strong suggestion is made that a proinflammatory diet may act as cofactor with cigarette smoking and diabetes to increase risk of pancreatic cancer beyond the risk of any of these factors alone. (5) Obviously a lifestyle change is needed for people at these elevated risk factors.

40 per cent of pancreatic cancers could be avoided through maintaining a healthy weight and not smoking

In a recent study from England, doctors say almost 40 per cent of pancreatic cancers could be avoided through maintaining a healthy weight and not smoking.

The English doctors noted that 8,800 people are diagnosed with the disease in the UK but survival rates remain very low, with only three per cent of people diagnosed with pancreatic cancer surviving their disease for five years or more after their diagnosis.

  • While more research is needed to find better ways of diagnosing and treating the disease, there is evidence to suggest that some pancreatic cancers are linked to being overweight and to smoking – and almost four in 10 could be prevented by lifestyle changes to address this.(6)

What we see here in this article is conflicting evidence. This is why the care of the cancer patients must rely on an individualized and monitored nutrition program. Our program emphasizes the concept of Thriving While Surviving. We strive to transform cancer from an acute disease into more of a chronic illness, one that can be lived with for many months or even years. Some of our patients have greatly outlived their life expectancy by even two or three-fold. Furthermore, most are able to continue with a productive and fulfilling life.

1 Ok JH, Lee H, Chung HY, Lee SH, Choi EJ, Kang CM, Lee SM. The Potential Use of a Ketogenic Diet in Pancreatobiliary Cancer Patients After Pancreatectomy. Anticancer research. 2018 Nov 1;38(11):6519-27.
2 Weisbeck A, Jansen RJ. Nutrients and the Pancreas: An Epigenetic Perspective. Nutrients. 2017;9(3):283. Published 2017 Mar 15. doi:10.3390/nu9030283
3 Azeem K, Horakova D, Tomaskova H, Prochazka V, Shonova O, Martinek A, Kysely Z, Janout V, Kollarova H. Evaluation of dietary habits in the study of pancreatic cancer. Klin. Onkol. 2016;29(3):196-203.
4 Pericleous M, Rossi RE, Mandair D, Whyand T, Caplin ME. Nutrition and pancreatic cancer. Anticancer Res. 2014 Jan;34(1):9-21.
5. Antwi SO, Oberg AL, Shivappa N, Bamlet WR, Chaffee KG, Steck SE, Hébert JR, Petersen GM. Pancreatic cancer: associations of inflammatory potential of diet, cigarette smoking and long-standing diabetes.Carcinogenesis. 2016 Feb 12. pii: bgw022.
6 D M Parkin, L Boyd, L C Walker. The fraction of cancer attributable to lifestyle and environmental factors in the UK in 2010. British Journal of Cancer, 2011; 105: S77 DOI: 10.1038/bjc.2011.489