Eating Well With Pancreatic Cancer and Diabetes

by Columbia Surgery on March 18, 2015

PANCREAS DIABETES NUTRITION BLOGBy Deborah Gerszberg, RD, CNSC, CDN
Clinical Nutritionist, The Pancreas Center

Many of those diagnosed with pancreatic cancer already have (or will get) diabetes. Pancreatic cancer often leads to a significant amount of unintentional weight loss; therefore, a typical diabetic diet may not always be appropriate. If blood sugar is well controlled (or even somewhat controlled) one is usually able to follow a more liberal diabetic diet. The higher the degree of weight loss or malnutrition, the more liberalized the diabetic restrictions should be. Difficult to control blood sugar can be managed with oral medications or insulin injections, as prescribed by a physician.

In general, consuming added sugars is unhealthy and should be avoided in excess. Whether or not a patient is diabetic, eating nutrient dense foods with plenty of fat and protein during treatment is a wise choice. That being said, there is nothing wrong with enjoying a sweet treat every now and then, especially if you are eating much less than usual and are losing weight. At that point, stopping any further weight loss is the first priority, even if that means more sugar in your diet.

Aim for 3 meals per day with around 4 carbohydrate servings at each meal. In between meals, snacks are encouraged and may include up to 1 carbohydrate serving per snack. Examples of healthy, nutrient dense snacks include nuts and nut butters, sliced cheese, cottage cheese, hummus, plain yogurt, slices of turkey, tuna or egg salad. All of these foods are very low in carbohydrates and also provide a good amount of calories from protein and fat. You may include a serving of a nutrient rich carbohydrate such as ½ banana, a small apple, pear, or orange, ½ cup of cut fruit or berries, a slice of bread or small pita, or vegetable slices.

Be sure to not purchase any “diet” foods if you are struggling with unintentional weight loss. Rather choose full fat foods (ie: full fat yogurt instead of fat free or low fat), and keep your intake of carbohydrates consistent when possible). Sometimes, I find a patient eating so little that diet restrictions are not warranted, even with diabetes. If you need help managing your diet, ask your doctor for a referral to a dietitian who can help you design a meal plan for your individual needs.

If you experience gas, cramping, or yellow floating stools after eating a high in fat food, you may need to take pancreatic enzymes. Be sure to discuss this with your doctor and dietitian during your next visit.

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8 Tips for Managing Chemotherapy-Induced Nausea

by Columbia Surgery on March 26, 2015


NAUSEA FROM CHEMOBy Deborah Gerszberg, RD, CNSC, CDN
Clinical Nutritionist, The Pancreas Center

One of the biggest pitfalls of undergoing chemotherapy can be dealing with nausea. Not everybody will experience this uncomfortable side effect, and often times, symptoms may be  only mild Even mild nausea however, can have a significant impact on how much food one is able to eat, contributing to weight loss. Knowing how to manage nausea is important to staying healthy during your treatment. The following are suggestions to minimize your discomfort:

1)     Avoid your favorite food. Do not eat your favorite food if you are feeling nauseated. This may create a negative association with that food and the next time you try to eat it, your favorite food may cause you to feel queasy. Rather, have foods that are easy to digest such as crackers, toast, yogurt, potato, broth, or rice.

2)     Talk to your doctor about nausea medications. Common medications for nausea include ondansetron (Zofran) and prochlorperazine maleate (Compazine). It is best to take these medications about an hour before eating. This will help you maximize how much you can eat and allow you to enjoy your meal more.

3)     Avoid strong smells. Half of our taste sensors come from our nose, so avoid the kitchen while your family or friends are cooking (this would be a good time for a nap in your bedroom). Open a window to help neutralize any smells.

4)     Avoid warm foods. Cold foods like yogurt and ice cream are often well tolerated. Try letting your warm food cool down for 30 minutes before eating (this will also allow more time to pass when airing out the kitchen). If you cannot wait, place your warm dish in a large bowl of ice to it cool down quickly.

5)     Eat every 2-3 hours. Sometimes an empty stomach causes a queasy stomach. Try to not let your stomach get completely empty by snacking on pretzels, crackers, toast, yogurt, cheese, or a milkshake.

6)     Eat what you want to eat. If you feel like having macaroni and cheese, and that appeals to you, then by all means, eat some macaroni and cheese. Breakfast food for dinner? Go for it! Don’t try to force yourself to eat a meal that causes your stomach to turn at the thought of it. Some patients are turned off by salty foods, some by sweet foods. Some patients find that everything tastes very bland and enjoy extra herbs or spices. Adjust how your food is prepared so that is appeals to you. This is not a one size fits all approach to eating.

7)     Drink liquids in-between meals/snacks. Filling your stomach up with liquids during mealtime there will be less room for food! You will feel full faster if you drink too much with your meals. Staying hydrated is important, so sip on liquids in between your meals. Small sips during meal times should be well tolerated.

8)     Use ginger and peppermint. Ginger and peppermint are age old remedies used for treating nausea. Make a cup of ginger or peppermint tea, or purchase ginger or peppermint candies. Put a drop of peppermint essential oil on a tissue and bring it with you to inhale. If you know you like the scent of peppermint, you could put a drop underneath the collar of your shirt or pin a handkerchief with a drop underneath your shirt. Caution: make sure you find the smell of something pleasant before putting it on your clothing.

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