Dietary taboos for patients with pancreatic cancer

There are three types of red-line foods that patients with pancreatic cancer must not touch - high-fat and oily foods, any alcoholic drinks/foods, and deeply processed pickled/smoked/red meat products.； In addition, high-sugar foods, rough and difficult-to-digest foods, and highly irritating foods need to be eaten with caution according to your own condition. There is no absolute one-size-fits-all taboo. Everything must be done without discomfort and nutritional intake can be ensured.

When I was following up in the pancreatic team of the General Surgery Department, the one who impressed me most was the 62-year-old Uncle Zhang. He was recovering well on the 20th day after his pancreaticoduodenectomy. His son secretly brought him half a piece of his favorite pork elbow. However, within two hours of eating, he started to suffer from abdominal pain and bloating. His amylase level soared to 5 times the normal value. He had to be treated overnight for pancreatitis before he recovered. Later, the bedside doctor was so angry that he lectured his son for half an hour.

The pancreas itself is responsible for secreting lipase to digest fat. After pancreatic cancer, whether before or after surgery, the exocrine function of the pancreas will be greatly reduced. Excess fat that cannot be digested will accumulate in the intestines, which can range from diarrhea and abdominal distension to stimulating a large amount of pancreatic juice secretion. The already fragile pancreas cannot withstand this stimulation, which can easily induce acute pancreatitis. Post-operative patients may even develop pancreatic leakage, which can be fatal. Of course, high-fat foods are not completely uncontroversial. For example, the nutrition department sometimes recommends that patients who have recovered their digestive function well and have no symptoms of abdominal pain or diarrhea for more than half a year after surgery can eat a small amount of lean pork belly, or one or two spoons of healthy fats such as peanut butter to supplement essential fatty acids. However, surgeons are generally more conservative and generally recommend avoiding foods high in saturated fat within one year after surgery. This is actually because different departments have different considerations. Family members can make decisions based on the patient's actual condition and communicate with the attending physician.

Oh, by the way, among the three types of red lines mentioned just now, alcohol is the least controversial. No matter whether you are before or after surgery, early or late, whether it is 5% beer or 53% liquor, even if it is cooked meat with half a bottle of cooking wine, you must not touch it. Alcohol's damage to pancreatic cells is direct and irreversible. Even healthy people who drink for a long time are prone to pancreatitis, let alone a cancerous pancreas. Drinking once is equivalent to stabbing the pancreas, which is really not a crime.

Another red line is that all types of pickled, smoked, and processed red meat, such as sausages, bacon, cured meats, and smoked fish, are all clearly listed as carcinogens by the World Health Organization. A family member of a patient was very aggrieved before, saying that the bacon he had cured at home was clean without preservatives, so why couldn’t he eat it? In fact, the nitrite content of homemade cured meat is less accurate than that of commercially available ones. When these things enter the body, they will not only increase the burden of intestinal metabolism, but may also stimulate the proliferation of tumor cells. Don't use "appetizer" as an excuse to eat it to patients. If you want to appetize, cut two slices of fresh lemon and soak it in warm water, or fry a sweet and sour peeled tomato, which is better than anything else.

As for the remaining categories that need to be consumed with caution, there is really no need to overdo it. For example, when it comes to high-sugar foods, many family members see that the patients cannot eat, so they buy various milk teas, cream cakes, and honey water to replenish energy for the patients. In fact, many patients with pancreatic cancer have abnormal insulin secretion, and blood sugar itself is unstable. Eating a large amount of high-sugar foods can easily increase blood sugar to over ten, which will increase the metabolic burden on the body. Some studies even show that a high-sugar environment can promote the growth of tumor cells. But here is a special case: if you are a patient with advanced cachexia who can no longer eat anything and just wants to eat something sweet, then there is really no need to restrict food. The quality of life is the first priority. You can eat cakes if you want, drink milk tea if you want, and don’t have to hold those restrictions to the last days of the patient.

There are also rough and difficult-to-digest foods, such as whole celery, leeks, and bamboo shoots that are rich in fiber, as well as sticky foods made from glutinous rice such as rice cakes, green dumplings, and rice dumplings. Especially within 3 months after surgery, patients with anastomotic edema and stenosis in the digestive tract should avoid touching them as much as possible. There was an aunt who had a craving for two mugwort balls more than two months after the surgery. The pills were blocked in her intestines and caused an intestinal obstruction. She was so painful that she broke into a cold sweat and had to have her intestines opened twice. Of course, this does not mean that all vegetables cannot be eaten. Boiling pumpkin, winter melon, and carrots until soft, or beating the vegetables into fine vegetable juices, and drinking a small amount to supplement dietary fiber can prevent constipation, which is absolutely fine.

As for spicy, iced, and extremely hot foods, there is actually a lot of controversy. Many places say that spicy food must not be eaten. However, some patients have been eating spicy food all their lives and cannot eat spicy food at all. So if they do not have abdominal pain, diarrhea, or stomachache after eating mildly spicy food, can they eat it? The advice of the nutrition department is to add a small amount of fresh chili pepper to enhance the flavor. You don’t have to give it up completely. However, if you have a peptic ulcer or a history of pancreatitis before, you must not touch it. Otherwise, it will irritate the digestive tract and pancreas, and you will be the one to suffer.

In the past few years, I have seen too many family members who have gone to extremes. One type is that they dare not give anything to them. They give patients white porridge and pickles every day. They have lost more than 20 kilograms in three months. Their immunity is so weak that they cannot even withstand chemotherapy.； The other is to eat whatever is expensive, such as soft-shell turtle today and sea cucumber tomorrow. Eating it will make the patient suffer from diarrhea and abdominal pain every day, which will aggravate the condition. In fact, there are really not that many rigid rules. Except for the three red lines mentioned above, which must not be touched, you can try small steps. For example, if you want to eat two bites of an apple today, just scrape it into puree and eat one or two spoonfuls. If you feel no discomfort after eating, you can eat more next time. If you feel a little bloated after eating, touch less next time.

To put it bluntly, for patients with pancreatic cancer, eating well, eating comfortably, and having enough nutrition are more important than any strict taboos. Don't believe those "universal anti-cancer recipes" posted on the Internet. Everyone's condition and digestive function are different. Communicate more with your attending doctor and bedside nurse, as any folk prescription is more reliable.