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Principles of Health: Obesity

Pancreatic cancer

by Cherie Marcel

CATEGORY: Disorder

Pancreatic cancer is a malignant neoplasm that originates in the pancreas, a gland located between the stomach and the spine. The pancreas produces the enzymes and hormones necessary for food metabolism and control of blood glucose levels. Because of the relatively hidden location of the pancreas and the vagueness of signs and symptoms, pancreatic cancer is frequently identified at an advanced stage, and more than 95% of patients with pancreatic cancer die from it within 5 years. Treatment depends on the stage and type (i.e., exocrine or endocrine tumors) of the cancer as well as the age and health status of the patient, and can require the use of surgery, chemotherapy, radiation therapy, or nonchemotherapeutic, targeted therapies such as sunitnib malate or erlotinib hydrochloride.

Dietary and Lifestyle Recommendations for the Prevention of Pancreatic Cancer

According to researchers, obesity is directly responsible for up to 20% of all cancers. Overweight and obese individuals, particularly those with increased abdominal fat, are at significantly higher risk for developing pancreatic cancer and other gastrointestinal (GI) cancers (e.g., colon, gastric, esophageal) than healthy-weight persons.

The mechanisms of obesity complications that lead to carcinogenesis are varied in function and affect different tissues. Some of the obesity-related contributors that are implicated in cancer development include insulin and insulin-like growth factor (IGF) signaling pathways, adipokines, inflammation and immune responses, and microbiota of the GI tract.

RISK FACTORS SIGNS AND SYMPTOMS Age over 45 years with over 65% diagnosed over 65 years of age Jaundice (i.e., yellowing of the eyes and skin) Men are more likely to develop pancreatic cancer than women Fatigue Smoking Abdominal and back pain Long-term diabetes, type 1 (DM1) or diabetes, type 2 (DM2) Unexplained weight loss Chronic pancreatitis Nausea and vomiting Cirrhosis of the liver Blood clots Overweight and obesity

Regular intake of fruits (especially citrus) and vegetables has shown potential to protect against pancreatic cancer in some but not all studies. The exact mechanism of the protective effect is not fully understood. The antioxidant vitamins A, C, and E; vitamin D; folate; magnesium; and calcium have demonstrated anticancer activity but are still being investigated. Regardless of whether a direct preventive relationship exists, higher fruit and vegetable consumption is associated with lifestyle habits such as higher fiber and lower fat intake, lower body weight, and increased physical activity, all of which are associated with cancer prevention.

Regular intake of whole grains has been demonstrated to reduce the risk of pancreatic cancer. There is some evidence that fortification of whole grain foods with folate can provide further protection against pancreatic cancer.

Research Findings

Evidence suggests that lifestyle behaviors such as achieving and maintaining a healthy weight, physical activity, consuming a diet rich in fruits and vegetables and low in saturated fat, limiting alcohol intake, and not smoking can reduce the risk of developing pancreatic cancer.

In a large prospective cohort study of over 500,000 adults, higher intakes of total, saturated, and monounsaturated (but not polyunsaturated) fats from red meat and dairy products were found to increase risk for pancreatic cancer.

Diagram showing the position of the pancreas, behind the stomach. (Cancer Research UK)

POHObesity_p0129_1.tif

One possible explanation for this increased risk is that excessive secretion of digestive enzymes in response to high intake of dietary fat can lead to pancreatic hypertrophy and hyperplasia, which increase vulnerability to the effects of carcinogens. The link between saturated fat intake and pancreatic cancer risk may be due to the association between saturated fat and insulin resistance.

Summary

Individuals at risk and diagnosed with pancreatic cancer (and their family members/caregivers) should learn about dietary recommendations based on personal characteristics and health needs. Patients should eat a high-fiber diet that includes a wide variety of fruits, vegetables, lean proteins, and unsaturated fats. Patients undergoing treatment for pancreatic cancer need to be monitored for weight loss, signs of malnutrition, vitamin/mineral deficiencies and electrolyte imbalances. It is important to report any health-related changes to the treating clinician as soon as possible to prevent worsening health status. A registered dietitian may provide appropriate nutrition support and counsel patients on appropriate foods or supplements to prevent weight loss or nutrient deficiencies. Patients and their family members should understand and adhere to the prescribed treatment regimen, while continuing medical surveillance to monitor health status. Research suggests that maintaining a healthy weight, physical activity, consuming a diet rich in fruits and vegetables and low in saturated fat, limiting alcohol intake, and not smoking can reduce the risk of developing pancreatic cancer.

References

1 

American Association for Cancer Research. “Excess Body Weight before 50 Is Associated with Higher Risk of Dying from Pancreatic Cancer.” ScienceDaily, 31 Mar. 2019, www.sciencedaily.com/releases/2019/03/190331192525.htm.

2 

Berger, Nathan A. “Obesity and Cancer Pathogenesis.” Annals of the New York Academy of Sciences, vol. 1311, no. 1, 2014, pp. 57–76., doi:10.1111/nyas.12416.

3 

Bracci, Paige M. “Obesity and Pancreatic Cancer: Overview of Epidemiologic Evidence and Biologic Mechanisms.” Molecular Carcinogenesis, vol. 51, no. 1, 12 Jan. 2013, pp. 53–63., doi:10.1002/mc.20778.

4 

Eibl, Guido, et al. “Diabetes Mellitus and Obesity as Risk Factors for Pancreatic Cancer.” Journal of the Academy of Nutrition and Dietetics, vol. 118, no. 4, 2018, pp. 555–567., doi:10.1016/j.jand.2017.07.005.

5 

Pothuraju, Ramesh, et al. “Pancreatic Cancer Associated with Obesity and Diabetes: an Alternative Approach for Its Targeting.” Journal of Experimental & Clinical Cancer Research, vol. 37, no. 1, 2018, doi:10.1186/s13046-018-0963-4.

Citation Types

Type
Format
MLA 9th
Marcel, Cherie. "Pancreatic Cancer." Principles of Health: Obesity, edited by Dawn Rutherford, Salem Press, 2020. Salem Online, online.salempress.com/articleDetails.do?articleName=POHObesity_0056.
APA 7th
Marcel, C. (2020). Pancreatic cancer. In D. Rutherford (Ed.), Principles of Health: Obesity. Salem Press. online.salempress.com.
CMOS 17th
Marcel, Cherie. "Pancreatic Cancer." Edited by Dawn Rutherford. Principles of Health: Obesity. Hackensack: Salem Press, 2020. Accessed December 14, 2025. online.salempress.com.