When you are diagnosed with cancer, one of the first things you realize is that people have a lot of advice. Some of it is good, some of it is not so good, and a lot of it is focused on diet.
One person told me that I got cancer because I eat dairy products. Her advice was that I should become a vegan. Others have blamed the cancer on carbohydrates and recommended a “keto” diet where I eat only meat, eggs and high-fat dairy. Another person suggested that I fast throughout chemo. My chemo sessions are 3 days long.
Either way, the goal is the same: to starve the cancer of the thing it needs to survive, and therefore defeat it. The problem is that starving the cancer through a restrictive diet hasn’t been shown to be effective in studies, and can in fact exacerbate the problem with pancreatic cancer.
The pancreas is an often under-appreciated organ best known for the production of insulin. It sits nestled among the stomach, liver, spleen and the duodenum. Insulin, produced in the islet cells of the pancreas, allows sugars in the bloodstream to be taken up and used by cells. The pancreas also makes an array of enzymes that help us break down and digest food. It is central to our ability to use the food we eat.
When cancer invades the pancreas, it often causes digestive dysfunction as a primary symptom. Weight loss almost always accompanies this, along with muscle wasting. Maintaining weight is both incredibly important and exceptionally difficult with pancreatic cancer.
When people suggest one diet or another to “starve” the cancer they often neglect to realize that, using broad tools like diet, or fasting, you have to starve the host organism — in this case, me — in order to starve the cancer. With sustained weight loss, treatment options diminish and become more difficult to tolerate.
So, to follow that metaphor, if I want to gain and maintain weight I have to feed my whole body. That includes the cancer, as well as the vast majority of my body, which is otherwise quite healthy. It is a paradox, on the surface, to focus on health when you have such a deadly disease, but it is my health that lets my body endure chemo and fight back against the cancer.
When I can eat enough to maintain my weight, I can eat enough also to fuel exercise which is broadly recognized as beneficial to both tolerating and responding to treatment. The calories that cancer burns need to be eaten back, or the cancer will rob them from my muscles instead. Over time, however, my cancer has receded and my healthy body has remained strong.
The best diet advice I’ve found for pancreatic cancer is to eat small, frequent meals and to focus on foods I can tolerate. Many patients struggle to digest fats and need replacement enzymes. Others have blood sugar issues. We are all different in terms of what foods we can tolerate, but we all have issues with digestion. The most important thing is eating enough of whatever I can to keep weight on, and making sure that my diet is as varied and nutritionally complete as possible.