Severe weight loss with pancreatic cancer: What can be done?

Posted by tww60223 @tww60223, Jul 17, 2024

Having serious problems with weight loss due to pancreatic cancer. My wife was diagnosed in mid January 2024 with advanced pancreatic cancer. No metastasis, but very large tumor on pancreas. Started chemo in March, no possibility of surgery (Whipple) although she did have a stent placed in the bile duct.

The problem is she isn't eating, maybe 300 calories a day, mostly liquids. The doctors have prescribed 4 different anti-nausea drugs, and she is taking Pancreaze 210000 when she tries to eat. She started this weighing 135, last week she was down to 78. She looks like a concentration camp survivor, and barely has the strength to walk. Yesterday while going in for a chemo treatment she just collapsed in the waiting room, and ended up in the emergency room for four hours. All they did was give her IV saline because she was dehydrated.

I just don't think she can go on much longer, and we get very little help from the doctors. We've spoken to the nutritionist several times, but I don't think she (or anyone at the hospital) has any experience with pancreatic cancer.

If anyone has any ideas or suggestions to help her get some weight back I would appreciate it.

Interested in more discussions like this? Go to the Pancreatic Cancer Support Group.

@amberswt

Hi My Dad has had severe weight loss. He has 2 spots on pancreas. Through chemo , 1 spot has gone away but the other one has not. He had to stop chemo due to a fungal infection in his port. They’ve treated that but the whole issue is that my Dad continues to lose weight. He’s tried appetite stimulants but they aren’t working. Does anyone else have a similar story that can relieve me of my worries.

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It's important to get to the root of the weight loss. Is it that he's simply not eating enough despite the appetite stimulants? Or does it seem he is eating plenty but losing weight anyway?

If he seems to be eating enough, his pancreas might not be producing enough of the right enzymes to properly digest food and extract nutrition from it. Or if there's a partial blockage of a bile duct, there might not be enough bile to do the job. There are simple liver and pancreas blood tests for this. Changes in stool color, flotation, greasiness, smell, etc. can be big indicators of these problems. I lost 30 pounds before my pancreatic cancer was diagnosed in part due to these causes. I regained all the weight after a bile duct stent was placed.

If he's just not eating enough, you might be able to get temporary supplementation with a PICC or Central line to infuse nutrients intravenously. When my pancreas tumor came back (after Whipple) and blocked my stomach outlet, I went several weeks without eating and again lost 30 pounds. Finally, a "Central" line was placed in my chest, and I had a 2000-calorie bag of nutrients and hydration ("TPN") pumped into my veins over a 12-hour period every night. After a gastric outlet stent was placed, I slowly became able to eat an almost normal PO diet. Between the TPN and the PO, I again regained all 30 pounds.

Doctors seem reluctant to place invasive pathways like PICC/central lines if other options exist, because of the potential for infection, but they might be underutilized, if you can keep a patient from crashing due to poor nutrition. That's no fun, speaking from experience. You should definitely run these thoughts and questions by his medical team.

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@amberswt

Hi My Dad has had severe weight loss. He has 2 spots on pancreas. Through chemo , 1 spot has gone away but the other one has not. He had to stop chemo due to a fungal infection in his port. They’ve treated that but the whole issue is that my Dad continues to lose weight. He’s tried appetite stimulants but they aren’t working. Does anyone else have a similar story that can relieve me of my worries.

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Creon enzymes, eatent with each meal, helps my wife's pancreas with digestion.
Then Kates Farm a a protein shake snack also helped.
She tried Glucerna, but as its dairy based it aggravated her GI and the diarrhea offset the benefits.
Kate's Farms option expensive but so far, less diarrhea, and maintaining weight.

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@amberswt

Hi My Dad has had severe weight loss. He has 2 spots on pancreas. Through chemo , 1 spot has gone away but the other one has not. He had to stop chemo due to a fungal infection in his port. They’ve treated that but the whole issue is that my Dad continues to lose weight. He’s tried appetite stimulants but they aren’t working. Does anyone else have a similar story that can relieve me of my worries.

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@amberswt, I can imagine you are very worried about your Dad. I moved your question about weight loss to this existing discussion:

- Severe weight loss with pancreatic cancer: What can be done?
https://connect.mayoclinic.org/discussion/severe-weight-loss-with-pancreatic-cancer/
I did this so you can click the link to read previous helpful posts and connect with other members like @tww60223 @mimimmx @mnewland99 and others.

Amber, how is your dad doing? Has his oncologist discussed the option of total parenteral nutrition (TPN)? TPN is when complete nutrition is given by IV (intravenously) when people can't use their digestive systems at all. What solutions has the doctor or nurse suggested?

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Hi, I am sorry about your wife. I went thru the weight loss at first, then I started to drink lots of muscle milk, (it comes in all different flavors). Muscle milk has lots of protein, ice cream shakes. etc. For nausea I took Prochlorperazine (Compazine) 10 mg. and /or Ondansetron orally disintegrating tablets. 8 mg. I got better after adjusting to the chemo. I am stage 4 inoperable. Regards, Kathy74.

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