Pancreatic cancer dietary taboos

High-fat, high-sugar, high-salt, highly processed foods, strict avoidance of alcohol and highly irritating drinks, and one-time overeating are absolutely prohibited. There is no unified "one size fits all" standard for the remaining taboos, which need to be flexibly adjusted based on the patient's treatment stage, physical tolerance, and even personal survival needs.

Last week, I received an emergency referral at the Pancreatic Surgery Clinic. He was a 62-year-old patient who had just been discharged from the hospital 10 days after a pancreaticoduodenectomy. The children at home dutifully cooked a bowl of braised pork with pickles and vegetables. The old man was greedy and ate two large pieces. He started to suffer from epigastric pain in the early morning. The amylase in the blood test directly increased to 8 times the normal upper limit. It was a typical acute pancreatitis induced by a high-fat diet. The incision that had recovered well almost collapsed.

Think about it, the pancreas is the core organ of the human body responsible for digesting fat. After cancer, whether the tumor compresses the pancreatic duct before surgery, or part of the pancreatic tissue is removed after surgery, the secretion of pancreatic lipase will drop significantly. If high-fat foods such as fried foods, fatty meats, cream cakes, and hot pot butter are entered into the stomach, the pancreas will not be able to secrete enough enzymes for digestion. The pancreas will try its best to digest fat. At worst, it can cause diarrhea and abdominal distension. At worst, it can induce pancreatitis like the aunt just now, and even stimulate tumor progression. Of course, that doesn’t mean you can’t touch any meat or fish. The two schools of thought have been arguing for a long time in clinical practice. Most nutrition doctors recommend eating only low-fat, high-quality proteins such as skinless poultry and steamed fish in the first three months after surgery, and completely avoiding saturated fat. ； The oncology doctor will be more relaxed. If the patient usually just has a bite of braised pork, and there is no discomfort if he eats 1 or 2 small pieces, there is no need to stop eating it completely. After all, the benefits of being able to eat and being in a good mood are much greater for the immune system than the harm of a little fat.

Speaking of which, I have to mention a drink taboo that many family members tend to miss. It is true that you should not touch half a sip of alcohol. Whether it is liquor, beer or so-called "health medicinal wine", alcohol will not only directly stimulate pancreatic secretion, but also damage the pancreatic mucosa. Even for patients who have recovered for three to five years after surgery, I have seen several cases of relapse after exposure to alcohol. There are also strong irritating things such as iced American cuisine, spirits, and particularly spicy hot pot soup bases, and they should be touched as little as possible. Cold and spicy things will stimulate gastrointestinal spasms and affect the discharge of pancreatic juice. Of course, the same sentence remains. If the patient has reached the terminal stage and the patient wants to drink iced Coke or eat spicy hot pot for the rest of the day, and there is no obvious pain after eating, then let him go. The comfort of life is more important than any taboos. There is no need to treat others harshly in the last days.

Another mistake that many people make is that they always think that the patient needs to take care of themselves when they are sick, stew old hens and turtle soup, and chase after others to persuade them to "eat more, eat more," but in fact this actually harms people. The pancreas is inherently "working with illness". If you stuff a bunch of food into it all at once, it can't bear the load. It can range from indigestion and diarrhea to severe pancreatic leakage, which can be fatal. I followed up an old man who had early postoperative surgery two years ago. He listened to my advice and ate 6 meals a day, less than half a bowl at each meal. When he was hungry, he would take a few mouthfuls of steamed corn and a boiled egg. All indicators were normal during the follow-up examination 3 years after the surgery, and he recovered much better than the patients in the same ward who received heavy supplements every day.

Oh, by the way, don’t believe the list of “10 foods you must not eat for pancreatic cancer” that has been widely circulated on the Internet. It’s all nonsense that eggs and seafood are fat. As long as you eat without allergies, bloating or abdominal pain, boiled eggs and steamed egg custards are the most cost-effective sources of high-quality protein. Steamed shrimps and seabass are much better than indigestible red meat. If you can't eat this, you can't eat that. The patient has a poor appetite due to illness, cannot keep up with nutrition, and his immunity weakens faster, which in turn gives the opportunity for tumor progression.

In fact, after all, the dietary taboos for pancreatic cancer are never strict rules. The core is "not to put extra burden on the pancreas." For specifics on how to eat and what not to eat, it is best to ask your attending doctor and nutritionist for evaluation together, which is 10,000 times more reliable than searching for those messy taboo lists on the Internet.