Pancreas Cancer-Associated Weight Loss

on behalf of the Precision Promise Consortium, Andrew E. Hendifar, Maria Q.B. Petzel, Teresa A. Zimmers, Crystal S. Denlinger, Lynn M. Matrisian, Vincent J. Picozzi, Lola Rahib, Andrew Hendifar, Richard Tuli, Brian Wolpin, Manuel Hidalgo, David Ryan, Sunil Hingorani, Elena Gabriela Chiorean, Andrew Coveler, Eileen O'Reilly, Vinod Balachandran, Diane Simeone, Andrew LowyPaul Fanta, Razelle Kurzrock, Tony Reid, Andrew Ko, Eric Collisson, Margaret Tempero, Hedy Kindler, Thomas George, Jose Trevino, Robert Vonderheide, Gregory Beatty, Vincent Picozzi, Margaret Mandelson, Andrea Wang-Gillam, William Hawkins, Julie Fleshman, Manuel Hidalgo, Sunil Hingorani, Anirban Maitra, Victoria Manax, Lynn Matrisian, Vincent Picozzi, Diane Simeone

Research output: Contribution to journalReview articlepeer-review

102 Scopus citations

Abstract

Unintentional weight loss in patients with pancreatic cancer is highly prevalent and contributes to low therapeutic tolerance, reduced quality of life, and overall mortality. Weight loss in pancreatic cancer can be due to anorexia, malabsorption, and/or cachexia. Proper supportive care can stabilize or reverse weight loss in patients and improve outcomes. We review the literature on supportive care relevant to pancreatic cancer patients, and offer evidence-based recommendations that include expert nutritional assessment, counseling, supportive measures to ensure adequate caloric intake, pancreatic enzyme supplementation, nutritional supplement replacement, orexigenic agents, and exercise. Pancreatic Cancer Action Network-supported initiatives will spearhead the dissemination and adoption of these best supportive care practices. Implications for Practice: Weight loss in pancreatic cancer patients is endemic, as 85% of pancreatic cancer patients meet the classic definition of cancer cachexia. Despite its significant prevalence and associated morbidity, there is no established approach to this disease entity. It is believed that this is due to an important knowledge gap in understanding the underlying biology and lack of optimal treatment approaches. This article reviews the literature regarding pancreas cancer-associated weight loss and establishes a new framework from which to view this complex clinical problem. An improved approach and understanding will help educate clinicians, improve clinical care, and provide more clarity for future clinical investigation.

Original languageEnglish
Pages (from-to)691-701
Number of pages11
JournalOncologist
Volume24
Issue number5
DOIs
StatePublished - May 2019

Keywords

  • Anorexia
  • Cachexia
  • Malabsorption
  • Pancreatic cancer
  • Supportive care
  • Weight loss

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