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Review
. 2017 Feb 23;9(3):183.
doi: 10.3390/nu9030183.

Pancreatic Exocrine Insufficiency in Pancreatic Cancer

Miroslav Vujasinovic  1 , Roberto Valente  2 , Marco Del Chiaro  3 , Johan Permert  4 , J-Matthias Löhr  5
Affiliations
Review

Pancreatic Exocrine Insufficiency in Pancreatic Cancer

Miroslav Vujasinovic et al. Nutrients. .

Abstract

Abstract: Cancer patients experience weight loss for a variety of reasons, commencing with the tumor's metabolism (Warburg effect) and proceeding via cachexia to loss of appetite. In pancreatic cancer, several other factors are involved, including a loss of appetite with a particular aversion to meat and the incapacity of the pancreatic gland to function normally when a tumor is present in the pancreatic head. Pancreatic exocrine insufficiency is characterized by a deficiency of the enzymes secreted from the pancreas due to the obstructive tumor, resulting in maldigestion. This, in turn, contributes to malnutrition, specifically a lack of fat-soluble vitamins, antioxidants, and other micronutrients. Patients with pancreatic cancer and pancreatic exocrine insufficiency have, overall, an extremely poor prognosis with regard to surgical outcome and overall survival. Therefore, it is crucial to be aware of the mechanisms involved in the disease, to be able to diagnose pancreatic exocrine insufficiency early on, and to treat malnutrition appropriately, for example, with pancreatic enzymes.

Keywords: malnutrition; pancreatic cancer; pancreatic exocrine insufficiency; pancreatic surgery; vitamin.

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Conflict of interest statement

J.M.L. and M.V. have received honoraria from Abbott and Mylan. The other authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Intrinsic (tumor cell-triggered) and extrinsic (host-triggered) factors contributing to malnutrition in pancreatic cancer patients. For details and references see text. IAPP = islet amyloid polypeptide; PEI = pancreatic exocrine insufficiency. GI = gastrointestinal
See this image and copyright information in PMC

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