title: Pancreatic enzyme replacement therapy (PERT) for malabsorption in patients with metastatic pancreatic cancer.
abstract: OBJECTIVE
  The diagnosis of metastatic pancreatic cancer (PC) carries a poor prognosis. PC is associated with weight loss and malabsorption in high rates secondary to pancreatic exocrine insufficiency. UK and USA guidelines exist recommending the empiric use of pancreatic enzyme replacement therapy (PERT) for quality of life in these patients. The aim of this study is to review the use of PERT in patients with metastatic PC referred to a specialist palliative care service.
  
  
  METHODS
  Retrospective observational study of patients referred to the service between January 2010 and July 2012 with a diagnosis of PC. Information about PERT use, tumour site and frequency of symptoms was collected.
  
  
  RESULTS
  129 patients were referred, with a higher number in the eighth decade. Only 21% of this study group were prescribed PERT. Over 70% of patients had symptoms that could be attributable to malabsorption, mainly abdominal pain. Other symptoms such as bloating, wind and steatorrhoea were also common.
  
  
  CONCLUSIONS
  Guidelines recommending empiric treatment of PERT in patients with metastatic PC are not currently being utilised.
authors.affiliation: Hospice Palliative Care Service, Nurse Maude Association, Christchurch, New Zealand.
authors.forename: Amanda
authors.initials: A
authors.lastname: Landers
authors.affiliation: Department of Palliative Care, Queen Elizabeth Hospital, Adelaide, South Australia, Australia.
authors.forename: Wendy
authors.initials: W
authors.lastname: Muircroft
authors.affiliation: Hospice Palliative Care Service, Nurse Maude Association, Christchurch, New Zealand.
authors.forename: Helen
authors.initials: H
authors.lastname: Brown
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D056947:Enzyme Replacement Therapy; D010188:Exocrine Pancreatic Insufficiency / Q000150:complications* / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D010190:Pancreatic Neoplasms / Q000209:etiology* / Q000556:secondary; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Pharmacology; Supportive care