title: Pancreatic Exocrine Insufficiency in Pancreatic Cancer.
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.
authors.affiliation: Center for Digestive Diseases, Karolinska University Hospital, Stockholm SE-141 86, Sweden. miroslav.vujasinovic@karolinska.se.
authors.forename: Miroslav
authors.initials: M
authors.lastname: Vujasinovic
authors.affiliation: Center for Digestive Diseases, Karolinska University Hospital, Stockholm SE-141 86, Sweden. roberto.valente@karolinska.se.
authors.forename: Roberto
authors.initials: R
authors.lastname: Valente
authors.affiliation: Center for Digestive Diseases, Karolinska University Hospital, Stockholm SE-141 86, Sweden. marco.del-chiaro@ki.se.
authors.forename: Marco
authors.initials: M
authors.lastname: Del Chiaro
authors.affiliation: Center for Digestive Diseases, Karolinska University Hospital, Stockholm SE-141 86, Sweden. johan.permert@karolinska.se.
authors.forename: Johan
authors.initials: J
authors.lastname: Permert
authors.affiliation: Center for Digestive Diseases, Karolinska University Hospital, Stockholm SE-141 86, Sweden. matthias.lohr@ki.se.
authors.forename: J-Matthias
authors.initials: JM
authors.lastname: Löhr
mesh_terms: D056947:Enzyme Replacement Therapy; D010188:Exocrine Pancreatic Insufficiency / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D006801:Humans; D010190:Pancreatic Neoplasms / Q000150:complications / Q000628:therapy*; D016032:Randomized Controlled Trials as Topic; D014815:Vitamins / Q000008:administration & dosage
chemical_list: D014815:Vitamins
keywords: malnutrition; pancreatic cancer; pancreatic exocrine insufficiency; pancreatic surgery; vitamin