Managing the Side Effects of Pancreatic Cancer and Its Treatment

The medicines below are used for pancreatic cancer. Only the most basic problems are listed. Ask your doctor if there are any other steps you need to take. Use each of them as your doctor tells you. If you have any questions or can’t follow the package instructions, call your doctor.

Medicines are used to help with the side effects of cancer or its care. They can prevent problems or be taken as they come up. Be sure to let your doctor know when you have problems so they can be taken care of.

Some of the problems linked to pancreatic cancer need to be cared for. These are:

Development of Diabetes

If you have surgery to remove part or all of your pancreas, you may develop diabetes. Your body no longer makes insulin or becomes resistant to it. Insulin helps you digest food, breaking down carbohydrates into glucose. Your body uses this for energy. It can also be stored for future use. Insulin keeps your blood glucose within a normal, healthy range.

Insulin is mainly given as a shot. You will need to check the level of glucose in your blood on a routine basis. Caring for diabetes also means eating the right foods and using the shots at certain times. Your healthcare team will teach you how to do this.

Taking Insulin

The main forms are:

  • Humulin
  • Novolin
  • Velosulin

The insulin shot is placed just under your skin. It needs to be done many times during the day. It can be given as a shot or with a pump. The pump will work by itself to give you a dose during the day. There are many types of insulin. You may need more than one type.

Side Effects of Insulin Therapy

If your glucose levels are too high or low, you can have problems.

High blood glucose causes you to:

  • Feel more thirst
  • Feel more hunger
  • Pass urine more often
  • Feel tired

Low blood glucose causes:

  • Shaking
  • Lightheadedness, which can lead to fainting
  • Problems with thinking clearly
  • Sweating
  • Fast heartbeat
  • Vision problems

When to Contact Your Doctor

Call your doctor for:

  • Seizures
  • Fainting
  • Chest pain
  • Breathing problems
  • Yellow eyes or skin—jaundice
  • Easy bleeding or bruising

Problems Digesting Food

As cells in the pancreas are damaged, normal digestion is impaired. This can also happen if all or part of the pancreas was removed. You may have problems digesting food or getting all the nutrients from it. Taking enzyme tablets when you eat will solve these problems.

Pancrelipase has enzymes like the ones made by the pancreas. Enzymes help you digest your food and break it down in to small units your body can use for energy.

The enzymes may cause:

  • Mouth pain
  • Skin rashes
  • Diarrhea
  • Nausea
  • Belly cramps or pain

When to Contact Your Doctor

Call your doctor for:

  • Pain or diarrhea
  • Stools that look greasy or float on the toilet water
  • Breathing problems or wheezing

Weight Loss    TOP

You may lose weight if you don't feel hungry. You may be asked to take supplements. These may be pills or liquids. For more severe problems, a tube can be placed into the stomach or small intestine. Let your healthcare team know if you're losing weight. A dietitian can help you plan meals. It's important to get as much as nutrition as you can from the foods you eat.

Pain    TOP

Cancer can cause pain that can be severe and debilitating. During surgery, your doctor may choose to cut some nerves that carry pain signals to your brain. In some cases, alcohol can be shot into the nerves to lessen pain.

If you're not having surgery, the shots can be given through the skin of the belly. Your doctor will help you with the types of medicines you can have. The goal of these medicines is to ease pain as much as possible. This will help make your quality of life better.

The most common used are opioids. These are:

  • Hydrocodone
  • Morphine
  • Methadone
  • Oxycodone
  • Fentanyl patch
  • Acetaminophen combined with:
    • Oxycodone
    • Hydrocodone

Some problems are:

  • Lightheadedness or feeling faint
  • Drowsiness
  • Nausea or vomiting
  • Constipation

Nausea and Vomiting    TOP

Nausea and vomiting can happen if the tumor is blocking part of the gastrointestinal tract. It can also happen if you're constipated, or because of chemotherapy or radiation therapy.

Depression    TOP

Depression is common in people with pancreatic cancer. Often, the depression is noted before the diagnosis is made. If you are feeling the symptoms of depression—feeling very tired, lack of interest in things that once mattered to you, mood swings—for at least 2 weeks, talk with your doctor.

Depression can be treated with medicines, counseling, or both.

Special Considerations    TOP

If you are taking medicines:

  • Take the medicine as directed. Don’t change the amount or the schedule.
  • Ask what side effects could occur. Report them to your doctor.
  • Talk to your doctor before you stop taking any prescription medicine.
  • Don’t share your prescription medicine.
  • Medicines can be dangerous when mixed. Talk to your doctor or pharmacist if you are taking more than one medicine. This includes over-the-counter products and supplements.
  • Plan for refills as needed.
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References:

De La Cruz MD, Young AP, Ruffin MT. Diagnosis and management of pancreatic cancer. Am Fam Physician. 2014;89(8):626-632.
Management of pancreatic cancer. EBSCO DynaMed Plus website. Available at: https://www.dyname.... Updated August 13, 2018. Accessed October 24, 2018.
Pain control in pancreatic cancer. American Cancer Society website. Available at: https://www.cancer.org/cancer/pancreatic-cancer/treating/pain-control.html. Updated May 31, 2016. Accessed October 24, 2018.
Pancreatic cancer. Merck Manual Professional Version website. Available at: https://www.merckmanuals.com/professional/gastrointestinal-disorders/tumors-of-the-gi-tract/pancreatic-cancer. Updated October 2017. Accessed October 24, 2018.
Pancreatic cancer and pain. EBSCO Nursing Reference Center website. Available at:https://www.ebscoh.... Updated July 20, 2018. Accessed October 24, 2018.
Treatment option overview. National Cancer Institute website. Available at: https://www.cancer.gov/types/pancreatic/patient/pancreatic-treatment-pdq#section/_162. Updated May 23, 2018. Accessed October 24, 2018.
Last reviewed September 2018 by EBSCO Medical Review Board Mohei Abouzied, MD, FACP
Last Updated: 10/24/2018

 

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