The pancreas is an organ in the abdomen that plays a crucial role in the digestive system. Up to 90% of patients diagnosed with pancreatic cancer also develop a condition called exocrine pancreatic insufficiency, or EPI, which causes the pancreas to not produce enough of the enzymes the body needs to successfully digest food. Pancreatic enzyme supplements are one type of treatment that may be prescribed to help manage EPI.
“Patients need these supplements to mimic a working pancreas, allowing them to digest nutrients, stop weight loss and reduce painful digestive symptoms,” says Mustafa Raoof, M.D., M.S., a surgical oncologist at City of Hope® Cancer Center Duarte who works closely with patients diagnosed with pancreatic cancer, as well as liver, bile duct and other gastrointestinal diseases.
This article covers the basics of pancreatic enzyme supplements and how they are used, covering topics such as:
- What are pancreatic enzymes?
- Types of pancreatic enzyme supplements
- Reasons to take pancreatic enzymes
- Symptoms that should prompt a doctor visit
- Special guidelines for cancer patients
If you or a loved one has been diagnosed with pancreatic cancer or another type of cancer and you are looking for a second opinion, call us 24/7 at 877-460-4673.
What Are Pancreatic Enzymes?
The pancreas helps the body manage blood sugar levels and digest food. One of the ways it does this is by producing pancreatic enzymes — proteins that break down the fats, proteins and carbohydrates in our food into nutrients that may be absorbed by the body.
EPI is a condition that disrupts how the pancreas produces these enzymes, which maycause potentially serious digestive problems. While EPI is often related to conditions like chronic pancreatitis or cystic fibrosis, it is also extremely common among pancreatic cancer patients.
“While EPI does not cause cancer, pancreatic tumors frequently cause EPI by physically blocking the pancreatic duct or destroying healthy pancreatic tissue,” says Dr. Raoof.
This type of treatment regimen is often called pancreatic enzyme replacement therapy, or PERT.
Types of Pancreatic Enzyme Supplements
According to Dr. Raoof, “pancreatic enzyme replacement therapy, or PERT, involves taking prescription pills containing lipase, protease and amylase,” the enzymes normally produced by the pancreas in order to aid digestion. Each PERT pill contains a different type of enzyme. These are:
- Lipase, an enzyme that helps break down fat molecules
- Protease, an enzyme that breaks down proteins and helps reduce the risk of gut infections
- Amylase, an enzyme that helps break down carbohydrates into sugars that are absorbed by the body
Some of the brand names for PERT pills that have been approved for use by the U.S. Food and Drug Administration include:
- CREON®
- Pancreaze®
- Pertzye®
- Viokace®
- Zenpep®
Patients taking pancreatic enzyme supplements should follow their doctor’s guidelines for how and when to take PERT pills. But in general, they should be taken in small doses at first and should be swallowed whole with food.
Reasons to Take Pancreatic Enzymes
“People develop EPI when the enzyme-producing cells of the pancreas are damaged or destroyed,” says Dr. Raoof. “EPI affects 60% to 90% of pancreatic cancer patients, depending on the stage and location of their tumor.”
While pancreatic cancer is one reason patients may take pancreatic enzyme supplements, there are other conditions that may also lead to EPI, including those listed below.
Chronic pancreatitis: This is the most common cause of EPI. It is a long-term condition that causes inflammation of the pancreas.
Benign and malignant pancreatic tumors: These may also cause EPI.
Cystic fibrosis: This is a genetically inherited condition of the lungs and digestive system. It is also linked to the development of EPI.
Symptoms That Should Prompt a Doctor Visit
Digestive issues are common. But anyone who experiences severe gastrointestinal symptoms should make an appointment to see his or her primary care doctor. Some common symptoms that may suggest screening for EPI include:
- Greasy or oily stool (steatorrhea)
- Unexplained diarrhea
- Unexplained weight loss
- Sever indigestion or bloating
- Severe abdominal cramping or gas
When diagnosing EPI, a doctor may suggest a specialized blood test that checks a patient’s pancreatic enzyme levels.
Special Guidelines for Cancer Patients
Pancreatic enzyme supplements are a common treatment option for many pancreatic cancer patients who also develop EPI.
"These supplements are routinely combined with cancer therapies like chemotherapy, radiation and surgery to keep the patient nutritionally strong enough to tolerate treatment,” Dr. Raoof says.
“There are no major safety concerns or negative interactions between these supplements and cancer treatments, but the primary challenge is ensuring patients take the correct dose with every meal and snack.”
If you or a loved one has been diagnosed with pancreatic cancer or another type of cancer and you are looking for a second opinion, call us 24/7 at 877-460-4673.
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