Introduction The average life expectancy for someone with locally advanced pancreatic cancer is 9–12 months. It is associated with weight loss and malabsorption secondary to pancreatic exocrine insufficiency. The management of this is often deficient and has been shown to have a severe impact on the quality of life (QOL). A recent research has shown patients prescribed Creon have a longer survival length than those who are treated with palliative chemotherapy. Also other research have highlighted the importance of nutritional intervention in influencing survival. The All Party Parliamentary Group on Pancreatic Cancer has recommended that all patients be reviewed by a Dietitian. The aim of this project is to improve QOL by ensuring all pancreatic patients have timely access to a Dietitian.
Method Research papers focusing on QOL and pancreatic insufficiency, along with previous clinical knowledge, were used to develop a treatment pathway and a questionnaire. Trust figures were used to determine the number of patients with pancreatic cancer who need to be seen by a Dietitian.
Results A treatment pathway for dietetic intervention was established. All patients with an inoperable cancer are offered dietetic support, all patients with an operable cancer are seen by the dietetic team at the Tertiary Centre. All confirmed inoperable pancreatic cancer patients discussed at the multidisciplinary meeting, are contacted by a Dietitian to be offered a clinic appointment. All Gastroenterologists and Specialist Nurses have been asked to provide patients with a leaflet titled Why Do I Need to See a Dietitian. All newly diagnosed patients are booked into clinic within two weeks, if appropriate. Patients who are unable to attend clinic are offered a home visit.
A questionnaire was developed to use during the initial appointment to assess factors that research has shown to affect QOL. This incorporates both malabsorption symptoms and nutritional problems. Pancreatic enzyme replacement therapy is discussed in detail with supportive literature provided. Each patient is then reviewed within two weeks to review dosage and tolerance. Personalised dietary advice has been provided to each patient to help deal with highlighted issues.
The treatment pathway also involves checking each inoperable patient for Type 3C Diabetes Mellitus and nutritional deficiencies.
Conclusion All patients in East Sussex diagnosed with an inoperable pancreatic cancer are able to access a Dietitian within two weeks of diagnosis. This enables speedy management of nutritional problems and pancreatic exocrine insufficiency, which is improving quality of life and helping to optimise chances for increasing survival.
Disclosure of interest None Declared.