Healing from the Inside Out

For patients like Derek Mann, nutrition can play a crucial role in cancer recovery

By Erin Brereton

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Before being diagnosed with pancreatic cancer in 2012, Derek Mann says he didn’t really pay much attention to what he ate.

After rapidly losing nearly 50 pounds due to a blocked bile duct that hindered digestion, however, as Mann began undergoing treatment, nutrition became a focal point.

In addition to chemotherapy, Mann’s treatment included robotic radiosurgery, in which beams of intense energy are used to destroy cancer cells and reduce tumor growth. He also had a Whipple surgical procedure to remove his tumor and scarred portions of his pancreas and stomach.

During the course of Mann’s treatment, his care team at Cancer Treatment Centers of America® (CTCA) at Southwestern Regional Medical Center (Southwestern) in Tulsa, Oklahoma, individualized nutritional guidance.

At times, his care team relied on oral nutrition to nourish his body. At other times, they relied on a form of nutrition therapy that provides nutrients intravenously through total parenteral nutrition (TPN), in combination with oral nutrition, to support the high calorie and protein needs Mann required for his treatment, according to Jessica Engelbrecht, MS, RD, CSR, LD, CNSC, the clinical oncology dietitian who was a part of Mann’s care team at Southwestern.

“Each treatment presented a different type of nutrition obstacle,” says Engelbrecht. “The goal was for Mr. Mann to be able to continue his treatment without having to interrupt or delay treatment due to his nutrition status.”

TPN is one of many interventions that can be used to support a patient’s nutritional health, according to Kalli Castille, MS, RDN, Director of Integrative and Culinary Services at Southwestern.

“Pancreatic cancer can affect how we digest food, as the pancreas is responsible for our digestive enzymes and insulin that helps regulate blood glucose levels,” Castille says. “TPN may or may not be used in pancreatic care. It is an option for those who are unable to use their gastrointestinal tract for a time period, where we can provide all nutrients to support the nutrition needs of the patient intravenously.”

After completing treatment and recovering from the Whipple procedure, Mann began transitioning from TPN to a solid food-based diet, which required some adjustments. With reduced pancreatic and stomach capabilities, he now processes sugar and other foods differently.

“I was a meat-and-potatoes guy,” Mann says. “I changed my whole diet. My team at CTCA® was outstanding. They explained things in detail, such as red meat can be hard to digest. There are restrictions on things I can do. But every now and then, I can go out and have steak.”

Mann takes insulin and a pancreatic enzyme replacement supplement daily to aid in digestion. He also drinks a supplement shake every morning to help regulate his blood sugar.

He and his wife of 34 years, Nancy, make dinner at home much more than they used to, he says.

“In the past, we’d probably go out to eat two times a week,” Mann says. “Now we may go out once a month. It’s kind of nice. We get home and get supper going and cook together. We’ve come up with a lot of different recipes.”

After recovering from surgery, Mann returned to work in August 2015. In September of this year, he attended a five-year Celebrate Life® event at Southwestern.

In addition to the dietary changes he’s made, Mann says he now approaches both daily and long-term events differently than in the past.

“Being diagnosed changed my outlook on life,” he says. “The most important change I’ve made is to slow down, appreciate things more, not stress out over the things we cannot control, keep thinking ahead—and be positive.”

A number of patients, according to Castille, make New Year’s resolutions involving similar nutritional, mindset or other health modifications at the start of each year.

With 2018 approaching, if you’re considering making a lifestyle change in the coming months, she advises choosing something with meaning—which may help you reach your goal.

“Maybe that’s better food choices, or increased physical activity or improved quality of life,” she says. “Add a new betterment opportunity each year that really inspires you. It’s easiest to keep layering good choices you really believe in each year. That ultimately will improve your happiness level—and health.”

No case is typical. You should not expect to experience these results.