Pancreatic Cancer

Diabetes can be a sign of pancreatic cancer and can also be a side effect of pancreatic cancer treatment. It is a condition where your blood sugar level is too high.

The pancreas helps control your blood sugar level, so pancreatic cancer and its treatment can cause long-term problems.

Here people we spoke to with pancreatic cancer talk about their experiences with diabetes.

If you have pancreatic cancer, you may get a diagnosis of diabetes first.

Symptoms of diabetes include:

• thirst
• needing to pee more often
• hunger
• feeling weak
• unexplained weight loss
• eyesight problems

Experiences with diabetes and pancreatic cancer

Steve was very thirsty, and his eyesight had gotten worse. His doctor prescribed injections of insulin.

Steve gave himself an injection of insulin before each meal. He had another injection before going to bed.

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Steve gave himself an injection of insulin before each meal. He had another injection before going to bed.

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Age at interview: 47

Sex: Male

Age at diagnosis: 47

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The only regular medication I have now is I have insulin with each meal, which helps to deal with the sugar high of your digested food as you consume that food. And I also take Creon.

 

And that’s because the pancreas has been affected by the growth?

 

Yes, because the effectiveness of the pancreas is compromised by the disease. There’s less of the pancreas to produce the chemicals in your body to deal with the blood sugar.

 

So I have to live with diabetes. I take insulin, inject myself before each meal, breakfast, lunch and an evening meal. And then I have at night, before I go to sleep I have another type of insulin which is long lasting, 24 hour cover, and that’s designed to keep all my sugar levels down a little bit, so that the meal time insulin just deals with any spike. So the regime, I’ve adapted to that quite easy. 

 

Carol’s diabetes was diagnosed at the same time as her pancreatic cancer. She started daily injections of insulin and had surgery for the cancer.

Later, she saw an endocrinologist and found out that what was left of her pancreas was working again, so she could stop her injections.

Carol attended a diabetic clinic where she had advice about diet. A nurse visited her at home to make sure she knew how to inject herself with insulin.

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Carol attended a diabetic clinic where she had advice about diet. A nurse visited her at home to make sure she knew how to inject herself with insulin.

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Age at interview: 67

Sex: Female

Age at diagnosis: 65

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He [the surgeon] didn’t go into any detail at that stage of what it entailed other than he; this particular surgeon did surgery on the pancreas. I didn’t want detail at that point, what, what the surgery entails, although I knew it would have been radical.

 

He then went on to explain about you know I’d always be diabetic if they did surgery, or even without surgery I’d have to have insulin, my lifestyle would be sort of vastly different from what it had previously been…

 

Then things just seemed to be moving from there, I then was sort of seen by the diabetic nurse who was amazing. Told me everything about the diabetes, about taking bloods which I did, I take my blood sugars everyday.

 

So they confirmed then that you had diabetes?

 

Yes because of the type of the position of the tumour.

 

I came home. I then had to wait for an appointment with the other consultant. I came home on the Monday, oh the Wednesday. On the following Monday I had to attend the diabetic clinic where I was met with the diabetic nurse and the dietician. And I was informed at that point I’d have to go onto insulin.

 

So I was shown how to self medicate, I had twenty units of Lantus through one injection daily, advised on the sort of foods to eat, you know I had normal food with some tweaking, you know, some diet sheets, “You must follow this, its, it’s really being sensible.” Three days after I had seen the diabetic nurse she visited me at home to observe me doing the injections,

 

Okay.

 

Which I thought was excellent.

 

It gave me confidence because it, it is a slightly overwhelming, again, suddenly you’ve got to inject yourself. And I thought, “Am I going to be diabetic for the rest of my life?” And all the consequences of being diabetic, it’s not just, it’s everything else obviously with diabetes long term one has to consider, it’s a bit daunting.

 

People with pancreatic cancer and diabetes may need to see a dietitian. A low-calorie diet is usually what's recommended for diabetes.

However,  a high-calorie diet may also be recommended to help regain weight that was lost due to cancer. 

A consultant explains that people who have part of their pancreas removed are likely to develop diabetes and may need advice from a dietitian.

A consultant explains that people who have part of their pancreas removed are likely to develop diabetes and may need advice from a dietitian.

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When, in all patients who have pancreatic disease, there are, the pancreas may not function quite as well as it did in health and each aspect of the function of the pancreas is an area where, which may require to be helped through improving its function by medicines. Patients who have had part of their pancreas removed, part of their body’s insulin producing cells have also been removed, and there is an increased risk or an increased incidence of diabetes following resection.

 

So a number of patients require to have a degree of diabetic control following a pancreatic resection. Contrary to many other diabetic patients, they also often have a requirement for a relatively high calorific intake because they’re trying to recover from an operation.

 

And so the advice, the standard diabetic advice regarding your diet may need to be altered by a specialist dietician to try and get a balance between your glucose control and your diabetes management.

 

And your nutritional recovery from your surgery.

 

Richard developed diabetes while he was having chemotherapy. He changed his diet and took a tablet morning and evening to control his diabetes.

Richard developed diabetes while he was having chemotherapy. He changed his diet and took a tablet morning and evening to control his diabetes.

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Age at interview: 59

Sex: Male

Age at diagnosis: 58

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Two things which I probably had better mention had happened to me on the way. In early December I discovered that I was diabetic. And the way I discovered that was that I developed terrific thirsts, really powerful thirst. And I began passing urine very frequently, particularly at night. And in the way that one does I looked it up on the web, and of course it, I was absolutely, it was absolutely clear that I was, I was diabetic. 

 

So I went and presented myself, it had happened over a weekend. I went and presented myself to the GP, my GP on Monday morning, who immediately took my blood sugar level, which was dangerously high, and referred me to the hospital straightaway. Again, one of those things that I learnt was that before I went to the hospital I rang my specialist nurse, and said, “I have been diagnosed as diabetic. I’m coming into A&E and would you alert the registrar and so on.” 

 

So another trip to A&E?

 

Another trip to A&E. And it was very fortunate that I’d done that because in fact somehow the e-mail from my GP to the Diabetic team had gone astray and they were sort of denying all knowledge of me. But fortunately the oncology registrar came…

 

down to A&E?

 

…came down to A&E, saw me, arranged for various blood tests to be done, confirmed the diagnosis, and gave me some, prescribed me some drugs. It was then arranged that I would go into the oncology clinic and have a discussion with the dietician about how I balanced off my diet, because at the time I was still, I was on chemotherapy which would mean that you would want a relatively high fat diet, whereas classically on diabetes you would be looking at low fat. And it in effect, the chemo won. So I was on a, on a sort of high fat diet, but low, low sugar.

 

And again that that worked very well because the dietician I’d already talked to about managing my diet as part of managing my chemotherapy, I already knew her; we were able to go through my diet step by step, meal by meal, about the changes that I needed to make. And the original idea was, from the oncology team, was that my diabetes would be managed by my GP, and that I didn’t need hospital treatment for that.

 

Do you also have to take any medicines for the diabetes? Or is it just diet?

 

Yes, I take a tablet morning and evening, which is not insulin, it’s a tablet, and obviously if it got worse, then there, it may be necessary for me to move onto insulin, but at the moment I’m managing fine and it’s quite interesting because I think that most people with type II diabetes, who are, have got it because of their lifestyle, they tend to be overweight, don’t take any exercise, and are notoriously non-compliant. Whereas I, you know I’m fighting for my life here, so I am doing everything that I should do, and I took in my diary for my first meeting with the diabetes consultant, and I’ve been taking my blood sugar and filling it in, and it was sort of nearly perfect. I mean it had the odd blip ah, but it was nearly perfect. And he looked at it, and he was just sort of almost astounded. And I, he said, “That,” well he said, “That’s just fantastic,” he said, “that’s absolutely great. You’re obviously managing your diabetes perfectly. There’s nothing to worry about.”

 

Your GP can usually help manage your diabetes. However, Richard’s GP was concerned that his needs might be different from others with diabeties because of the cancer.

See also 'Managing digestive symptoms with pancreatic cancer'.

For more information about diabetes, see ‘Diabetes Type 2’.