A diagnosis of pancreatic cancer carries with it an often unfathomable prognosis. Pancreatic cancer patients face complicated decisions pertaining quality of life issues as well as life expectancy. For many pancreatic cancer patients, life prolongation becomes a principal issue.
What I am going to report here is by no means a panacea that will fix all problems, but it might be crucial knowledge that sufferers from pancreatic cancer and their loved ones can wrap their heads around and work with.
I am going to use a fictional set of identical twins “Alice” and Allyson,” to highlight the exciting impact the original study by Dalal et al.  could have on life extension for pancreatic cancer patients.
Alice and Allyson are a set of identical twin sisters, 58.9 years of age with a Body Mass Index (BMI) of over 30 kg/m2, who have struggled with obesity for a really long time. The twins are inseparable. They live next door to each other. They married on the same day. Each of them gave birth to their first child in the same month and year. Alice and Allyson received the unfortunate news and wretched diagnoses together; locally advanced, inoperable pancreatic cancer.
Two months into treatment, the twins receive good news for a change. They just found out that Alice’s daughter is pregnant while Allyson’s daughter in law is pregnant, as well. Within the next eight months, Alice and Allyson are about to become grandparents for the first time.
The good news is unfortunately dimmed by a single thought that plagues both day and night. “Will I live long enough to see the birth of my first grand child?” Being pancreatic cancer patients for a while now, the sisters continue to undergo chemoradiation treatment, being keenly aware of how confined their treatment choices are.
While continuing treatment, something else is going on obesity wise. Alice is on her way to a 4% weight loss in skeletal muscle mass and a weight loss of more than 13% in visceral adipose tissue. Allyson is also experiencing a weight loss in visceral adipose tissue; however, Allyson manages to increase skeletal muscle mass (lean body mass) .
Sadly enough, after struggling with pancreatic cancer for 10.7 months, only weeks before the due date of her first grand child, Alice loses her battle with pancreatic cancer and succumbs to the disease. Allyson, who gained skeletal muscle mass, i.e. lean body mass, seems to be doing better.
Allyson not only lives long enough to see the birth of her son’s and niece’s children, but before succumbing to the disease, 16.8 months after diagnosis, Allyson was able to spend another six precious months with her grandchild.
Dalal et al.  have shown that not only obesity at diagnosis plays a role in survival of pancreatic cancer, the rate of weight-loss and type of weight-loss may have dramatic outcomes on survival as well. I tried to illustrate the statistical results with the story of the fictional identical twins, Alice and Allyson.
Paradoxical, given that obesity at diagnosis of pancreatic cancer might predispose cancer patients to higher morbidity and mortality weight loss is considered beneficial. It turns out that mortality could be hastened if any weight loss is too fast and accompanied with substantial loss of skeletal muscle mass .
In the meantime, the take home message from Dalal et al.  is that patients diagnosed with pancreatic cancer and obesity at the onset of treatment experience increased weight loss, increased loss of skeletal muscle mass and increased loss of visceral adipose tissue. A finding that contributes to poorer survival in pancreatic cancer .
While weight-bearing exercise might not even be on the radar for many pancreatic cancer patients, it seems that finding a way to either support or increase skeletal muscle mass during pancreatic cancer treatment might carry with it considerable benefits, increased longevity being one of them.
How about you?
Has pancreatic cancer affected your life? Are you a cancer patient who “hits the gym regularly?”
Okay, you might be thinking, Werner, dude, I am literally fighting for my life here, and you want me to hit the gym? Are you nuts? Well maybe, but here are some nuggets of information that might inspire. Sindy Hooper’s story for example.
Sindy was diagnosed with pancreatic cancer January 2013. She had half of her pancreas, half of her stomach and her gallbladder removed. Statistically, she’s got a ten per cent shot at living five more years. What’s special about Sindy’s story? Sindy might be the first pancreatic cancer patient ever to complete a triathlon while in treatment undergoing chemotherapy! To refresh the reader’s memory: A triathlon is race that consists of (back to back) a 2.4 mile swim, a 112 mile bike ride and a full marathon (26.2 miles) .
While nobody is aiming at a blanket recommendation that sufferers from pancreatic cancer should start running a triathlon, if Kathryn Schmitz, from the University of Pennsylvania School of Medicine had her way
Cancer Patients and Survivors Should AVOID INACTIVITY to Boost Quality of Life, Strength and Fitness. <Tweet This Now>
Schmitz  and colleagues, who helped put forth national cancer guidelines, report that cancer patients who are able to support lean body mass benefit from increased strength and well-being. It is worth repeating. The study by Dalal et al.  discussed above seems to take this notion one step further. It looks like pancreatic cancer patients who were able to increase skeletal muscle mass did live longer, as well. On average, an increase in skeletal muscle mass was associated with increased longevity of 6.1 months. The finding comes with the warning that longevity outcome did not reach statistical significance and Dalal et al.  consider this research preliminarily, and further research is warranted to confirm results.
See, I am not as nuts as you might think. I am certainly not the only one who seems to think that “hitting the gym” for cancer patients is a sensible recommendation. Before “hitting the gym” make sure you discuss this with your oncologist. It is also helpful to find a trainer, yoga teacher, coach etc. that has experience working with, and serving the very unique needs of cancer patients.
What techniques to maintain skeletal muscle and lean body weight do you use? Yoga, Qigong, walking, swimming, Zumba, spinning, maybe even light weight lifting? Engage with me via Twitter, I’m @WernerAbsenger, email me or share your story below, in the comments.
1. Dalal S, Hui D, Bidaut L, et al. Relationships Among Body Mass Index, Longitudinal Body Composition Alterations, and Survival in Patients With Locally Advanced Pancreatic Cancer Receiving Chemoradiation: A Pilot Study. J Pain Symptom Manage. 2012;44(2):181–191. doi:10.1016/j.jpainsymman.2011.09.010.
3. Penn Medicine. New Cancer Guidelines: Exercise During and After Treatment is Now Encouraged, Says Penn Medicine-Led Panel. Penn Med News Publ. 2013. Available at: http://www.uphs.upenn.edu/news/News_Releases/2010/05/cancer-exercise-guidelines/. Accessed August 19, 2013.