A missed treatment for pancreatic cancer

Pancreatic exocrine insufficiency (PEI) is a well-established phenomenon post-pancreaticoduodenectomy (PD) and in patients with advanced pancreatic cancer. Signs and symptoms of PEI include pain after meals, abdominal bloating and discomfort, fatty faeces, indigestion, weight loss and malnutrition which impact on the quality of life and overall survival of pancreatic cancer patients.

Pancreatic enzyme replacement therapy (PERT) is an integral part of treatment for pancreatic cancer, however international studies report low rates of PERT prescribing despite the treatment guidelines highly recommending the therapy.

The ASPERT (Aotearoa Australia Pancreatic Enzyme Replacement Treatment) research team, in conjunction with the UTS Faculty of Health’s Improving Palliative, Aged and Chronic Care through Clinical Research and Translation research centre have been investigating current practices in Australia and New Zealand (ANZ), to clarify how PERT is being prescribed for people with pancreatic cancer.

The team are currently looking into the number of people with pancreatic cancer who are prescribed PERT, in what dose and quantity, and how it is tolerated. This information aims to ensure all Australians and New Zealanders with this illness receive best practice care.

The researchers have a 6 min patient survey open across Australia and New Zealand asking these questions. People can visit the ASPERT study website to find out more information and access the survey links.

In a second study, University of Auckland Masters student Sophie Hooke has teamed up with ASPERT and UTS to conduct an electronic survey which seeks to ask clinicians in ANZ about their experience prescribing and monitoring PERT in patients post-pancreaticoduodenectomy (Whipple’s procedure) as well as in patients with inoperable pancreatic cancer. The researchers are interested in how clinicians decide when to commence a patient on PERT, how decisions are made regarding dosing and timing, and how the efficacy of PERT is monitored.

By carrying out this research, the team hope to identify gaps in knowledge with regards to PERT prescribing practice. The survey findings aim to better understand the current use of PERT from a clinician perspective; the information they are imparting to patients and the difficulties they face utilising this medication regime.

The research team say, “This research will allow clinicians to reflect on their practice and treatment of pancreatic cancer patients to provide higher quality health care.

“The findings will help with the development of education and support for clinicians who care for patients requiring PERT, and also inform future research in this area, for example a larger, international survey”.

If you're a clinician and would like to take part, you can find out more about the ASPERT study and access the survey.