General measures
- Nicotine restriction (refraining from tobacco use).
- Limited alcohol consumption (men: max. 25 g alcohol per day; women: max. 12 g alcohol per day).
- Aim for or maintain normal weight! Determination of BMI (body mass index, body mass index) or body composition by means of electrical impedance analysis.
- Falling below the BMI lower limit (from the age of 45: 22; from the age of 55: 23; from the age of 65: 24) → Participation in a medically supervised program for underweight people.
- Avoidance of environmental stress:
- Benzo(a)pyrene – found in exhaust fumes, smoke and tar.
Conventional non-surgical therapy methods
- High-intensity focused ultrasound (HIFU) therapy-in advanced pancreatic cancer in addition to standard palliative therapy; was effective on the leading symptom of pain within the first week; effect of pain relief persisted over the 3-month observation period.
Vaccinations
The following vaccinations are advised:
- Flu vaccination
- Pneumococcal vaccination
Regular checkups
- Regular follow-up examinations for early detection of recurrence (recurrence of the disease).
Nutritional medicine
- Nutritional counseling based on a nutritional analysis including targets for caloric and protein intakeNote: 80% of all patients with pancreatic cancer develop malnutrition; likewise, sarcopenia is usually present.Sarcopenia can be found in as few as 30-65% of patients with a normal body mass index (BMI) between 18.55 and 24.9 kg/m2 body surface area [KOF] and 16-67% of patients with a BMI > 25 kg/m2 KOF.
- Dietary recommendations according to a mixed diet taking into account the general knowledge of nutrition in tumor disease. This means:
- Little red meat, i.e. muscle meat of pork, beef, lamb, veal, mutton, horse, sheep, goat – This is classified by the World Health Organization (WHO) as “probably carcinogenic to humans”, i.e. carcinogenic. Meat and sausage products are classified as a so-called “definite group 1 carcinogen” and are thus comparable (qualitatively, but not quantitatively) to the carcinogenic (cancer-causing) effect of tobacco smoking. Meat products include products whose meat component has been preserved or improved in flavor by processing methods such as salting, curing, smoking, or fermenting: Sausages, sausage products, ham, corned beef, jerky, air-dried beef, canned meat.
- Once or twice a week fresh sea fish, i.e. fatty marine fish (omega-3 fatty acids) such as salmon, herring, mackerel.
- Daily total of 5 servings of fresh vegetables and fruits (≥ 400 g; 3 servings of vegetables and 2 servings of fruits).
- Refrain from contaminated foods such as offal and wild mushrooms
- Do not eat moldy food
- Eat a high-fiber diet (whole grains, vegetables)
- Observance of the following special dietary recommendations:
- High-calorie oral nutrition (high-calorie energy drinks).
- Administration of pancreatic enzymes: 2,000 IU per 1 g of fat.
- Diet rich in:
- Antioxidants
- Trace elements (zinc)
- Omega-3 fatty acids – alpha-linolenic acid (vegetable oils, green leafy vegetables), eicosapentaenoic acid and docosahexaenoic acid (once or twice a week fresh sea fish, ie fatty marine fish such as salmon, herring, mackerel).
- L-carnitine – required to transport the long chain fatty acids into the mitochondrial matrix for β-oxidation.
- Probiotic foods (if necessary, supplements with probiotic cultures).
- Timely additional parenteral nutrition (delivery of vital nutrients directly into the bloodstream, bypassing the gastrointestinal tract) – and in the penultimate stage total parenteral nutrition.Note: In the last stage, additional drug therapy: non-steroidal anti-inflammatory drugs (NSAID) and Cox-2 inhibitors and progesterone.
- Selection of appropriate foods based on the nutritional analysis.
- See also under “Therapy with micronutrients (vital substances)” – if necessary, taking a suitable dietary supplement.
- Detailed information on nutritional medicine you will receive from us.
Sports Medicine
- Endurance training (cardio training) and strength training (muscle training).
- In general, endurance training on a bicycle ergometer can be recommended, which is performed according to the principle of interval training. This means that load phases lasting 1 to 3 minutes alternate with rest phases also lasting 1 to 3 minutes. The training should be performed at about 80% of the maximum heart rate for a total of 30 minutes.
- Preparation of a fitness or training plan with suitable sports disciplines based on a medical check (health check or athlete check).
- Detailed information on sports medicine you will receive from us.
Psychotherapy
- Stress management, if necessary
- Detailed information on psychosomatics (including stress management) can be obtained from us.