{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T21:01:05Z","timestamp":1785445265324,"version":"3.56.0"},"reference-count":31,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T00:00:00Z","timestamp":1770336000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T00:00:00Z","timestamp":1770336000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["aspenjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nut in Clin Prac"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Pancreatic enzyme insufficiency (PEI) contributes to symptom burden and malnutrition in advanced pancreatic cancer (aPC). We aimed to evaluate the impact of pancreatic enzyme replacement therapy (PERT) on symptom burden and weight during chemotherapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients with aPC who were referred to a dietitian for suspected PEI at the Cross Cancer Institute (Edmonton, Canada) were enrolled. Baseline (BL) PEI symptoms were evaluated prior to PERT initiation; dose was optimized by 1 month. PEI symptom severity was assessed with the Pancreatic Enzyme Insufficiency Questionnaire (PEI\u2010Q) at BL, reassessed after 1 and 3 months, and compared between BL and first reassessment. Mean weight change from BL to 1 month (percentage per 30 days) was compared with change from 1 to 3 months. Continuous and categorical variables were compared using paired samples t tests and McNemar test, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 29 patients enrolled, 23 initiated PERT and completed \u22651 symptom reassessment. Median reported PERT dose at reassessment was 200,000 USP lipase units\/day (IQR 97,200, 300,000). Improvements in mean severity scores for stomach pain (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.001) bloating (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.049) and stomach noises (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.032) were reported at reassessment, with a trend toward improved appetite (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.053). Prevalence of moderate\/severe PEI decreased (11\/23\n                      <jats:italic>vs<\/jats:italic>\n                      4\/23,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.020). Weight loss slowed after 1 month (\u22124.3\u2009\u00b1\u20094.8%\/30 days [BL to 1 month] vs \u22120.2\u2009\u00b1\u20093.9%\/30 days,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.033).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Patients receiving dietitian\u2010directed PERT showed improved abdominal symptoms and attenuated weight loss after dose optimization, addressing a patient priority for those with aPC.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ncp.70096","type":"journal-article","created":{"date-parts":[[2026,2,7]],"date-time":"2026-02-07T05:46:33Z","timestamp":1770443193000},"page":"1157-1165","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Addressing the distressing: Pancreatic enzyme replacement therapy mitigates abdominal symptoms and weight loss during chemotherapy for advanced pancreatic cancer: A prospective study"],"prefix":"10.1002","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3734-4061","authenticated-orcid":false,"given":"Pamela N.","family":"Klassen","sequence":"first","affiliation":[{"name":"Department of Agricultural, Food and Nutritional Sciences University of Alberta Edmonton Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3847-2583","authenticated-orcid":false,"given":"Christina A.","family":"Kim","sequence":"additional","affiliation":[{"name":"Paul Albrechtsen Research Institute CancerCare Manitoba Winnipeg Manitoba Canada"},{"name":"Department of Internal Medicine, Section of Medical Oncology and Hematology Rady Faculty of Health Sciences Winnipeg Manitoba Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Kasnik","sequence":"additional","affiliation":[{"name":"Nutrition Services, Cross Cancer Institute Edmonton Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael B.","family":"Sawyer","sequence":"additional","affiliation":[{"name":"Department of Oncology University of Alberta Edmonton Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9763-5058","authenticated-orcid":false,"given":"Sunita","family":"Ghosh","sequence":"additional","affiliation":[{"name":"Department of Oncology University of Alberta Edmonton Alberta Canada"},{"name":"Department of Public Health Sciences Henry Ford Hospital Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vickie","family":"Baracos","sequence":"additional","affiliation":[{"name":"Department of Oncology University of Alberta Edmonton Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7724-6354","authenticated-orcid":false,"given":"Vera C.","family":"Mazurak","sequence":"additional","affiliation":[{"name":"Department of Agricultural, Food and Nutritional Sciences University of Alberta Edmonton Alberta 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