ABSTRACT OF THESIS submitted by Christine Ann CooperFor the degree of Master of Philosophy and entitled 'An exploratory study of the views and experiences of food and weight loss in patients with operable pancreatic cancer, before and after surgical intervention' Month and Year of Submission Submitted May 2013.Background: Malnutrition and cachexia are common in patients with pancreatic cancer and can affect up to 85% of patients. Cancer and its treatments place significant demands on the nutritional status of patients, which can be exacerbated by admission to hospital. Cancer of the pancreas also has a major impact on the nutritional status of patients after surgery, due to the resection of the gastrointestinal and biliary tract as well as the pancreas. Patients with cancer may have additional protein energy depletion due to cachexia, because of an imbalance between the nutritional needs of the patients and demands of the tumour. Nutrition can play an important role in the management of surgical cancer patients, but intervention needs to be implemented early to prevent malnutrition and weight loss becoming the dominant feature of the disease trajectory.Aim: In this study, the aim was to investigate the perceptions and experience of patients about food, weight loss and nutritional interventions before, during and after surgical treatment of pancreatic cancer.Methods: An exploratory study underpinned by hermeneutic phenomenological philosophy was conducted in 2011. Thirteen post surgery patients with pancreatic cancer were recruited from an NHS Trust in the north of England. Sampling was purposive and data were collected using semi-structured, in-depth, open-ended interviews, which were digitally recorded and transcribed verbatim. The interpretation of the data was guided by phenomenological and hermeneutic methodology. Findings: Each of the participants interviewed told a unique story of their experiences and the findings convey the commonalities found in the participants' perceptions of their experiences. Six themes emerged from the data: recovery from cachexia, adaptation and surgical effects on oral intake, experiences of nutritional support interventions, dietary information, dietary counselling and the road to recovery post surgery. Conclusion: This study revealed how patients with pancreatic cancer experienced physical and psychosocial difficulties, with weight loss and adaption to changed physiology after surgery, to maintain their nutritional status. Nutritional support interventions need to be targeted to aid in the rehabilitation of this group of patients, with the goal of providing individual dietary counselling and information to prevent disease recurrence. The most important finding in this study is that patients with operable pancreatic cancer after surgical intervention require a lot more nutritional input, from healthcare professionals, including dietitians.Relevance to clinical practice: These findings highlight the importance of dietitians, in particular those working as part of a multi disciplinary team. They are in a key position to have a positive therapeutic influence on the nutritional status of patients with pancreatic cancer and could enable clear guidelines for the nutritional management of this group of patients to be developed. A specialist dietitian dedicated to this group of patients could facilitate more dietetic involvement and regular contact with patients. This would enable the promotion of individualised dietary counselling and help to improve nutritional intake and quality of life in this group of patients.