Palliative therapy is treatment aimed at relieving symptoms. It is not meant as a cure for the cancer.
Several types of treatment can be used to help prevent or relieve symptoms from esophageal cancer. In some cases, they are given along with other treatments that are intended to cure the cancer. In other cases, palliative treatments are given when a cure is not possible. The main purpose of this type of treatment is to improve the patient's comfort and quality of life.
Esophageal dilation
In this procedure, a small balloon-like device or a device shaped like a cylinder is passed down the throat and pushed through an area of the esophagus that is narrowed or blocked. The goal is to stretch out the area and allow better swallowing. This procedure can be repeated if needed. Before the procedure, your doctor may give you a sedative to help you relax and may numb your throat by spraying it with a local anesthetic.
There is a small risk of bleeding or tearing a hole in the esophagus (called perforation) with this procedure, which could require surgery or other treatments to fix. The esophagus typically stays open only about 2 weeks after dilation, so it is often followed by other treatments to help keep the esophagus open.
Endoscopic procedures
Several types of endoscopic procedures can be used to help keep the esophagus open in people who are having trouble swallowing. These techniques are described in more detail in the section, "Endoscopic treatments for esophagus cancer." Procedures that may be used include:
- Esophageal stent placement
- Photodynamic therapy
- Electrocoagulation
- Laser ablation
- Argon plasma coagulation
Radiation therapy
External-beam radiation can often help relieve some of the symptoms from advanced esophageal cancer, including pain and problems swallowing. Radiation is often used for cancer that has spread to the brain or spine, but it is also useful in treating problems with swallowing from a narrowed or blocked esophagus.
If an area had been treated with external beam radiation therapy earlier, it may not be able to be treated that way again. In that case, brachytherapy may be an option. Brachytherapy is especially useful in helping to relieve a blocked esophagus. (See "Radiation therapy for esophagus cancer" for more details.)
Pain management
Pain control is an important concern for people with cancer. There are many ways to treat cancer pain. People with cancer should let their cancer care team know immediately if they are in pain. The cancer care team can provide medicines and other palliative treatments to relieve pain and other symptoms.
Nutritional support
Nutrition is another concern for many patients with esophagus cancer. A team of doctors and nutritionists can work with you to provide nutritional supplements and information about your individual nutritional needs.
Some people having trouble swallowing may need to have a feeding tube, usually called a jejunostomy tube (or J-tube), put into the first part of the small intestine. This is done through a small hole in the skin over the abdomen during a minor operation. A J-tube allows liquid nutrition to be put directly into the small intestine to help prevent weight loss and improve nutrition. Less often, the tube may be placed into the stomach instead. This is known as a gastrostomy tube or G-tube.
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