Palliative therapy is intended to relieve symptoms but is not expected to be a cure. Depending on individual circumstances, palliative therapy may be given in combination with other treatments intended to cure the disease or alone when a cure is not possible. The main purpose of palliative therapy is to improve the patient’s comfort and quality of life.

Esophageal dilatation: In this procedure, a cylindrical device is pushed through an obstruction to open it up and allow better swallowing. This can be repeated. It has a small risk of perforation – that is, tearing a hole in the esophagus. Relief usually lasts up to 2 weeks; therefore, dilatation is often followed by other palliative therapies.

Radiation therapy: External-beam radiation can help relieve symptoms from advanced esophageal cancer. If external beam radiation therapy has already been given, brachytherapy is another option. Brachytherapy is especially useful in helping to relieve an obstructed esophagus.

Electrocoagulation: This method involves burning the tumor off with electric current. This treatment can help relieve obstruction in certain instances.

Photodynamic therapy: It can be useful as a palliative treatment in some cases. However, it can only be used to remove superficial layers of tumor tissue and is therefore limited in relieving esophageal obstruction.

Laser endoscopy: This method involves aiming laser beams at the cancer through an endoscope, so a surgical incision is not needed. Patients with tumors that are partially blocking the esophagus may benefit from vaporization and coagulation of the cancerous tissues with a special laser called a neodymium: yttrium-aluminum-garnet (Nd:yag) laser. About 70% to 80% of patients will benefit from laser endoscopy. However, the procedure needs to be repeated every 6 to 8 weeks. In some cases, the Nd:yag laser therapy is performed before an esophageal stent is placed.

Esophageal metallic stents: These are metal mesh devices that are placed via endoscopy into the esophagus across the length of the tumor. There they self-expand to help keep the esophagus open. The success of these stents depends on the location of the tumor and the type of stent selected. Stents will relieve dysphagia (difficulty swallowing) in more than 80% of treated patients.

Pain management: Pain control is an important concern for people with cancer of the esophagus. Growth of the cancer around certain nerves may cause severe pain. However, there are proven ways to relieve pain caused by cancer. People with cancer should let their cancer care team know immediately if they are in pain. The cancer care team can provide medications and other palliative treatments to relieve pain and other symptoms.

Revised: 08/04/2006