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Palliative therapy is treatment aimed at relieving symptoms --
it is not meant as a cure for the disease (cancer). In some cases,
palliative therapy is given along with other treatments that are
intended to cure the disease. 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 dilatation
In this procedure, a device shaped like a cylinder is pushed
through an area of the esophagus that is blocked. The goal is to open
up the blocked area and allow better swallowing. This procedure can be
repeated. There is a small risk of tearing a hole in the esophagus
(called perforation). After this procedure, the esophagus stays open
only about 2 weeks; therefore, dilatation is often followed by other
treatments to keep the esophagus open.
Esophageal stents
A stent is a device made of mesh material. Most often stents
are made out of metal, but they can also be made out of plastic. They
are placed into the esophagus across the length of the tumor under
endoscopy. Once in place, they self-expand (open up) to become a tube
that helps hold the esophagus open. The success of these stents depends
on the type of stent that is used and where it is placed. Stents will
relieve trouble swallowing in most patients that are treated. They may
be used after dilatation to keep the esophagus open.
Electrocoagulation
This method involves burning the tumor off with electric
current. In some cases, this treatment can help relieve esophageal
blockage.
Photodynamic therapy
This treatment is discussed in more detail in the section, "How
is cancer of the esophagus treated?" It can be used to remove
superficial layers of tumor tissue and help relieve esophageal
blockage.
Laser endoscopy
In this treatment, laser beams are aimed at the cancer through
an endoscope. A surgical incision is not needed. The laser opens up the
esophagus by vaporizing and coagulating cancerous tissue. The laser
used is called a neodymium: yttrium-aluminum-garnet (Nd:yag) laser.
About 70% to 80% of patients will benefit from laser endoscopy.
However, the cancer grows back, so the procedure may need to be
repeated every month or 2. In some cases, this type of laser therapy is
performed before an esophageal stent is placed.
Radiation therapy
External-beam radiation can 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 is also useful in treating problems with swallowing
from a 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.
Pain management
Pain control is an important concern for people with cancer.
However, 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 medications and other palliative
treatments to relieve pain and other symptoms.
Last Medical Review: 05/04/2009 Last Revised: 05/13/2009
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