Supportive Therapy for Esophageal Cancer

Esophageal cancer often causes trouble swallowing, which can lead to weight loss and weakness due to poor nutrition. Certain cancer treatments can also affect your eating habits and may make it hard to gain or even maintain your weight.

Eating right can be hard for anyone, but it can be even tougher during and after cancer treatment. This is especially true for esophageal cancers. The cancer or its treatment may affect how you swallow or cause other problems. Nausea can be a problem from some treatments. You may not feel like eating and lose weight when you don’t want to.

For more on these issues, see After Treatment for Esophageal Cancer.

People with esophageal cancer might have pain from the cancer itself or from treatments such as surgery. There are many ways to treat pain. If you have pain, tell your cancer care team, so they can give you quick and effective pain management.

People with esophageal cancer often have already lost weight before the cancer is found. They might have trouble swallowing or eating because of the cancer, or they might not have much of an appetite. Cancer treatments such as chemotherapy and radiation can also cause problems such as painful sores in the mouth and throat. These can make it hard to eat well.

Some people with esophageal cancer may need to have a feeding tube put in place to help them get the nutrition and calories they need. There are different types of feeding tubes

Often, a jejunostomy tube (or J-tube), is put in place before treatment. This is done through a small hole in the skin over the belly during a minor operation. A J-tube lets liquid nutrition be put directly into the small intestine to help prevent further weight loss and improve nutrition. This can make treatment easier to tolerate. Sometimes the tube might be placed into the stomach instead. This is known as a gastrostomy tube or G-tube.

A feeding tube can easily be removed when it's no longer needed.

This procedure is used to stretch out an area of the esophagus that is narrowed or blocked to allow better swallowing.

A small balloon-like device or a device shaped like a pipe is passed down the throat and pushed through the narrowed area to stretch it out. This 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 a perforation) with this procedure, which could require surgery or other treatments to fix.

The esophagus typically stays open only a few weeks after dilation, so this is often followed by other treatments (such as placing an expandable stent) to help keep the esophagus open.

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 Endoscopic Treatments for Esophageal cancer. Procedures that may be used include:

• Esophageal stent placement
• Photodynamic therapy
• Electrocoagulation
• Laser ablation
• Argon plasma coagulation

External radiation therapy can often help relieve some of the symptoms from advanced esophageal cancer, including pain and problems swallowing from a narrowed or blocked esophagus.

If an area had been treated with external beam radiation therapy earlier, it might not be able to be treated that way again. In that case, brachytherapy may be an option. Brachytherapy can be especially useful in helping to relieve a narrowed or blocked esophagus.

See Radiation Therapy for Esophageal cancer for more details.

When used to help treat advanced esophageal cancer, chemotherapy, targeted therapy, and immunotherapy can be considered a type of palliative or supportive therapy because they are intended to help slow the growth of the cancer and relieve symptoms from the cancer, as opposed to trying to cure it.

Pain relief is an important concern for many people with cancer. There are many ways to treat cancer pain.

It’s important to let your cancer care team know right away if you are in pain. The team can provide medicines and other supportive treatments to relieve your pain.

See Cancer Pain to learn more.