Esophageal Cancer Symptoms, Causes, Treatment - What are the side effects of treatment for cancer of the esophagus? on MedicineNet

Esophageal Cancer (cont.)

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Second Opinion

Before starting treatment, you might want a second opinion about your diagnosis and treatment plan. You may want to find a medical center that has a lot of experience with treating esophageal cancer. You may even want to talk to several different doctors about all of the treatment options, their side effects, and the expected results.

Some people worry that the doctor will be offended if they ask for a second opinion. Usually the opposite is true. Most doctors welcome a second opinion. And many health insurance companies will pay for a second opinion if you or your doctor requests it.

If you get a second opinion, the second doctor may agree with your first doctor's diagnosis and treatment plan. Or the second doctor may suggest another approach. Either way, you have more information and perhaps a greater sense of control. You can feel more confident about the decisions you make, knowing that you've looked at your options.

It may take some time and effort to gather your medical records and see another doctor. In most cases, it's not a problem to take several weeks to get a second opinion. The delay in starting treatment usually will not make treatment less effective. To make sure, you should discuss this delay with your doctor.

There are many ways to find a doctor for a second opinion. You can ask your doctor, a local or state medical society, a nearby hospital, or a medical school for names of specialists.

Supportive Care

Esophageal cancer and its treatment can lead to other health problems. You can have supportive care before, during, or after cancer treatment.

Supportive care is treatment to control pain and other symptoms, to relieve the side effects of therapy, and to help you cope with the feelings that a diagnosis of cancer can bring. You may receive supportive care to prevent or control these problems and to improve your comfort and quality of life during treatment.

Cancer Blocks the Esophagus

You may have trouble swallowing because the cancer blocks the esophagus. Not being able to swallow makes it hard or impossible to eat. It also increases the risk of food getting in your airways. This can lead to a lung infection like pneumonia. Also, not being able to swallow liquids or saliva can be very distressing.

Your health care team may suggest one or more of the following options:

Stent: You get an injection of a medicine to help you relax. The doctor places a stent (a tube made of metal mesh or plastic) in your esophagus. Food and liquid can pass through the center of the tube. However, solid foods need to be chewed well before swallowing. A large swallow of food could get stuck in the stent.

Laser therapy: A laser is a concentrated beam of intense light that kills tissue with heat. The doctor uses the laser to destroy the cancer cells blocking the esophagus. Laser therapy may make swallowing easier for a while, but you may need to repeat the treatment several weeks later.

Photodynamic therapy: You get an injection, and the drug collects in the esophageal cancer cells. Two days after the injection, the doctor uses an endoscope to shine a special light (such as a laser) on the cancer. The drug becomes active when exposed to light. Two or three days later, the doctor may check to see if the cancer cells have been killed. People getting this drug must avoid sunlight for one month or longer. Also, you may need to repeat the treatment several weeks later.

Radiation therapy: Radiation therapy helps shrink the tumor. If the tumor blocks the esophagus, internal radiation therapy or sometimes external radiation therapy can be used to help make swallowing easier.

Balloon dilation: The doctor inserts a tube through the blocked part of the esophagus. A balloon helps widen the opening. This method helps improve swallowing for a few days.

Other ways to get nutrition: See the Nutrition section for ways to get food when eating becomes difficult.

Pain

Cancer and its treatments may cause pain. It may be painful to swallow, or you may have pain in your chest from the cancer or from a stent. Your health care team or a pain control specialist can suggest ways to relieve or reduce pain.

Sadness and Other Feelings

It's normal to feel sad, anxious, or confused after a diagnosis of a serious illness. Some people find it helpful to talk about their feelings. See the Sources of Support section.

Nutrition

It's important to meet your nutrition needs before, during, and after cancer treatment. You need the right amount of calories, protein, vitamins, and minerals. Getting the right nutrition can help you feel better and have more energy.

However, when you have esophageal cancer, it may be hard to eat for many reasons. You may be uncomfortable or tired, and you may not feel like eating. Also, the cancer may make it hard to swallow food. If you're getting chemotherapy, you may find that foods don't taste as good as they used to. You also may have side effects of treatment such as poor appetite, nausea, vomiting, or diarrhea.

If you develop problems with eating, there are a number of ways to meet your nutrition needs. A registered dietitian can help you figure out a way to get enough calories, protein, vitamins, and minerals:

A dietitian may suggest a change in the types of foods you eat. Sometimes changing the texture, fiber, and fat content of your foods can lessen your discomfort. A dietitian may also suggest a change in the portion size and meal times.

A dietitian may recommend liquid meals, such as canned nutrition beverages, milk shakes, or smoothies.

If swallowing becomes too difficult, your dietitian and your doctor may recommend that you receive nutrition through a feeding tube.

Sometimes, nutrition is provided directly into the bloodstream with intravenous nutrition.

Nutrition After Surgery

A registered dietitian can help you plan a diet that will meet your nutrition needs. A plan that describes the type and amount of food to eat after surgery can help you prevent weight loss and discomfort with eating.

If your stomach is removed during surgery, you may develop a problem afterward known as the dumping syndrome. This problem occurs when food or liquid enters the small intestine too fast. It can cause cramps, nausea, bloating, diarrhea, and dizziness. There are steps you can take to help control dumping syndrome:

Eat smaller meals.

Drink liquids before or after eating solid meals.

Limit very sweet foods and drinks, such as cookies, candy, soda, and juices.

Also, your health care team may suggest medicine to control the symptoms.

After surgery, you may need to take daily supplements of vitamins and minerals, such as calcium, and you may need injections of vitamin B12.

You may want to ask a registered dietitian these questions about nutrition:

How do I keep from losing too much weight? How do I know whether I'm getting enough calories and protein?

What are some sample meals that would meet my needs?

How can I include my favorite foods without causing or worsening digestive problems?

Are there foods or drinks that I should avoid?

What vitamins and minerals might I need to take?

Next: What follow-up care is necessary during recovery?

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