If you've been diagnosed with esophageal cancer, maintaining good nutrition will be a crucial part of your treatment program. Research suggests that people who receive help with nutrition and avoid losing more than five pounds during treatment tend to have a better chance of survival.
Treatment for cancer of the esophagus—the swallowing tube that connects the back of your throat to your stomach—may include surgery, chemotherapy (cancer drugs), or radiation therapy (X-ray treatments). All of these treatments can affect your ability to get the level of nutrition you need.
Cancer of the esophagus can narrow your esophagus, making it difficult or painful to swallow and take in the nutrition you need. You can get help to overcome this from an important member of your treatment team: the nutrition specialist. Here are some of the concerns a nutritionist can help you with:
Loss of appetite during treatment with cancer drugs
Dryness and narrowing of the throat and esophagus from radiation therapy
Inability to swallow while recovering from surgery
The treatment you receive for esophageal cancer will depend on the stage of your cancer and your overall health. Here are some of the nutrition options you may face:
You may be able to eat the regular way—taking food by mouth. In some cases, even if swallowing is difficult, you may be able to use strategies, such as consuming a diet of soft, high-protein foods, to make eating easier.
Tube feeding may be needed if you just can't eat enough food by mouth or are recovering from surgery. This involves inserting a tube through your nose and into your stomach for short periods of time.
If you need tube feeding for a long time, a tube called a gastrostomy tube can be inserted directly into your stomach during a short surgical procedure. This type of tube can be removed if you are able to start swallowing by mouth again.
Parenteral nutrition is nutrition you get through an intravenous (IV) drip and doesn't depend on swallowing or digestion. You may need this type of nutrition after surgery or when you don't get enough food by mouth. Fluids that contain proteins, fats, and vitamins are given through a catheter placed directly into a vein in your upper chest or in an arm.
If you need tube or intravenous feedings, your medical team will select the type of nutrition you get.
If you are able to take foods by mouth before, during, or after treatment, these tips can help lessen any discomfort and increase nutrition intake:
Eat foods with the most calories and proteins, such as whole dairy products, nut products, and meats. Examples include milkshakes, smoothies with protein powder, peanut butter, beans, eggs, cheese, and yogurt.
If swallowing is still difficult, soften your foods with gravies or sauces and chop up meat into small pieces. Examples of nutritious soft foods include scrambled eggs, pasta, custard, pudding, and soups and stews made with ground meat.
If you have had surgery, your stomach may be smaller and you may find that you fill up quickly. It may help to eat frequent smaller meals, avoid drinking fluids before meals, and keep lots of snacks around for between meals. Examples of tasty, calorie-dense snacks include cheese and crackers, toast with peanut butter, crackers and hummus, yogurt and fruit, and cereal with whole milk and bananas.
You may need to sip fluids while you are eating to assist in swallowing comfort, and to promote the passage of food through the esophagus.
Add butter, margarine, or oil to your foods whenever you can.
Nutrition is important before, during, and after treatment for esophageal cancer. Learn as much as you can about nutrition and work with your medical team to make sure this part of your cancer treatment is well managed.