Nutrition during treatment for esophageal cancer

Maintaining good nutrition is essential to staying as healthy as possible and meeting the demands of living with cancer and treatment for cancer. This is especially true for people with esophageal cancer, a type of cancer that can significantly impair a person's ability to eat.

Difficulties with eating and nutrition

Esophageal cancer refers to cancer that forms in the esophagus, the muscular tube that connects the throat to the stomach. Common symptoms of esophageal cancer include problems with swallowing—difficulty swallowing, pain while swallowing, or a feeling of food being stuck in the throat while swallowing.

Many people with esophageal cancer (and cancers in general) experience malnutrition and unintended weight loss, which are caused by numerous contributing factors.

Treatment side effects can impact nutrition

Surgery, chemotherapy, radiation therapy, targeted therapies, and immunotherapy may all be used in the treatment of esophageal cancer. Multiple therapies are often used in combination with one another. Side effects during treatment can include nausea, vomiting, mouth sores, loss of appetite, and changes in taste and smell, which can all impact a person’s ability to eat.

Treatment for esophageal cancer will depend on many different factors, including the exact location of the tumors, the size of the tumors, the stage of the cancer, and the biological features of the cancer. The decision on how to treat will also depend on the person with cancer—their age, their overall health, their priorities and how they weigh the risks and benefits of different approaches to treatment.

Nutrition during cancer treatment

Addressing difficulties with eating and nutrition are an important part of a treatment plan. Like other aspects of treatment, this will vary from one person to the next. Some of the strategies a healthcare team may use to address difficulties with nutrition include:

• Nutrition counseling. A clinical dietitian is a valuable member of a healthcare team when treating cancer. This provider can assess nutritional needs and preferences and build a meal plan tailored to those needs and preferences.
• Tube feeding. In some cases, a feeding tube may be necessary to provide nutrition and hydration if swallowing difficulties or other complications make it impossible to eat or drink. Feeding tubes are also used during recovery from surgery to remove tumors in the esophagus.
• Other procedures. Procedures like stents and dilation can be used to help widen the esophagus and improve a person’s ability to swallow food.
• Medications. Medications can be prescribed to manage symptoms such as nausea, vomiting, and diarrhea. This can help improve appetite and nutrient absorption.
• Nutritional supplements. Nutritional supplements such as shakes, smoothies, and protein powders can help meet calorie and protein needs if solid foods are difficult to tolerate. Always talk to your healthcare providers before taking any nutritional supplement.
• Food texture modification. Foods may be modified in texture—they can be pureed, chopped, or ground—to make them easier to swallow and digest.
• Palliative care. Palliative care specialists can provide symptom management and support to improve a person’s quality of life while living with cancer.

If you are living with esophageal cancer, or caring for someone with esophageal cancer, remember that you are an important part of the healthcare team. Whether it is nutrition, mental health, or another aspect of living with esophageal cancer, talk to your healthcare providers about how you are feeling and anything you are finding difficult. Good communication with healthcare providers is essential to getting the best care possible.