Supportive Therapy for Esophageal Cancer

Supportive therapy is treatment aimed at preventing or relieving symptoms instead of trying to cure the cancer. The main purpose of this type of treatment is to improve the comfort and quality of life for someone diagnosed with cancer no matter what stage the cancer or the goal of treatment might be. You might also hear supportive care referred to as palliative care, symptom management, or comfort care.

Several types of treatment can be used to help prevent or relieve symptoms of esophageal cancer. In some cases, they are given along with other treatments that are intended to cure the cancer. In other cases, supportive or palliative treatments are given when a cure is not possible.

Feeding tube

People with esophageal cancer often have already lost weight before the cancer was found. Treatments such as chemo, radiation, and chemoradiation can cause painful sores in the mouth and throat. These can make it hard to eat well enough to get good nutrition, making weight loss worse.

Some people with esophageal cancer may need to have a feeding tube, usually called a jejunostomy tube (or J-tube), put in place before treatment. This is done through a small hole in the skin over the abdomen during a minor operation. A J-tube lets liquid nutrition be put directly into the small intestine to prevent further weight loss and improve nutrition. This can make treatment easier to tolerate. Less often, the tube is 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.

Esophageal dilation

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.

Other endoscopic procedures

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

Radiation therapy

External-beam radiation can often 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 it is also useful in treating problems with 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 is especially useful in helping to relieve a blocked esophagus. See Radiation Therapy for Esophageal Cancer for more details.

Chemotherapy and targeted therapy

When used to help treat advanced esophageal cancer, chemotherapy and targeted therapy can both 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 management

Pain control is an important concern for people with cancer. There are many ways to treat cancer pain. People with cancer should let their cancer care team know right away if they are in pain. The cancer care team can provide medicines and other supportive treatments to relieve pain and other symptoms. See Cancer Pain to learn more.