Esophageal Cancer: Nutrition During and After Treatment

If you have esophageal cancer, chances are you've already had trouble eating and may have lost weight. Good nutrition will be a key part of your treatment plan.

There are many treatments for this type of cancer. They include surgery, chemotherapy, radiation therapy, targeted therapy, and other types of treatment. All of these treatments can affect your ability to eat and get the nutrition you need.

This type of cancer can narrow your esophagus. This can make it painful to swallow. Cancer treatment can also cause problems that make it harder for you to get the food your body needs. Working with a nutrition specialist or registered dietitian can help. This member of your care team can help you with the following:

• Loss of appetite
• Dryness, sores, and pain in your throat and esophagus
• Not being able to swallow
• Nausea and vomiting

Your treatment will depend on the stage of your cancer and your overall health. Here are some of the nutrition challenges you may face:

• You may be able to eat the regular way with some diet changes. In some cases, even if swallowing is hard, you may be able to do things to make it easier. For instance, a diet of soft, high-protein foods may help.
• You may need tube feeding if you can't eat enough food by mouth or are recovering from surgery. This is when a tube is put through your nose and into your stomach for short periods of time.
• If you need tube feeding for a long time, a tube can be put right into your small intestine. This is called a J-tube. Or a tube may be put into your stomach. This is called a G-tube. These tubes are put in through the skin over your belly. You will be taught how to give yourself fluids and nutrition through the tubes. And how to care for the skin where the tube is placed. They can be taken out if you're able to eat by mouth again.
• Parenteral nutrition is nutrition you get through an I.V. (intravenous) drip. It doesn't depend on swallowing or digestion. You may need this type of nutrition after surgery or if you don't get enough food by mouth. Fluids that contain proteins, fats, and vitamins are given through a catheter that's in a vein. Or a device like a port can be used. Your health care team will choose the type of nutrition you need.

Most people with esophageal cancer have trouble getting the nutrition they need and keeping a normal weight. These tips can help.

If you're at a higher weight, talk to your doctor or dietitian before adding calories to your diet.

• Eat foods and drinks high in calories and protein. These include whole, full-fat dairy products, nut products, and meats. Examples include milkshakes, smoothies with protein powder, peanut butter, beans, eggs, cheese, and yogurt.
• If swallowing is still hard, soften your foods with gravies or sauces. Chop up meat into small pieces. Examples include scrambled eggs, pasta, custard, pudding, and soups and stews made with ground meat.
• If you've had surgery, your stomach may be smaller. You may fill up quickly. It may help to eat smaller meals more often. You should also stay away from drinking fluids before meals. And keep lots of snacks on hand for between meals. Some 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're eating. This can help make swallowing easier. It can also help food pass through your 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. Work with your health care team. Getting the right amount of calories, nutrients, and protein is important for healing, fighting infection, and having enough energy.