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Q&A with Australian Health Practitioners
When is a gastrostomy needed for someone with oesophageal cancer?
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My father was recently diagnosed with oesophageal cancer. He reported difficulty swallowing and pain when doing so… if this continues, I'm assuming it will eventually become TOO painful to eat. How will he still receive the right nutrients? Is gastrostomy the solution when this occurs? -
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Dr Salena Ward
Bariatric (Obesity) Surgeon, General Surgeon, Upper GI Surgeon (Abdominal)
I am a specialist Upper Gastrointestinal (gut) Surgeon, who performs surgery for weight loss, tumours of stomach and oesophagus, reflux, hiatus hernia and gallstones. I … View Profile
In your father's circumstance. it depends on what further treatment your father may undergo. You've written the question as though your father is not going to undergo surgery.
Generally, if a patient is diagnosed with oesophageal cancer and for one reason or another is not going to undergo surgery to try and achieve a cure, then the best thing to help the swallowing improve a bit would be inserting a stent (an expandable tube inserted into a hollow tube-like organ to hold it open). The stent would only be put in when the dietary intake was significantly restricted, indicating that the opening in the oesophagus is quite narrow, as a stent will not hold so well in the correct position if the narrowing is not tight enough. In a few circumstances a stent may not be possible either with technical difficulty, or if the cancer is too high in the oesophagus.
If a patient however is going to undergo surgery (often with other therapies) to try and achieve a cure, then a feeding tube may need to be placed if the diet is too restricted, to keep up the patient''s nutrition prior to surgery. However an altered diet onto soft/liquid foods and high calorie drinks sometimes may keep up nutrition enough without a feeding tube.
A gastrostomy means a tube into the stomach. If a patient did require a feeding tube prior to surgery and other treatment with intention to cure the patient, then some surgeons consider another feeding tube into the small bowel instead (called a jejunostomy), which is the same tube that many surgeons place during surgery.
Each patient's circumstances are different so I strongly suggest you and your father have a discussion with the specialists treating his condition about what, if anything at this stage, is required for your father's swallowing.
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