Managing side effects of oesophageal cancer treatment

Oesophageal cancer and its treatment can cause side effects. Some may be permanent and may change what you can eat, and how your body digests foods and absorbs essential nutrients.

Eating during and after treatment

It is important to eat and drink enough to get the nutrition to stay hydrated and maintain your weight. This will help you avoid malnutrition. If you are unable to eat and drink enough to meet your nutritional needs, you may need a feeding tube during or after treatment.

To help prevent weight loss during treatment:

• try eating small meals or snacks every 2–3 hours
• keep a variety of snacks handy and eat when you feel hungry or crave a particular food
• drink high-energy fluids like milkshakes or nutritional supplement drinks
• talk to a dietitian about how to get more energy and increase your protein. 

After treatment, you may also find that some foods cause digestive problems. You will need to try different foods and change your eating habits, such as eating smaller meals more often throughout the day. Ask your doctor for a referral to a dietitian with experience in cancer care. 

Reflux and choking

Stomach acid rising into the oesophagus (reflux) is common after surgery for oesophageal cancer. This can cause heartburn, chest discomfort, or your stomach contents to flow up your oesophagus, particularly when lying flat or bending over. Medicines to reduce stomach acid may help.

After surgery or radiation therapy for oesophageal cancer, scar tissue may cause choking or swallowing problems while eating or drinking. See your doctor if this continues. After an oesophagectomy, the stomach can take longer to empty. You may feel full more quickly or be more likely to vomit or bring up food after eating.

To reduce reflux and choking, you can:

• avoid spicy or fatty foods, fizzy drinks, and alcohol
• sit upright while eating and for at least 30 minutes afterwards
• take small sips of water to help with coughing
• raise the head end of your bed so your head is higher than your stomach.

Swallowing difficulties

You may have difficulty swallowing (dysphagia) before, during or after treatment. This may be caused by the cancer itself or by swelling in the oesophagus after surgery. Signs include taking longer to chew and swallow; food getting caught in your mouth or throat; or bringing up food or vomiting.

Some people find that food and fluid go into the windpipe instead of the food pipe. This is called aspiration, and it can lead to chest infections like pneumonia. Talk to your doctor about these symptoms.