Diet and nutrition when living with oesophageal cancer
Oesophageal cancer itself and cancer treatment place extra demands on your body. It is very important to maintain good nutrition before, during, and after cancer treatment. Treatments may involve surgery, chemotherapy, radiotherapy, immunotherapy, or a combination of these. These treatments can cause you to lose your appetite and energy, putting you at an increased risk for malnutrition.
Your food choices when you have cancer and are undergoing treatment may be very different from what you are used to eating. The main goal is to try to keep your weight constant, maintain muscle strength, maintain a healthy weight, and have more energy, all of which help your body to heal properly, improve your quality of life and give you the energy to cope with all the new challenges treatment may bring.
The role of the oesophagus and the digestive system
The oesophagus is part of the digestive system. The oesophagus is a muscular tube, about 25cm long, with a sphincter (valve) at each end. Its function is to transport food and fluid, after being swallowed, from the mouth to the stomach. No absorption of nutrients takes place in the oesophagus. A mouthful of food which has been chewed and swallowed is called a bolus, this is then propelled from the throat into the oesophagus and down into the stomach to be digested. Any disease or treatment targeting the oesophagus can affect digestion.
Tips on good nutrition during treatment
Good nutrition can help to:
manage the side effects of treatment
speed up recovery after treatment
heal wounds and rebuild damaged tissues after surgery, radiotherapy, chemotherapy or other treatment
improve your body’s immune system and ability to fight infections.
Overall, try to make food choices that provide you enough calories (to maintain your weight), protein (to help rebuild tissues that cancer treatment may harm), nutrients such as vitamins and minerals, and fluids (essential for your body’s functioning). Exercise can also help with appetite and digestion issues related to treatment.
Good nutrition during treatment:
You may need more energy (kilojoules/calories).
Eat small, frequent meals or snacks, rather than three large meals a day.
Ask for a referral to a dietitian – discuss eating issues, weight issues, muscle loss.
Do some light physical activity, such as walking, to improve appetite and mood, reduce fatigue, help digestion, and prevent constipation.
Check with your doctor or dietitian before taking vitamin or mineral supplements or making other changes to your diet.
Relax dietary restrictions, e.g. choose full-cream rather than low-fat milk.
Consider using nutritional supplements if you cannot eat enough – discuss options with your doctor, palliative care specialist or dietitian.
Oesophagus cancer diet and nutrition changes
Oesophageal cancer and the associated treatments change how your body functions. Managing these changes is important for your nutritional health, your recovery, and to make you feel better in general. Treatments can affect people differently. You may have no side effects, some, or all of them, but there are plenty of things you can do to improve your general wellbeing. We will explain the side effects of cancer treatments, and how to manage them.
Stomach cancer may impact:
your nutritional requirements and what you need to eat
how much you eat
your ability to digest food
your ability to maintain your weight and muscle mass
your energy levels and general wellbeing.
Recovering from surgery
Surgeries used to treat cancer may result in a variety of side effects, including weight loss and diarrhoea. The side effects usually only last for a short period of time, but you may have to make some changes to your diet to ensure that you are getting enough nutrition and maintaining your weight.
Your body needs good nutrition after surgery and it is an important part of your recovery process. If you are struggling to eat or drink, the hospital may prescribe nutrition supplements, or recommend tube feeding, to help you to maintain weight and provide you with the nutrients you need for speedy recovery.
Tips on maintaining weight after surgery:
Monitor your weight – weigh yourself once or twice a week to monitor for any weight loss.
If you are losing weight, tell your doctor and get a referral to see a dietitian.
Eat small, frequent meals after surgery so your digestive system only has to deal with a small amount of food at a time.
Some patients have trouble taking in enough nutrition after surgery for stomach cancer. Further treatment like chemotherapy with radiation can make this problem worse. To help with this, a tube can be placed into the intestine at the time of gastrectomy. The end of this tube remains outside of the skin on the abdomen. Through this, liquid nutrition can be put directly into the intestine to help prevent and treat malnutrition.
Types of feeding tubes:
Gastrostomy tube – PEG, PEJ
Nasogastric tube (NG tube)
Nasojejunal tube (NJ)
Caring for your feeding tube:
Check type of tube feed is right for your needs.
Follow the hygiene rules, wash hands before and after feeds, keep syringes & equipment clean & dry.
Check that the feeding tube is in the right position before feeding – your care team will show you how to do this.
Flush the tube through before and after adding the feed (or medication) to avoid blockages – follow the instructions provided by your dietitian.
Position yourself in an upright position when feeding.
Clean around the insertion site every day.
Look after the skin around the tube to avoid irritation.
Make sure that you stay hydrated by having water through the tube (speak to your dietitian to discuss how much water you can use) or orally if safe, appropriate, and agreed with healthcare team.
Keep your teeth and gums healthy by cleaning teeth twice a day even if you are not feeding or drinking through the mouth.
We recognise that dietary changes have a huge impact on everyone with cancer. It can take a while to get used to changes to your diet and lifestyle, but finding ways to manage your diet and symptoms can help you feel more in control. It can also be helpful to speak to your dietitian, doctor or nurse.