NCCN Guidelines for Patients
: Esophageal Cancer
Part 3: Preparing for treatment
• Nurse – an expert trained to care for the sick,
• Social worker – an expert in meeting social and
emotional needs, and a
• Nutritionist – an expert in healthy foods and drinks.
At the meetings, your treatment team will create a
treatment plan based on the clinical stage of the cancer.
More information about treatment plans can be found in
Part 7. Your treatment team will also meet while you are on
treatment and afterward to discuss the treatment results
and the next steps of care.
3.3 Getting good nutrition
It is recommended that you meet with a nutritionist before
starting treatment. The nutritionist can assess the toll of
the cancer on your nutrition. For example, the cancer may
have made swallowing difficult or painful. This is called
dysphagia, which may have stopped you from getting
good nutrition. Likewise, the cancer may also have caused
you to lose too much weight.
It is important that you receive adequate and sustained
nutrition before you start treatment. Surgery and other
cancer treatments may be too dangerous if you are weak
from a lack of nutrition. A nutritionist can advise you on
ways to eat or drink better. You may be advised to receive
your food through a nasogastric tube. This feeding tube
is inserted down your nose and into your stomach. See
Figure 6. Otherwise, a J-tube (
be used. A J-tube is inserted through a cut made in your
abdomen and into the small intestine. PEG (
astrostomy) tubes, which are inserted
through a cut into the stomach, are not recommended.
3.4 Help to quit smoking
If you had been smoking tobacco before you learned
you had cancer, it is important to stop. Nicotine addiction
is one of the hardest addictions to stop. The stress of
esophageal cancer may make it harder to quit. Quitting
is important since smoking can limit how well cancer
treatment works. If you smoke, ask your doctor about
counseling and drugs to help you quit.
Figure 6. Feeding tubes
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