NCCN Guidelines for Patients® | Esophageal Cancer - page 74

74
NCCN Guidelines for Patients
®
: Esophageal Cancer
Version 1.2013
Part 6: Adenocarcinomas
6.5 Supportive care for adenocarcinomas
The goal of supportive care is to prevent and relieve
discomfort you may have. Supportive care is given at
any stage of cancer, but is often the main type of care
when the cancer is advanced. When used for advanced
cancers, supportive care is often called palliative care.
It is used to relieve symptoms from the cancer or
treatments. Supportive care may also extend life, improve
your eating, and help you feel better overall. Relief of
specific symptoms and chemotherapy are described next.
Symptom control
Cancer or its treatment can cause unpleasant and
sometimes harmful symptoms. One of the most
common symptoms of esophageal cancer is dysphagia.
Endoscopic treatments, stents, radiation therapy, and
surgery are used by doctors to widen areas that have
narrowed. Bleeding is another symptom, although not
as common as dysphagia. Surgery, radiation therapy,
and endoscopic treatments can help stop the bleeding.
You may have pain or nausea with or without vomiting.
Drugs and sometimes surgery are used to control these
symptoms. You may have other symptoms that aren’t
listed here. If you have a new or worse symptom, tell
your treatment team. There may be ways to help you feel
better.
Chemotherapy and trastuzumab
Chemotherapy is often used for supportive care of
stage IV disease. It is also used for locally advanced
cancers that can’t be treated with either surgery or
radiation. Since chemotherapy can cause severe side
effects, it is only given if your health hasn’t seriously
limited your activities. Your ability to do activities is
called performance status. Your doctor can rate your
performance status by one of two scales:
ECOG (
E
astern
C
ooperative
O
ncology
G
roup)
Performance Scale
• A
score of 0
means you are fully active.
• A
score of 1
means you are able to do all self-care
activities but are unable to do hard physical work.
• A
score of 2
means you are able to do all self-care
activities and spend most of waking time out of bed
but you are unable to do any work.
• A
score of 3
means you are unable to do all self-
care activities and any work and spend most of
waking time in bed.
• A
score of 4
means you are fully disabled.
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