As more people are alerted to the warning signs and symptoms of esophageal cancer, doctors expect to be able to diagnose and treat many more cases early on, when there is a greater chance of cure. Researchers are also continually working to improve esophageal cancer therapies. For both these reasons, the number of esophageal cancer survivors has grown over the past few years.
Follow-Up Care
Once treatment is completed, your doctor will continue to see you regularly for follow-up examinations and tests in order to monitor your health or to detect cancer recurrence or spread, should it occur.
If you experience any new symptoms — especially new complaints of pain or problems swallowing — you should contact your doctor right away.
Managing Complications
Surgical treatment for esophageal cancer can sometimes lead to specific problems such as infections; leaks and blockages of the anastomasis (surgical reattachment of the remaining esophagus to the stomach); gastroesophageal reflux; early satiety, in which patients feel full after only eating a small part of a meal; and dumping syndrome, a condition that occurs when food or liquid moves too fast into the small intestine.
Dumping Syndrome
Some of the longest lasting concerns of patients with esophageal cancer have to do with food and changes they must make to their diet and eating habits.
The speed at which food passes through the gastrointestinal tract is controlled by a multibranched nerve called the vagus nerve, which infiltrates the esophagus, stomach, intestine, and many other organs. During surgery for esophageal cancer, surgeons must sever or remove parts of this nerve, which complicates the digestion process. In most patients, surgeons must also disable the sphincter, or band of muscles, that controls movement of food from the stomach to the small intestine. These changes can cause patients to experience “dumping syndrome,” in which food passes too quickly from the stomach to the intestine, and which can lead to sweating, dizziness, cramps, and diarrhea.
Notify your cancer care team should you experience such symptoms after you leave the hospital.
Rehabilitation Therapy
Following treatment for esophageal cancer, a patient may notice changes in his or her range of motion, strength, flexibility, balance, and endurance. Rehabilitation therapists educate esophageal cancer patients about the most effective ways to perform daily activities after surgery or other medical treatments. At Memorial Sloan-Kettering, our therapists work closely with the surgical and medical team to improve patient's function and quality of life during and after hospitalization. Physical therapists may make recommendations on appropriate assistive devices or therapeutic exercises to improve mobility, strength, and endurance following treatment. They also educate patients on the most effective way to cough and maintain pulmonary hygiene following surgery.
Our occupational therapists educate patients about the changes that can result from treatment and about adaptive equipment and compensatory techniques that can increase their independence during their daily routines. They also evaluate and treat patients' ability to perform basic daily activities such as bathing, dressing, and moving around their environment. Therapists provide patients with exercises to help develop upper body strength, range of motion, and fine motor control to increase their independence and mobility.
See the section on Rehabilitation for further information about our services, including appointment information.
Nutrition
Esophageal cancer survivors can work with a nutritionist to assemble a dietary plan and to discuss other ways to alter their eating habits to minimize discomfort. Patients may be encouraged to:
- eat several small meals each day instead of fewer large meals
- avoid certain foods such as milk, chocolate, concentrated sweets, and spiced and fried foods
- change their sleeping configuration so that their heads are slightly elevated, to prevent food and stomach acids from traveling back up through the esophagus
- stop drinking or smoking to reduce the chance that a new cancer will develop
- improve appetite and nutrition
Some patients report that these changes in food preparation and diet affect their social life, their family system, and may cause strains on their relationship with their spouse. Dietary changes may interfere with their enjoyment of food and of the social pleasures that accompany meals, possibly leading to feelings of sadness and loss. But these feelings are likely to be most acute during the first few months after surgery when patients are adjusting to a new diet and their bodies are adjusting to internal changes. These feelings are likely to become becomes less pronounced with the passage of time.
Other Aspects of Survivorship
To help patients manage some of the other issues that may come up in survivorship, Memorial Sloan-Kettering offers a wide range of programs for cancer survivors, including the following:
- Memorial Sloan-Kettering Counseling Center
Our Counseling Center offers individual and family counseling sessions to help patients and their families address the problems that they may encounter in adjusting to life during and after treatment.
- Living Beyond Cancer
People facing the challenges of cancer survivorship can access a variety of support services through the Living Beyond Cancer section of our Web site. This section includes information about professionally led support groups and counseling; survivorship clinics to manage late effects of cancer and treatment; recommendations about screening and healthy living; and specialized services to address sexual and reproductive health. We also offer a range of resources to help survivors, families, and friends better understand the complex emotional and social issues following treatment.
Additional services are offered through our Resources for Life After Cancer program, which provides a full range of educational support services, including individual and family counseling, periodic lectures or workshops to provide medical updates, and practical guidance on employment and insurance issues.
- Integrative Medicine Service
Our Integrative Medicine Service is designed to enhance cancer patients' quality of life through healing regimens that address the body, mind, and spirit. Beneficial complementary therapies include various types of massage, acupuncture, hypnotherapy, meditation, visualization and other mind-body therapies, music therapy, and nutritional counseling, as well as classes such as yoga, t'ai chi, and chair aerobics.
- Help for Older Patients
A diagnosis of cancer is difficult at any age, but older patients face unique challenges. Memorial Sloan-Kettering Cancer Center is committed to providing cancer patients aged 65 and older with the treatment, facilities, and support they need.
Memorial Sloan-Kettering offers the services of a multidisciplinary geriatric team, which includes physicians, clinical nurse specialists, social workers, nutritionists, and psychiatrists, as well as members of the Pain and Palliative Care Department and the Integrative Medicine Service. The programs and care the team provides focus on the needs of elderly cancer patients.
For more information about our services for older patients as well as for their family and friends, visit the Help for Older Patients section of our Web site.
- Screening & Wellness
Memorial Sloan-Kettering provides numerous prevention, screening, and wellness services. Information about these services; guidance on how to stop smoking; and how to follow a healthy diet can be found on our Web site in the Prevention & Screening section.
Access Information Through our Patient Portal
Memorial Sloan-Kettering offers a secure Web site — called MYMSKCC — for patients to access personalized information about their care. If you enroll to use MYMSKCC, you can view, confirm, and keep track of appointments; access over 300 lab results; make changes to contact and insurance information; communicate with your healthcare team and other staff using secure electronic messages; and pay bills and view balances. Learn more about MYMSKCC.
To enroll in MYMSKCC, please ask a session assistant in clinic or contact your physician's office.
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