Navigating Treatment and Side Effect Management in Esophageal Cancer

Treatment approaches for gastroesophageal cancers continue to evolve, with multiple strategies now considered effective depending on individual patient factors, according to Dr. Sunil Dutta of Winship Cancer Institute of Emory University.

“Some studies looking at gastric cancer… have shown that chemotherapy before and after surgery is also an appropriate treatment pathway,” Dutta explained. “As recent as the past few years, they’ve really compared the two specifically for gastroesophageal junction tumors… and have found that both approaches are very effective.”

These decisions are not one-size-fits-all and are guided by several considerations.

“It’s usually based on the patient’s performance status, the tumor type and sometimes even the surgeon’s preference on what type of therapy they would recommend around surgery,” he said.

Managing Side Effects During Treatment

For patients undergoing treatment, side effects such as nausea and fatigue can be among the most difficult to manage and may affect daily life.

“Whether it’s chemotherapy or radiation, probably the hardest symptom to manage is… nausea or fatigue, and that often results in low appetite,” Dutta said.

Maintaining nutrition during treatment is critical, as weight loss can negatively affect overall health.

“One of the most important things to remember when going through treatment is that weight loss can be detrimental to your overall health,” he said. “We encourage patients to almost see eating as… something that you can try your best to do.”

Patients who struggle with eating or hydration are encouraged to seek support from their care team.

“If you’re having trouble with that, certainly reach out to your treating physicians,” Dutta said. “Sometimes they may want to add fluids to help support your hydration status.”

Additional support may also be available through nutrition specialists.

“There are very experienced dietitians in the health system that can kind of figure out what maybe is the hurdles from getting the calories we need you to get in to kind of work through that and get better nutrition,” he added.

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