Treatment
What is the treatment of oesophagus cancer?
Many years of treating cancer patients and testing treatments in clinical trials has helped doctors know what is likely to work for a particular type and stage of cancer. You will be advised on the best treatment for your cancer. This will depend on the type of cancer you have, where it is and how far it has spread and your general health.
The most common treatment options for oesophageal cancer are surgery, radiotherapy and chemotherapy. Your doctors take many factors into account when deciding which treatments are most suitable for you, including the stage of the cancer, your age, general health, and your level of fitness.
If your cancer hasn’t spread, you will almost certainly be offered surgery to remove your oesophagus.
Though cancer surgeries are extensive and take longer hours; with advanced medical care, surgeries have become safer and better equipments are now available to perform surgeries. Improved techniques of anaesthesia and post-operative monitoring have significantly contributed to overall safety of surgical procedures for cancers.
Surgery
SURGERY FOR OESOPHAGUS CANCER:
Though cancer surgeries are extensive and take longer hours; with advanced medical care, surgeries have become safer and better equipments are now available to perform surgeries. Improved techniques of anaesthesia and post-operative monitoring have significantly contributed to overall safety of surgical procedures for cancers.
If you are found suitable for the surgery, you will be usually admitted one or two days prior to the proposed date of surgery. There may be dietary restrictions and you may be given laxatives to evacuate your bowels prior to surgery. Your blood group will be checked and blood is usually reserved for all major abdominal surgeries. It is always a good idea to start with deep breathing exercises once you are admitted to the hospital.
Your doctor may summon a physiotherapist to assist you with the same. You will have most of your body parts shaved for the surgery. You will be given a consent form for your signature. The form would have details of the procedure to be performed on you by your treating surgeon. In case you have any doubts you should feel free to ask them to the surgical team.
The position of the tumour in the oesophagus will determine how much of the oesophagus is removed and what surgery will be performed
The position of the tumor at the oesophagus will also decide the approach to remove the tumor from your body. Your surgeon can approach the cancer via your neck, chest or abdomen and may sometimes combine these approaches.
If the cancer is at the lower portion of the oesophagus or the oesophago-gastric junction, the lower portion of food pipe and the upper part of stomach is removed. This is called an oesophago-gastrectomy.
If the cancer is at the middle portion of the oesophagus, the entire food pipe is removed. This is called a Total oesophagectomy The surgeon will pull the stomach up into the chest and use it to replace the oesophagus.
Removing lymph nodes
You will be transferred to the Intensive care unit after the surgery. Your recovery will depend on the magnitude of surgery performed. After the operation, the patient is usually monitored in the ICU for 48 to 72 hrs and the overall hospital stay (if no complications) is usually between 10–14 days.
Your pain and discomfort will be taken care of by the anaesthetic team. You will be given pain-killers and an intravenous infusion (drip) to replace your body’s fluids until you are able to drink and eat again after a few days. You will also have a naso-gastric (NG) tube in place.
This is a thin tube that passes down your nose into your stomach or small intestine and allows any fluids to be removed so that you don’t feel sick. It is usually taken out within 48 hours. Sometimes a small tube (catheter) is put into the bladder to drain your urine into a collecting bag.
A feeding tube is generally placed at your tummy to help you with feeds till the stitches taken to join the internal parts have healed.
After your operation you will be encouraged to start moving about as soon as possible. This is an essential part of your recovery. If you have to stay in bed the nurses will encourage you to do regular leg movements and deep breathing exercises. You will be seen by a physiotherapist who can help you to do the exercises.
Drinking and eating after surgery.
After an anaesthetic, the movement of the bowel slows down and usually takes about 72 hours to get back to normal. After about 48-72 hours you will probably be ready to start taking small sips of water, however your doctors will tell you when it is appropriate for you to start drinking some fluids. This will be gradually increased after a couple of days until you are able to eat a light diet.
Going home.
You will probably be ready to go home in about 10-14 days after your operation and once your stitches have been removed. If deemed appropriate your doctor may send you home with stitches and call you later to remove the stitches. By and large you should be able to climb several flights of stairs after your discharge from the hospital and you will be given diet instructions.
Before you leave hospital you will be given an appointment for a post-operative check-up at the outpatient clinic.
Diet after Oesophagus Surgery
You will be transferred to the Intensive care unit after the surgery. Your recovery will depend on the magnitude of surgery performed. After the operation, the patient is usually monitored in the ICU for 48 to 72 hrs and the overall hospital stay (if no complications) is usually between 10–14 days.
Your pain and discomfort will be taken care of by the anaesthetic team. You will be given pain-killers and an intravenous infusion (drip) to replace your body’s fluids until you are able to drink and eat again after a few days. You will also have a naso-gastric (NG) tube in place.
This is a thin tube that passes down your nose into your stomach or small intestine and allows any fluids to be removed so that you don’t feel sick. It is usually taken out within 48 hours. Sometimes a small tube (catheter) is put into the bladder to drain your urine into a collecting bag.
After your operation you will be encouraged to start moving about as soon as possible. This is an essential part of your recovery. If you have to stay in bed the nurses will encourage you to do regular leg movements and deep breathing exercises. You will be seen by a physiotherapist who can help you to do the exercises.
At first, even tiny meals may make you feel uncomfortably full. If you have had part of your stomach removed, it will not stretch as much as it did before. If you have had your stomach pulled into the chest, eating large amounts will cause heaviness in the chest. You will need to eat very small amounts very often at first. Then, gradually increase the amounts and then the time between meals. At first, you may find you need to eat every hour or so in order to get enough nutrition.
There is no restriction on the type of food you eat after a oesophagus surgery and you should be able to eat all that you did before surgery. Fizzy drinks can make you feel full – it is probably best not to drink with meals at all, as any liquid will fill you up and cause reflux.
You may be advised not to lie flat in bed, but to sleep propped up on a couple of pillows to avoid acid reflux.
Try keeping a food diary if you are having problems you think are related to your diet. Take a small notebook and draw a line down the centre of each page. Write down what you eat and when on the left of the page. Write down any symptoms you get and when on the other side of the page. After a few days, you may be able to spot which foods cause which symptoms.
+91-9821 0288 02
