Esophageal Cancer: Therapy

General measures

  • Nicotine restriction (refraining from tobacco use).
  • Alcohol restriction (abstaining from alcohol)
  • Normal weight to strive for or maintain! Determination of BMI (body mass index, body mass index) or body composition by means of electrical impedance analysis.
    • BMI ≥ 25 → participation in a medically supervised weight loss program.
    • Falling below the BMI lower limit (from the age of 45: 22; from the age of 55: 23; from the age of 65: 24) → Participation in a medically supervised program for the underweight.

Palliative therapy measures

In advanced esophageal cancer, the following measures may be considered:

  • Radiochemotherapy (RCTX) to reduce tumor mass (combination of radiatio (radiation therapy) and chemotherapy).
  • Repeated endoscopic bougienage/dilatation (widening).
  • Argon plasma coagulation therapy for exophytic tumor/share.
  • Insertion of a sheathed stent (support) into the esophagus to maintain food passage
  • Maintenance of food passage by laser therapy.
  • Installation of a percutaneous endoscopic gastrectomy (PEG; endoscopically created artificial access from the outside through the abdominal wall into the stomach).

Vaccinations

The following vaccinations are advised:

  • Flu vaccination
  • Pneumococcal vaccination

Regular checkups

  • Regular follow-up examinations for early detection of recurrence (recurrence of the disease).

Nutritional medicine

  • Nutritional counseling based on nutritional analysis
  • Curative therapy: nutrition therapy and feeding tube, fine needle catheter jejunostomy (FKJ)Patients with severe malnutrition i.e. high metabolic risk should receive nutrition therapy before surgery, even if surgery has to be postponed.
  • Following esophagectomy, enteral nutrition (nutrition via the gastrointestinal tract) should be started within 24 h because of the metabolic risk. Parenteral (“bypassing the intestinal tract”) supplementation may be recommended if less than 60-75% of energy can be provided by enteral means.
  • Dietary recommendations according to a mixed diet, taking into account the general knowledge of nutrition in tumor disease. This means:
    • Consume only limited energy-rich foods.
    • Moderate total fat intake
    • Little red meat (pork, beef, lamb, veal) and sausages.
    • Once or twice a week fresh sea fish, ie fatty marine fish (omega-3 fatty acids) such as salmon, herring, mackerel.
    • High-fiber diet (whole grains, vegetables).
    • Daily total of 5 servings of fresh vegetables and fruits (≥ 400 g; 3 servings of vegetables and 2 servings of fruit).
    • Refrain from contaminated foods such as offal and wild mushrooms
  • Observe the following special dietary recommendations:
    • Reduce consumption of smoked and cured foods, because they contain nitrate or nitrite as a component of curing salt. Their preparation produces compounds (nitrosamines) that are risk factors for esophageal cancer (cancer of the esophagus).
    • Do not eat moldy food – molds form toxic substances such as aflatoxin B and other mycotoxins.
    • Do not drink drinks too hot
    • Avoid hot and spicy foods
    • Be careful with mechanically irritating / injurious food components such as millet husks.
    • Diet rich in:
  • Selection of appropriate food based on the nutritional analysis
  • See also under “Therapy with micronutrients (vital substances)” – if necessary, taking a suitable dietary supplement.
  • Detailed information on nutritional medicine you will receive from us.

Sports Medicine

  • Endurance training (cardio training) and strength training (muscle training).
    • In general, endurance training on a bicycle ergometer can be recommended, which is performed according to the principle of interval training.This means that load phases lasting 1 to 3 minutes alternate with rest phases also lasting 1 to 3 minutes. The training should be performed at about 80% of the maximum heart rate for a total of 30 minutes.
  • Preparation of a fitness or training plan with suitable sports disciplines based on a medical check (health check or athlete check).
  • Detailed information on sports medicine you will receive from us.

Psychotherapy