Esophageal Cancer Nutritional Therapy
Our goal at Virginia Mason is to provide state-of-the-art nutritional therapy throughout a patient's treatment and recovery. Nutrition, always essential to maintaining good health, becomes especially important after major surgery and other cancer treatments.
The journey to recovery following an esophagectomy involves several gradual steps before returning to normal (or nearly normal) eating. Each individual is unique, so “one size fits all” does not apply to a nutrition plan. Everyone progresses through the recovery at his or her own pace.
After Esophagectomy Surgery
A registered dietitian visits every patient soon after an esophagectomy. Working with a team of physicians, nurses and Nutrition Services team members, the dietitian monitors the nutrition of each esophagectomy patient while in the hospital. In addition, the dietitian educates the patient and their caregivers about nutrition at home for the best recovery.
The dietitian focuses on two main goals for nutrition care:
The dietitian assess a patient's nutrition needs, determining how many calories are needed to heal while achieving or maintaining a healthy weight. They make recommendations for nutrition support and monitor nutritional status throughout the patient's hospitalization.
The dietitian coordinates the smooth transition from hospital to home. They ensure the patient and their caregivers understand the patient's nutritional needs, and feel comfortable about providing nutrition support at home.
Nutrition at Home
All diets are individualized for each person's distinctive needs. The dietitian provides the patient-specific, detailed guidelines after surgery. In general, the diet begins with a liquid diet, then changes to pureed, continuing to increase to soft solid foods until normal textures are tolerated.
The time to progress from liquids to normal textures varies from person to person, but it is about three to six months before returning to a normal or nearly normal diet.
A period of time for healing is necessary before a patient can eat an adequate quantity of food and resume regular textures. This is especially true if radiation or chemotherapy have preceded surgery.
During surgery the surgeon places a feeding tube into a part of the intestine, called the jejunum. This feeding tube is used to provide nutrition within a few days after surgery. This is called “enteral” feeding or “tube feedings.” For most patients, tube feedings start with formula given over a period of 24 hours. Feedings transition by decreasing the time the enteral formula is given, and increasing its volume.
For most patients, the goal at home is to get all the nutrition needed from enteral feeds during the night. This allows time during the day to resume normal activities, without enteral feedings. Normal activities can be resumed (as tolerated) with a feeding tube in place. It does not stop patients from doing any of their favorite activities, such as hiking, swimming, riding a bicycle, or any other activity allowed by the surgeon.
During this time, the texture of food taken by mouth increases. When the amounts of food are able to increase, the enteral feedings are tapered off gradually, and are then eventually discontinued. The timeframe for this varies, and may be affected by other cancer treatments after surgery, such as radiation or chemotherapy.
To learn more about nutrition after esophageal cancer treatment, please call (206) 223-6193.