Patients with advanced cancer may face many painful things, such as cancer pain, weakness, poor appetite, and depressed mood. In advanced stages of esophageal cancer, you may also be unable to eat or drink at all. To ease your pain and improve your quality of life, doctors have come up with many ways to do this, which fall under the umbrella of palliative care (also called hospice and palliative medicine).
What is palliative care?
The main goal of palliative care for cancer is to improve quality of life; the main task is to relieve symptoms and complications due to cancer and treatment, and to relieve physical and mental suffering.
Palliative care approaches include symptom relief and supportive care, as well as palliative antitumor therapy. For patients with advanced and end-stage disease, “best supportive care”, with symptom relief as the primary goal, is the only treatment you are likely to tolerate and benefit from.
Palliative antitumor therapy, including palliative surgery, palliative radiation therapy, and palliative antitumor drugs.
- Palliative surgery: When life-threatening symptoms such as hemorrhage, severe obstruction, or perforation occur, palliative surgery can be performed to bring you back from the line of life and death;
- Palliative radiotherapy: can be used for pain due to severe dysphagia or bone metastases in advanced esophageal cancer;
- Palliative antitumor drug therapy: you can use some relatively low-toxic chemotherapy drugs, molecular targeted drugs, etc., to improve your survival with tumor to some extent.
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What are some ways that doctors can help me to reduce my pain?
Swallowing disorders and malnutrition
Swallowing disorders are the number one problem that plagues patients with advanced esophageal cancer.
You should try to avoid solid or harder foods and switch to a semi-liquid or liquid diet, such as noodles and porridge. If the esophageal lumen is narrowed to a certain point or even blocked, doctors will use esophageal stents, create tube feeding access, and other means.
Patients with esophageal cancer are more likely to suffer from malnutrition due to eating disorders, which may accelerate disease progression and reduce quality of life.
National and international guidelines recommend early detection of nutritional imbalances and recommend that patients’ nutritional intake, weight change, and body mass index (BMI) be assessed regularly starting at the time of tumor diagnosis and repeated depending on the specific condition. This assessment can be performed by a professional health manager, such as a nutritionist.
Pain
Cancer pain is currently treated according to the three-step analgesic regimen proposed by the WHO: non-steroidal anti-inflammatory drugs (e.g., aspirin), weak opioids (e.g., codeine), and strong opioids (e.g., morphine), alone and/or in combination with other adjuvants as needed, depending on the extent, nature, and cause of the pain. Doing so provides relief in more than 80% of patients with cancer pain.
It is important to remember that you should use analgesics under the supervision of your doctor. Only when standard first-step therapy has failed should you start second-step therapy, and so on. If you have reached moderate to severe cancer pain at the time of your visit, you can apply opioids directly.
For advanced patients with symptoms such as nausea, vomiting, dyspnea, insomnia, depression, anxiety, etc., physicians can also use appropriate medications for symptomatic management. However, these medications need to be prescribed for you by your doctor and are not recommended for you or your family to purchase on your own.
Non-pharmacological therapies, such as music therapy and speech therapy, also play a positive role in treating your trauma. It is recommended to seek the help of a psychiatrist.