1. < Esophageal Cancer

NG feeding tube before radiation symptoms begin? Or when?

Posted by asapienlessordinary @asapienlessordinary, Mar 31 1:33am

I’ve started on radiation therapy and completed a week. They have not suggested any chemo for me.

Do those on radiation therapy alone always get a feeding tube? Is it put only after difficulty in swallowing begins or even before that in anticipation? If it is put only after, is there an increased risk of bleeding as the esophagus is already inflamed?

Thanks so much!

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Mentor
Don Higgins, Volunteer Mentor | @dsh33782 | Mar 31 6:34am

asapienlessordinary
I got my feeding tube during treatment because I could not swallow and did not have any appetite. I had it for several months during treatment to keep me nourished. It doesn;t hurt and it did help keep me from losing more weight. Do you have a feeding tube now?
Don

REPLY
2 replies
mrgvw | @mrgvw | Mar 31 6:55am

Can't be sure your exact data... age, cancer type, tumor location, etc. What matters most however is your ability to prevent more weight loss (if you've already seen a significant amount of weight loss). There are a few ways to feed yourself... thru an NG tube, PICC line, IV, G tube, or J tube, or getting a stretch or getting a stent.

Not all of these are feasible depending on your solid tumor's obstruction of your esophagus. If you are already having a difficult time swallowing (as I once was)... and they can't even pass a pediatric endoscope by the tumor... then getting an NG tube past this obstruction may also be a lost cause. And yes, tumor bleeds can happen... and a stretch is most likely out of the question and stent placement on top of the tumor not such a great idea. TPN feeding can be done, but depends on the setting and time frame for it's use. I tend to think of TPN feeding as more short-term. If you are possibly heading to surgery one day, then I prefer a J tube, as it can be used for as long as you need it. It's just a tool to serve you until you no longer need it... it pops out in 30 seconds, no surgery required to remove it. A G tube can also provide consistent long-term feeding... and if stage 4, this might be the way to go as they won't care about putting a hole in your stomach.

I don't look at the use of any of these feeding methods as being more or less favorable depending on whether you are doing chemo, radiation, immunotherapy, or any combination of these. When you need calories and hydration... this is a must regardless... or you will become weaker and lose so much weight that treatments must stop. So... your doctors must decide what path you are on towards treating your EC, combined with the present state inside your esophagus, and how dire your feeding situation is at this moment. At diagnosis, I could barely swallow anything... they installed a J tube in me asap... 3 weeks before my chemoradiation treatments even started... now they knew I had a way to feed myself as I made my way thru treatments and on to esophagectomy. I kept my J tube for 8 months... 4 before surgery, and 4 after. This was 5 years ago. Good luck.

Gary

REPLY
1 reply
asapienlessordinary | @asapienlessordinary | Apr 2 4:31am
In reply to @dsh33782 "asapienlessordinary I got my feeding tube during treatment because I could not swallow and did not..." + (show)
@dsh33782

asapienlessordinary
I got my feeding tube during treatment because I could not swallow and did not have any appetite. I had it for several months during treatment to keep me nourished. It doesn;t hurt and it did help keep me from losing more weight. Do you have a feeding tube now?
Don

Jump to this post

Thanks Don. I don't have a feeding tube yet. Just trying to find out more.

REPLY
asapienlessordinary | @asapienlessordinary | Apr 2 4:34am
In reply to @mrgvw "Can't be sure your exact data... age, cancer type, tumor location, etc. What matters most however..." + (show)
@mrgvw

Can't be sure your exact data... age, cancer type, tumor location, etc. What matters most however is your ability to prevent more weight loss (if you've already seen a significant amount of weight loss). There are a few ways to feed yourself... thru an NG tube, PICC line, IV, G tube, or J tube, or getting a stretch or getting a stent.

Not all of these are feasible depending on your solid tumor's obstruction of your esophagus. If you are already having a difficult time swallowing (as I once was)... and they can't even pass a pediatric endoscope by the tumor... then getting an NG tube past this obstruction may also be a lost cause. And yes, tumor bleeds can happen... and a stretch is most likely out of the question and stent placement on top of the tumor not such a great idea. TPN feeding can be done, but depends on the setting and time frame for it's use. I tend to think of TPN feeding as more short-term. If you are possibly heading to surgery one day, then I prefer a J tube, as it can be used for as long as you need it. It's just a tool to serve you until you no longer need it... it pops out in 30 seconds, no surgery required to remove it. A G tube can also provide consistent long-term feeding... and if stage 4, this might be the way to go as they won't care about putting a hole in your stomach.

I don't look at the use of any of these feeding methods as being more or less favorable depending on whether you are doing chemo, radiation, immunotherapy, or any combination of these. When you need calories and hydration... this is a must regardless... or you will become weaker and lose so much weight that treatments must stop. So... your doctors must decide what path you are on towards treating your EC, combined with the present state inside your esophagus, and how dire your feeding situation is at this moment. At diagnosis, I could barely swallow anything... they installed a J tube in me asap... 3 weeks before my chemoradiation treatments even started... now they knew I had a way to feed myself as I made my way thru treatments and on to esophagectomy. I kept my J tube for 8 months... 4 before surgery, and 4 after. This was 5 years ago. Good luck.

Gary

Jump to this post

Thanks Gary. I am Stage 1-2, non-metastatic, adenocarcinoma at the GE Junction. I just started radiation therapry a week ago. I am not going to be getting chemo or Immunotherapy. It will only be radiation for now. I have not had any weight loss as I do not have any symptoms currently (the tumour was discovered by accident). I have been told by my doc that I might need a tube if I start losing weight so just trying to find out more.

Thanks a ton for the detailed response!

REPLY
josk | @josk | Apr 2 10:21am
In reply to @dsh33782 "asapienlessordinary I got my feeding tube during treatment because I could not swallow and did not..." + (show)
@dsh33782

asapienlessordinary
I got my feeding tube during treatment because I could not swallow and did not have any appetite. I had it for several months during treatment to keep me nourished. It doesn;t hurt and it did help keep me from losing more weight. Do you have a feeding tube now?
Don

Jump to this post

I have my feeding tube prior to starting my 35 rounds of radiation, and it does help and/or very much required - to keep nourished. After a couple of weeks of radiation, swallowing is impossible - even water is near impossible. Even with the feeding tube, I lost 20 lbs during treatment.

jos

REPLY
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