Seeking input on experiences with stent versus other methods to eat

Posted by justtrust @justtrust, Aug 24, 2023

Due to a tumour, my husband is able to swallow only a liquid (and sometimes mash) diet.

We’re considering placement of a stent. I’ve read several comments on this platform related to stents and many have not been very positive.

I’d like to hear more stories and information (whether positive or negative) about experiences with esophageal stents.

Thanks for your time!

Interested in more discussions like this? Go to the Esophageal Cancer Support Group.

I would need to know more of his journey... what stage esophageal cancer... where is he relative to treatments, being surgery eligible or not... etc.

True... I've talked with hundreds of my fellow EC patients... and also true that I'm not a fan of stents. But there is a reason... even though I can find a couple of reasons (or instances) whet their use is justified.

First off, being able to swallow (whether at all, or even just a little) while in the early phases of our EC journeys... is just a nicety... not really necessary... but it does make us feel better! How do I know this? Because like many, I too was there. Upon being diagnosed, I was not swallowing too well. So... they installed a J tube the very next week, still 3 weeks before my first chemo and radiation treatment began. And as my treatments were starting, I could no longer swallow a sip of water! But my doctors did not care... I had a feeding tube, it was working, I could take in calories and hydration... so suck it up buttercup! And I was lucky... this condition only lasted 2 to 3 weeks... and then my treatments opened up my throat enough where I could start swallowing some once again... it was like heaven! I no longer used my J tube the last 6 weeks leading up to my esophagectomy. Just pushed a little water thru it daily to be sure it stayed clear. I knew I'd be back on it the day after surgery. All in all, I had my J tube for 8 months, 4 before surgery, 4 after. It was just a tool and it served its purpose until it was no longer needed. Ok... back to stents...

Maybe not so much in America, but I do talk to many all over the world. And in general, in most nationalized health service countries, these feeding tubes are not provided... and a quick stretch or stent is popped in, in order to provide the patient some desired relief. Now this is just fine... as long as two things are seen... are predictable. One... this temporary stretch will hold until the patient can make it to his surgery date... and two... the stent or stretch is possible, does not cause a perforation, and does not migrate, stays in place, and not fall into the stomach (I've seen this many times).

So why are these options used (as opposed to a permanent feeding tube)? My guess is cost, qualified personnel to perform J tube (or G tube) surgeries, as well as hospital space to perform these operations and house the patient for an overnight stay. This cost is enormous when compared to getting a stretch or popping in a stent, which are done during less expensive endoscopy procedures.

Now... are J tube installations simple and without risk? Will they always work, patients will not be allergic to the feed materials, no leaks, etc? Well no... There can be issues since this is indeed a surgery, and it does take a week or two to get over the pain of this operation (they do put a few laparoscopic holes in our abdomens!).

But to me there's a difference in the thought process as to care, long term care, for the patient. When first diagnosed, my doctors knew this can be a long journey, and they want to give me the best chance at making it thru everything... chemo, radiation, surgery, immunotherapy. This feeding tube would serve me well... and improve my chances greatly should my treatments work, I do get to surgery, and my post-op journey goes smoothly without a recurrence. So far so good as I am now past 3 years post-op.

So again, it depends on where you are on your EC journey... still going thru treatments? Now post-op? Stage 4 with major spread and no hope? Is this just for palliative use... some short term relief... just to make the patient feel better? Because stents are still short term solutions... and they can migrate, and I've seen tumors engulf them as well. Getting them out can sometimes be problematic.

Anyways, more to discuss... contact me privately if you'd like to chat. You can have my cell number. Be well,

Gary

REPLY

My husband had a stent put in last March. It was a game changer! Before the stent he was going in for stretching of his esophagus about every 6-8 weeks. And his only way of eating was via his J-tube.
He is now on his 2nd round of chemo and with that comes nausea. He’s started to vomit black (blood mixed with stomach acids). His endoscopy this week found “tissue in-growth” which is his tissue growing through the mesh in the stent. He will have another procedure to either remove or replace the stent. It will be an in-procedure decision.
While this is not ideal to have to go back in and deal with the issues, for us it’s worth it for him to be able to eat orally.

REPLY
@mrgvw

I would need to know more of his journey... what stage esophageal cancer... where is he relative to treatments, being surgery eligible or not... etc.

True... I've talked with hundreds of my fellow EC patients... and also true that I'm not a fan of stents. But there is a reason... even though I can find a couple of reasons (or instances) whet their use is justified.

First off, being able to swallow (whether at all, or even just a little) while in the early phases of our EC journeys... is just a nicety... not really necessary... but it does make us feel better! How do I know this? Because like many, I too was there. Upon being diagnosed, I was not swallowing too well. So... they installed a J tube the very next week, still 3 weeks before my first chemo and radiation treatment began. And as my treatments were starting, I could no longer swallow a sip of water! But my doctors did not care... I had a feeding tube, it was working, I could take in calories and hydration... so suck it up buttercup! And I was lucky... this condition only lasted 2 to 3 weeks... and then my treatments opened up my throat enough where I could start swallowing some once again... it was like heaven! I no longer used my J tube the last 6 weeks leading up to my esophagectomy. Just pushed a little water thru it daily to be sure it stayed clear. I knew I'd be back on it the day after surgery. All in all, I had my J tube for 8 months, 4 before surgery, 4 after. It was just a tool and it served its purpose until it was no longer needed. Ok... back to stents...

Maybe not so much in America, but I do talk to many all over the world. And in general, in most nationalized health service countries, these feeding tubes are not provided... and a quick stretch or stent is popped in, in order to provide the patient some desired relief. Now this is just fine... as long as two things are seen... are predictable. One... this temporary stretch will hold until the patient can make it to his surgery date... and two... the stent or stretch is possible, does not cause a perforation, and does not migrate, stays in place, and not fall into the stomach (I've seen this many times).

So why are these options used (as opposed to a permanent feeding tube)? My guess is cost, qualified personnel to perform J tube (or G tube) surgeries, as well as hospital space to perform these operations and house the patient for an overnight stay. This cost is enormous when compared to getting a stretch or popping in a stent, which are done during less expensive endoscopy procedures.

Now... are J tube installations simple and without risk? Will they always work, patients will not be allergic to the feed materials, no leaks, etc? Well no... There can be issues since this is indeed a surgery, and it does take a week or two to get over the pain of this operation (they do put a few laparoscopic holes in our abdomens!).

But to me there's a difference in the thought process as to care, long term care, for the patient. When first diagnosed, my doctors knew this can be a long journey, and they want to give me the best chance at making it thru everything... chemo, radiation, surgery, immunotherapy. This feeding tube would serve me well... and improve my chances greatly should my treatments work, I do get to surgery, and my post-op journey goes smoothly without a recurrence. So far so good as I am now past 3 years post-op.

So again, it depends on where you are on your EC journey... still going thru treatments? Now post-op? Stage 4 with major spread and no hope? Is this just for palliative use... some short term relief... just to make the patient feel better? Because stents are still short term solutions... and they can migrate, and I've seen tumors engulf them as well. Getting them out can sometimes be problematic.

Anyways, more to discuss... contact me privately if you'd like to chat. You can have my cell number. Be well,

Gary

Jump to this post

Thank you so much for sharing your knowledge & experience and being willing to connect further.

In a way, we’ve just started the journey.
While my husband has been facing dysphagia since early 2023, we’ve just received the EC diagnosis as of approximately July 26 (he had his endoscopy that day and while we didn’t receive results immediately, the way they rushed him to a CT scan and then PET—we knew something serious was up).
We haven’t yet met with Oncologists, but have learned that surgery is not currently an option.

Still processing all of this—as I’m sure we will be for many days.
Appreciate your time in sending an answer.

REPLY
@socalkelly

My husband had a stent put in last March. It was a game changer! Before the stent he was going in for stretching of his esophagus about every 6-8 weeks. And his only way of eating was via his J-tube.
He is now on his 2nd round of chemo and with that comes nausea. He’s started to vomit black (blood mixed with stomach acids). His endoscopy this week found “tissue in-growth” which is his tissue growing through the mesh in the stent. He will have another procedure to either remove or replace the stent. It will be an in-procedure decision.
While this is not ideal to have to go back in and deal with the issues, for us it’s worth it for him to be able to eat orally.

Jump to this post

Thank you so much for sharing both the pros and cons of your husband’s experience with a stent.
It helps us consider whether it would be worth it for our situation.

I’m sorry to hear about the difficult experiences he’s facing. It strikes me that a lot of these experiences seem unimaginable before you’re ever on a journey like this. Once you embark, it seems like they become somehow bearable (I mean, what choice do we really have). I don’t say this tritely. But how absolutely resilient and adaptable we are as human beings.

Sending prayers for your husband and family’s wellbeing.

REPLY

I have ec and a stent was placed in my esophagus April 2023 due to not eating or drinking. It migrated to my stomach . It didn’t help. I the got a j-tube and have it currently. I have an appointment to get it removed I eat most foods and can maintain my weight.

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@lcasry

I have ec and a stent was placed in my esophagus April 2023 due to not eating or drinking. It migrated to my stomach . It didn’t help. I the got a j-tube and have it currently. I have an appointment to get it removed I eat most foods and can maintain my weight.

Jump to this post

So... your stent is long gone now? And why is that... treatments worked? Or got to surgery already? But seems this would be a tad premature to have it out already.

Anyway... hope you are doing well.

Gary

REPLY
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