Cancer Management and Research (Nov 2022)
Optimal Management of Dysphagia in Patients with Inoperable Esophageal Cancer: Current Perspectives
Abstract
Sonmoon Mohapatra,1 Aadhithyaraman Santharaman,2 Krista Gomez,3 Rahul Pannala,1 Toufic Kachaamy3 1Department of Gastroenterology and Hepatology, Mayo Clinic, Phoenix, AZ, 85054, USA; 2Department of Internal Medicine, Saint Peter’s University Hospital, Rutgers Robert Wood Johnson School of Medicine, New Brunswick, NJ, 08901, USA; 3Department of Gastroenterology and Hepatology, Cancer Treatment Centers of America, Phoenix, AZ, 85338, USACorrespondence: Toufic Kachaamy, Cancer Treatment Centers of America, Phoenix, AZ, 85338, USA, Tel +1 919-451-5404, Fax +1 623-932-8633, Email [email protected]: The majority of patients with esophageal cancer are diagnosed at an advanced, incurable stage. Palliation of symptoms, specifically dysphagia, is a crucial component to improve quality of life and optimize nutritional status. Despite multiple available treatment modalities, there is not one accepted or recommended to be the preferred treatment option. Palliative management is often decided by a multidisciplinary team considering factors including local availability, preference, patient life expectancy, and symptom severity. Systemic therapies such as chemotherapy are the most commonly used palliative modalities. Oncologists are most familiar with radiation for dysphagia palliation, especially for advanced metastatic cancer patients with good performance status. One common approach used by endoscopist is self-expandable metal stents. This is preferred for patients with short-term survival and poor functional status as it provides rapid relief of dysphagia. Cryotherapy is a relatively new endoscopic ablative modality and appears to be a promising option for dysphagia palliation, but more data is needed for wider adoption. This review summarizes the current literature on endoscopic and non-endoscopic treatment options for malignant dysphagia.Keywords: esophageal cancer, self-expandable metal stent, cryotherapy, external beam radiation therapy
