Supportive Therapy in Esophageal Cancer

<p>Introduction: Esophageal cancer is one of the ten most common cancers globally with a high mortality rate. The etiology is multifactorial, non-hereditary risk factors are smoking, alcohol consumption, obesity, and hereditary risk factors are Lynch syndrome, Plummer-Vinson syndrome, Peutz-Jaegers syndrome, and Li-Fraumeni syndrome. The treatment is multidisciplinary, and combined, chemotherapy, radiotherapy, immunotherapy, and surgery are applied. From the moment of diagnosis, supportive therapy is necessary to alleviate and eliminate the symptoms of the disease. Dysphagia is present in almost all patients with esophageal cancer. A loss greater than 5% of total body weight is associated with a worse prognosis. Discomfort and vague chest pain, hoarseness, cough, and sore throat are less common. Locally invasive tumors cause other symptoms such as hematemesis, hemoptysis, melena, dyspnea, cough, and pleural effusion. Horner's syndrome and superior vena cava syndrome may also occur in advanced tumors. The involvement of large blood vessels can lead to fatal bleeding. In the case of metastatic disease, different symptoms may be present depending on the location. Objective: The objective of this literature review is to indicate the importance of supportive therapy in the treatment of patients with esophageal cancer. Supportive therapy in esophageal cancer: The purpose of good supportive therapy is to ensure the best possible quality of life for patients. In esophageal cancer, the reduction of symptoms significantly contributes to the extension of life. Esophageal cancer treatment is actually the treatment of symptoms. Given that the most common symptom of these cancers is dysphagia, treatment of the underlying disease will also lead to an improvement in symptoms. Patients who have a complete or severe obstruction at any level of the esophagus must be provided with adequate nutrition. Oral nutrition contributes to a better quality of life. Before starting pain therapy, it is necessary to assess the cause and characteristics of pain. A step-by-step approach involves the gradual introduction of analgesic therapy. Dosing of opioids and determining the therapeutic dose should be in accordance with the current guidelines of the World Health Organization. Conclusion: supportive therapy contributes to longer survival in esophageal cancer at an advanced stage of the disease, and better tolerance of aggressive treatment regimens, reducing the toxicity, which leads to improved quality of life.</p>