Eating problems with oesophageal cancer
Oesophageal cancer can cause problems with swallowing and make it hard to eat well. It’s important to eat and drink enough calories and protein to maintain your weight and strength.
There will be a dietitian in the team looking after you. They can help you cope with eating problems and suggest ways of dealing with diet difficulties.
Who can help?
Dietitians can help you cope with eating problems and suggest ways of dealing with diet difficulties. There will be a dietitian in your hospital team. If you haven't seen them, ask your doctor or nurse to refer you. The dietitian can support you from diagnosis, through treatment and afterwards.
If you are having trouble swallowing, you might also see a speech and language therapist (SLT). An SLT can assess your swallowing during and after treatment. They can teach exercises to support you with swallowing difficulties.
Eating problems can be difficult to cope with. They can cause tension within relationships or families. Social events and eating out of the house with friends can be much harder when you have a problem swallowing. Talking to your dietitian or a counsellor can help.
Try and maintain your weight during treatment. This is a good sign that your body is getting all the nutrients it needs. It is important to get help even before you have any problems.
Eating when swallowing is difficult
There are ways to help if you find swallowing difficult:
- eat small amounts more often
- eat soft, moist foods
- eat slowly and chew your food well
- take sips of a drink between mouthfuls
- try to make the most of the times during the day that you feel able to eat
Making a few changes to what you’re eating can help you to eat a variety of different foods.
Soft diet suggestions
A soft diet can help you eat more comfortably. Try scrambled egg, soups and mashed potato. You can also:
- use sauces, cream and gravies to moisten food and make it easier to swallow
- soften meat and vegetables with long, slow cooking
- finely chop meat and vegetables in a food processor before or after cooking
- blend or process meat or vegetable casseroles or curries to make soups
- make fruit smoothies or milkshakes in a blender
- try tinned fruit and add custard or cream
- have ice cream, yoghurts and mousse
Foods that can be difficult to eat
Avoid foods that are hard to swallow and might stick in your throat, like:
- raw fruit and vegetables
- tough meat
- soft, doughy bread
- dry or crispy foods
How to build yourself up
You can help to maintain your weight by adding calories to everyday foods. You can:
- have soft cereal for breakfast – add honey or sugar and cream or whole milk
- make instant soups or gravies with milk instead of water
- mix mashed potato with butter, grated cheese, or cream
- make drinks like coffee or hot chocolate with all milk instead of water and preferably whole milk
- drink liquid food supplements such as Complan and Meritene - sip them throughout the day
- make ice lollies or ice creams out of smoothies or liquid food supplements
Try to increase your protein intake
You can do this by:
- adding a couple of teaspoons of dried milk powder or vegan powder to each pint of milk to use like ordinary milk for drinking and cooking
- aiming to have some soft meat, Quorn, tofu, fish, beans or eggs at least twice a day
Liquid food supplements can be helpful if you are finding this difficult. Ask your dietitian for advice on which ones are best – some are available on prescription.
Feeding tubes
You may need a feeding tube down your nose or put into your small bowel if you can’t eat and drink enough. You can go home with the feeding tube in place. Your team will teach you or your carer how to use the tube once you're at home.
Eating after surgery
Your eating may return to normal after a few months. But this can take time, especially if you need more treatment after your surgery. For some people, it takes up to 2 years.
It can help to eat smaller meals about 6 to 8 times a day if you've had surgery to remove your oesophagus and part of your stomach. You’ll also need to eat slowly and chew food well or have a soft diet. Some people find certain foods uncomfortable to eat. You can choose not to eat these foods.
This video tells you how to eat well after surgery for oesophageal cancer. It lasts for 3 minutes and 31 seconds.
Eating after surgery for cancer of the oesophagus or stomach - Transcript
Voiceover: Eating is a very social thing. But surgery to your oesophagus or stomach can mean that when and how you eat is different. So, to carry on enjoying food and stay well, what changes do you need to make?
Catherine: After your operation, while you’re still in hospital, you’ll have plenty of support from people like me. We’ll help you to gradually build up what you’re able to eat and drink. However when you go home things may be a bit more difficult.
Voiceover: You will find that after your surgery, the amount of food and drink you can manage at any one time will be less.
Catherine: In general we tend to find that people cope best if they have 6 to 7 small meals or snacks each day, avoiding long gaps between eating and drinking. So that you don’t tire yourself out, have a selection of foods that are ready prepared that are quick and easy to get ready for you to eat when you fancy them.
So thinking about how you should actually eat. Make sure you’re relaxed and calm, chew, take it nice and slowly, and also try to make sure that you’re sitting upright when you’re eating. And avoid lying down too soon after eating. Drinks can be very filling, so it’s important to avoid drinking for about 15 to 30 minutes before you eat.
Voiceover: Generally, you can carry on eating what you like, just in smaller portions. But making a few changes can help you to overcome problems like poor appetite and weight loss.
Catherine: So this is what we suggest. Graze on high energy foods throughout the day. Choose foods that are full fat and avoid anything that’s labelled as diet or low in fat. You can also try enriching your favourite foods with things like cream, cheese, butter, sugar and honey.
Voiceover: Sometimes people find eating difficult because of issues like feeling sick, having diarrhoea or reflux.
Catherine: So making a few changes can really help to control these symptoms. Don’t rush your meals, chew well and try taking smaller portions more frequently. If you’re having a problem with reflux make sure that you don’t eat too late at night and try sleeping propped up with some pillows. Continue eating and drinking even if you have diarrhoea, as this will help to control your bowels and will keep you hydrated. But remember if any of these issues continue for more than a couple of days contact your doctor or your specialist nurse, as there are medications that you can be given to help control these.
Voiceover: While it’s good to eat and drink, taking too much food or fluid in one go, particularly sugary foods, can sometimes cause diarrhoea, bloating, sweating and palpitations – this is known as dumping syndrome.
Catherine: So it may help to eat little and often. And to have sugary foods and drinks in small portions as part of mealtimes rather than outside of mealtimes. Again, if you have any problems, so contact your doctor or your dietitian. Most people do have some problems after their surgery. But with time you will find that you’ll get back to eating and drinking, and enjoy your food again.
You may have problems after surgery to remove your oesophagus. These include:
- dumping syndrome (feeling faint and dizzy after eating)
- diarrhoea
- feeling or being sick
- indigestion and stomach pains
- difficulty swallowing
- acid from your stomach coming back up (reflux) into the oesophagus when you lie flat
- coughing at night time
- feeling full after eating small amounts
- low levels of minerals and vitamins which might make you tired
Talk to your healthcare team about any problems you are having. They may be able to prescribe medicines to relieve these symptoms and suggest other things that can help.
Eating after radiotherapy
During radiotherapy and for a few weeks or months afterwards, you may find it hard to swallow. You will also have some soreness and pain when you swallow.
Eating a soft or blended diet helps, as well as taking painkillers before you eat.
