Stent or no stent?

Dr. N. recently reminded us that a stent could be placed in E.'s esophagus if swallowing became too difficult.

An esophageal stent is a tube (can be plastic, silicone or metal) placed in the esophagus to keep a blocked area (specifically, the area with the tumor) open so that the patient can swallow food and liquids. While a stent does not “treat” cancer, it does offer “palliative care” and can make the patient more comfortable.

And so the discussion began . . .

Right now, E. does have difficulty swallowing (especially foods such as meat or bread), but he indicates it is not horrible.

Is having a procedure at this point necessary?

Should he subject his body to a procedure if it is unnecessary?

Would it be better to undergo a procedure now while his body isn’t weakened from radiation and/or chemotherapy?

Would a procedure weaken his body unnecessarily or would it be helpful to have a stent so he could get extra nutrition and calories now before facing harsh treatment?

Do the potential benefits of the surgery outweigh the possible risks and complications? Or, could the procedure make things worse?

In reading about other people’s stent experiences, we have discovered that for some people, their quality of life has greatly improved and they enjoyed eating again. But for other people, the stent proved to be painful and uncomfortable. Additionally, in rare cases, the stent can “slip” requiring yet another surgery, or the tumor can grow over the stent, causing even more complications.

One alternative to a stent might eventually be a feeding tube. Most people think of feeding tubes (NG tubes) that go through the mouth, down the throat and to the stomach. These are usually the kind of feeding tubes that a patient would have while in the hospital. The other kind of feeding tube is the “G tube” which is surgically implanted into the abdomen and liquid nutrients are fed through the port. While a patient would obtain necessary nutrients and calories via a feeding tube, they would no longer have the pleasure of eating “real” food. And we all know how much E. enjoys good food!

So today, we have another appointment with Dr. N. to discuss the pros and cons of a possible stent. Hopefully we can gather enough information that E. can make his decision with nothing but confidence that it is right for him.

S.