Controlling symptoms, such as difficulty swallowing, is an important part of treatment for many persons with cancer of the esophagus. Italian researchers recently reported improvements in swallowing ability with the use of self-expanding metal stents, which are devices that are placed in the esophagus to help keep it open.
Cancer of the esophagus is characterized by the presence of cancerous cells in the esophagus, the tube that connects the throat to the stomach. There are different types of cancer of the esophagus, including squamous cell cancer and adenocarcinoma. The treatment of esophageal cancer depends on the type and stage of disease. Treatment goals are often focused not only on prolonging survival time, but also on alleviating the symptoms of disease, such as difficulty passing food through the esophagus. The use of metal devices, called stents, has recently been employed to help with this symptom. The stents are placed width-wise in the esophagus, over the area of the cancerous tumor. The stents are self-expanding so as to be more effective in keeping the esophagus open and allow swallowing.
Italian researchers used stents to help alleviate difficulty swallowing in 160 persons with esophageal cancer; a traditional tube (intubation) was used in 84 persons, the metallic self-expanding stents in 75 persons. After the surgery, 82 persons underwent chemotherapy and/or radiation therapy as well. The results showed that difficulty swallowing was improved in 97% of the patients, with an average survival time after the procedure of 5 months. Complications occurred in 11% of patients, including 4 dislodgements of the device, 4 incomplete expansions, 2 perforations, and 2 hemorrhages. Eleven percent of the patients, all of whom underwent the traditional intubation, died in the hospital.
The researchers concluded that intubation is a relatively safe procedure that can be performed with few complications. Furthermore, the use of metallic, self-expanding stents have enhanced this procedure and have provided an alternative for persons in whom placement of the traditional tube is difficult or technically impossible. Individuals with esophageal cancer who are having difficulty swallowing may wish to talk with their doctor about the risks and benefits of the therapies currently available for relief of this symptom. In addition, participating in a clinical trial in which other promising new treatment regimens are being studied may be a consideration. (
Endoscopy, Vol 29, No 8, pp 701-709, 1997)