Swallowing Difficulties

 July 12, 2009

We live in Boston and my husband has been treated for stage IV esophageal adenocarcinoma cancer at Mass. General Hospital. He was diagnosed in Dec. 2008. After two unsuccessful chemotherapies, we finally were able to decrease the tumors that had metastisized in the liver with a combination of erbitux and irinotecan. Fortunately,a recent endoscopy revealed that the tumor at the distal  (bottom) portion of the esophagus has not grown and the probe easily passed through the opening. The problem, however, is that swallowing (in particular the passing of the food down the esophagus) has become a constant problem. My husband experiences fullness and has spasms in the esophagus and then the diaphragm. This leads to powerful hiccups. Our oncologist led us to believe there is not much you can do for that.

Last week we had our first appointment with a gastroenterologist who specializes in motility  (swallowing) disorders. We hope to get some more specific answers as to why he is having so much difficulty eating. It can take 1 to 1 and 1/2 hours to complete a meal as he has to stop frequently until the food goes down or he spits it up. At times, he has had to force himself to throw up part of what he has eaten. He has become anxious about eating and he has said he does not enjoy eating now.

If anyone has had any experience with these difficulties and knows of a specific doctor anywhere in the Northeast or anywhere in the US who has been able to improve these difficulties, I would greatly appreciate any information and or suggestions. We have not jumped to preparing all food in a blender at this time. I am concerned that my husband will start to lose weight, which has not been the case up to now.

I thank you in advance for your help.

Teri

Sorry I don't have much to offer. Husband's swallowing difficulties were due to size of growth at GE junction and were improved when radiation and chemo shrank growth. Hopefully the motility expert will have something to offer. I think I would try some blenderized food in the hope that giving the esophagus a rest might allow it to calm down enough to alleviate the spasming issue. Wonder if there is any type medication that might help with the esophageal spasm? It's good he hasn't lost a lot of weight.

Hi Terry:

My name is Jack.  I began having difficulty swallowing on October 2008 was diagnosed with Cancer and on January 2009 had an esophagectomy.  They rebuilt my esophagus by stretching the stomach. After the surgery I continued on having difficulty swallowing. My gastroenterologyst did two endoscopies in order to stretch my throat and this did help.

My husband has recently finished a first cycle of radiation and chemo and was having difficulity swallowing.  His oncologist prescribed a mixture of benadryl, maalox and licdocaine to be swallowed about 10 minutes before eating to numb the area.  It is fast acting and provides enough relief for him to swallow food and liquids. 

can you give the amounts of each?  We are constantly having to help Jill swallow.  She tends to hold food in her mouth instead of swallowing.  Getting her to take her meds is really hard!

 

On 7/13/2009 Y.Jack.T wrote:

Hi Terry:

My name is Jack.  I began having difficulty swallowing on October 2008 was diagnosed with Cancer and on January 2009 had an esophagectomy.  They rebuilt my esophagus by stretching the stomach. After the surgery I continued on having difficulty swallowing. My gastroenterologyst did two endoscopies in order to stretch my throat and this did help.

Thanks for your note. The physicians have told my husband they will not do an esophagectomy because the cancer metasized to his liver,

 The opening at the bottom of the esophagus appears to be ok. It is the movement of the muscles in the esophagus that spasm....and then the diaphragm spasms that is the problem. Do you know of any aid to this problem besides surgery? Are you in the Northeaster US?

 

 

 

On 7/13/2009 Joanne54 wrote:

My husband has recently finished a first cycle of radiation and chemo and was having difficulity swallowing.  His oncologist prescribed a mixture of benadryl, maalox and licdocaine to be swallowed about 10 minutes before eating to numb the area.  It is fast acting and provides enough relief for him to swallow food and liquids. 

Dear Joanne,

Thank you so much for the information, We atre going to a gastrenterologist for a second visit and we will bring this up.

If you know of any other possible solutions please do not hesitate to let us know. We do appreciate this!!!!!

Teri

 

 

On 7/13/2009 Jills cheerleader wrote:

can you give the amounts of each?  We are constantly having to help Jill swallow.  She tends to hold food in her mouth instead of swallowing.  Getting her to take her meds is really hard!

My husband will take little bites of whatever he feels he can eat. He only swallows part of what is in his mouth at a time. Pills are not a problem at this time. Any solutions to the swallowing suggested by your physician?

Thanks,

Teri

 

Teri I am from Massachusetts and had my surgery at Brigham & Womens on 2 Jan 08 and was a Stage lll. I recently had some problems swallowing and had a barium swallow and it showed nothing wrong. My gastroenterologist gave me a script for REGLAN and I believe he stated it would help. I am presently 18 1/2 months post surgery and have never had a dialation so far, and in no need of one. I have a CT tomorrow and then I will be going every six months for two years and then once a year. I was wondering if you have gone for a second opinion yet and if so, where? I hope you receive more info on this board for I know we have other Stage IV people that I believe had surgery. I wish him the best and please keep trying to receive all the info you can on this sight.  Phil A.

There are drugs to control the hiccups/spasms. I was given chlorpromazine which worked well. Another one is thorazine.