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Mesothelioma and Dysphagia

Dysphagia is a possible, although not common symptom of pleural mesothelioma. It is most often associated with extended growth of tumors in the chest cavity and with metastatic mesothelioma. Dysphagia means having difficulty swallowing, which can be uncomfortable and painful, and can also have an impact on weight, nutrition, and quality of life, even causing respiratory infections.

If you are living with mesothelioma and have begun to experience  the symptom of dysphagia, your oncologist may want to examine you and conduct imaging tests to look for metastases or to see how far your original tumor has grown. Treatments may help, but there are also simple steps you can take in how and what you eat that will make getting adequate nutrition easier if your dysphagia is not too severe.

What is Dysphagia?

Having dysphagia means difficulty swallowing and that you need more time and effort to swallow something. What was once something you rarely even thought about has become a chore and sometimes even painful. It may be obvious if you are experiencing dysphagia, but if it is not too severe your symptoms may be mild and less obvious. You may have a feeling of food getting stuck in your throat or chest; you may drool more or have a hoarse voice; you may have more heartburn, acid reflux, and regurgitation of food; and you may find yourself avoiding certain foods that have become uncomfortable to eat.

Complications of Dysphagia

It is important to address this symptom because it can cause complications that can become severe. Tell your doctor or oncologist if you are having difficulty swallowing. If it goes untreated or if you do not learn eating modifications to work around dysphagia, you can lose weight, become malnourished, or become dehydrated. Other potential complications include respiratory difficulties. Having trouble swallowing food can lead to food in the airways, which in turn can lead to upper respiratory infections or pneumonia. All of these complications have the potential to be serious, especially in someone whose health is already compromised.

How Mesothelioma Causes Dysphagia

Dysphagia is not a common symptom in the early stages of mesothelioma. It most often occurs in later stages as the tumors in the chest cavity grow and spread or metastasize. The esophagus is the tube that leads from the mouth to the stomach and food and liquids must move down it to get to the digestive tract. When tumors grow toward the esophagus and press against it, they can compress it and restrict movement of foods and liquids. A tumor may also grow directly into the esophagus, also causing dysphagia.

A few cases have been reported of patients presenting with dysphagia as the symptom that leads to a diagnosis of mesothelioma. It is rare, as most patients will first experience chest pains, difficulty breathing, coughing, and other symptoms that lead to a doctor’s visit and diagnosis. However, in rare cases, a tumor may grow close to the esophagus or a patient may not get a diagnosis until the cancer is advanced enough to affect the esophagus.

Treatment for Dysphagia

Experiencing difficulty swallowing is uncomfortable, but it also has a ripple effect on health. If you struggle to swallow, and even have pain while trying to swallow, it makes eating much more difficult. You may not eat as much as you would like, and when you do eat, you may turn to the same few foods that are easier to eat. The result of this can be weight loss and malnutrition. Treatment of dysphagia is important for these reason, but also to make life more enjoyable and as part of palliative care, even if the underlying cancer cannot be cured.

Treatment strategies depend on the extent of the dysphagia. Lifestyle and dietary changes may help early on, but when those fail to be effective, medical treatments may be necessary. Surgery may be used to remove part of the tumor and to restore flow through the esophagus, for instance, but this may be limited depending on a patient’s overall health. In severe cases of dysphagia, especially for patients in the hospital or hospice, a feeding tube can be used to maintain nutrition.

Coping with Dysphagia

In addition to medical treatment there are ways that you can eat, and a variety of foods that you can eat to overcome the issues associated with dysphagia. You can make eating easier by sitting upright with good posture when swallowing and eating smaller meals every few hours instead of trying to eat two or three big meals per day. Try eating colder or room temperature foods instead of hot foods, which can irritate your throat. Straws can also be helpful for eating liquid meals as opposed to drinking them out of a glass.

Any food that is smooth and liquid will be easiest to eat, but this doesn’t mean that you can only eat ice cream, milkshakes, and popsicles. To get better nutrition try things like smoothies, which blend together dairy products, fruits, vegetables, and nutritional supplements. These are easy to swallow and are packed with nutrition if made with a variety of foods. Soups are also great, especially blended soups. For protein, foods like scrambled eggs, cottage cheese, and yogurt are easy to swallow. If you still struggle to get adequate nutrition or to get anything down, talk to your doctor about working with a dietician or physical therapist.

Living with mesothelioma is challenging because of symptoms like dysphagia. When you can no longer enjoy food or drink, life becomes less enjoyable. When the inability to eat or drink causes things like dangerous weight loss, malnutrition, infections, and dehydration, dysphagia can cause your health to deteriorate significantly. Monitor your symptoms carefully and always talk to your doctor when you notice something new. Dysphagia can be managed so that you can continue to get good nutrition and continue to fight mesothelioma.

Page edited by Dave Foster

Dave has been a mesothelioma Patient Advocate for over 10 years. He consistently attends all major national and international mesothelioma meetings. In doing so, he is able to stay on top of the latest treatments, clinical trials, and research results. He also personally meets with mesothelioma patients and their families and connects them with the best medical specialists and legal representatives available.

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