Question

You are a palliative nurse and today you are visiting a 39-year-old woman with cancer of the esophagus.

She has had trouble swallowing since before her diagnosis and has lost more than 40 pounds. She has a
gastrostomy tube (G-tube) inserted for nutrition.
This woman is being cared for by her young family. She has recently transitioned to a PPS of 30%. She is
now in a hospital bed in the living room of her home. She has begun to have pain in her epigastric area
and under her sternum.

Answer 1

This procedure is used to stretch out an area of the esophagus that is narrowed or blocked to allow better swallowing.

A small balloon-like device or a device shaped like a pipe is passed down the throat and pushed through the narrowed area to stretch it out. This can be repeated if needed. Before the procedure, your doctor may give you a sedative to help you relax and may numb your throat by spraying it with a local anesthetic.

There is a small risk of bleeding or tearing a hole in the esophagus (called a perforation) with this procedure, which could require surgery or other treatments to fix. The esophagus typically stays open only a few weeks after dilation, so this is often followed by other treatments (such as placing an expandable stent) to help keep the esophagus open.