Eating problems with oesophageal cancer

Oesophageal cancer can cause problems with swallowing and make it hard to eat well. It’s important to eat and drink enough calories and protein to maintain your weight and strength.

There will be a dietitian in the team looking after you. They can help you cope with eating problems and suggest ways of dealing with diet difficulties. 

Who can help?

Dietitians can help you cope with eating problems and suggest ways of dealing with diet difficulties. There will be a dietitian in your hospital team. If you haven't seen them, ask your doctor or nurse to refer you. The dietitian can support you from diagnosis, through treatment and afterwards. 

If you are having trouble swallowing, you might also see a speech and language therapist (SLT). An SLT can assess your swallowing during and after treatment. They can teach exercises to support you with swallowing difficulties. 

Eating problems can be difficult to cope with. They can cause tension within relationships or families. Social events and eating out of the house with friends can be much harder when you have a problem swallowing. Talking to your dietitian or a counsellor can help.

Try and maintain your weight during treatment. This is a good sign that your body is getting all the nutrients it needs. It is important to get help even before you have any problems.

Eating when swallowing is difficult

There are ways to help if you find swallowing difficult:

  • eat small amounts more often 
  • eat soft, moist foods
  • eat slowly and chew your food well
  • take sips of a drink between mouthfuls 
  • try to make the most of the times during the day that you feel able to eat  

Making a few changes to what you’re eating can help you to eat a variety of different foods.

Soft diet suggestions

A soft diet can help you eat more comfortably. Try scrambled egg, soups and mashed potato. You can also:

  • use sauces, cream and gravies to moisten food and make it easier to swallow
  • soften meat and vegetables with long, slow cooking
  • finely chop meat and vegetables in a food processor before or after cooking
  • blend or process meat or vegetable casseroles or curries to make soups
  • make fruit smoothies or milkshakes in a blender
  • try tinned fruit and add custard or cream
  • have ice cream, yoghurts and mousse

Foods that can be difficult to eat

Avoid foods that are hard to swallow and might stick in your throat, like:

  • raw fruit and vegetables
  • tough meat
  • soft, doughy bread
  • dry or crispy foods

How to build yourself up

You can help to maintain your weight by adding calories to everyday foods. You can:

  • have soft cereal for breakfast – add honey or sugar and cream or whole milk
  • make instant soups or gravies with milk instead of water
  • mix mashed potato with butter, grated cheese, or cream
  • make drinks like coffee or hot chocolate with all milk instead of water and preferably whole milk
  • drink liquid food supplements such as Complan and Meritene - sip them throughout the day
  • make ice lollies or ice creams out of smoothies or liquid food supplements

Try to increase your protein intake

You can do this by:

  • adding a couple of teaspoons of dried milk powder or vegan powder to each pint of milk to use like ordinary milk for drinking and cooking
  • aiming to have some soft meat, Quorn, tofu, fish, beans or eggs at least twice a day

Liquid food supplements can be helpful if you are finding this difficult. Ask your dietitian for advice on which ones are best – some are available on prescription.

Feeding tubes

You may need a feeding tube down your nose or put into your small bowel if you can’t eat and drink enough. You can go home with the feeding tube in place. Your team will teach you or your carer how to use the tube once you're at home.

Eating after surgery

Your eating may return to normal after a few months. But this can take time, especially if you need more treatment after your surgery. For some people, it takes up to 2 years.

It can help to eat smaller meals about 6 to 8 times a day if you've had surgery to remove your oesophagus and part of your stomach. You’ll also need to eat slowly and chew food well or have a soft diet. Some people find certain foods uncomfortable to eat. You can choose not to eat these foods.

This video tells you how to eat well after surgery for oesophageal cancer. It lasts for 3 minutes and 31 seconds.

    You may have problems after surgery to remove your oesophagus. These include:

    • dumping syndrome (feeling faint and dizzy after eating)
    • diarrhoea
    • feeling or being sick
    • indigestion and stomach pains
    • difficulty swallowing
    • acid from your stomach coming back up (reflux) into the oesophagus when you lie flat
    • coughing at night time
    • feeling full after eating small amounts
    • low levels of minerals and vitamins which might make you tired

    Talk to your healthcare team about any problems you are having. They may be able to prescribe medicines to relieve these symptoms and suggest other things that can help.

    Eating after radiotherapy

    During radiotherapy and for a few weeks or months afterwards, you may find it hard to swallow. You will also have some soreness and pain when you swallow.

    Eating a soft or blended diet helps, as well as taking painkillers before you eat.

    • Guidelines for perioperative pare in esophagectomy: Enhanced recovery after surgery (ERAS) society recommendations
      DE Low and others
      World Journal of Surgery, 2019. Volume 43. Pages 299-330

    • ESPEN guidelines on nutrition in cancer patients 
      J Arends and others
      Clinical Nutrition. 2017. Volume 36. Pages 11-48

    • ECCO essential requirements for quality cancer care: Oesophageal and gastric cancer
      W Allum and others
      Critical Reviews in Oncology/Haematology, 2018. Volume 122. Pages 179-193

    • Oesophago-gastric cancer: assessment and management in adults 
      National Institute for Health and Clinical Excellence (NICE),January 2018

    Last reviewed: 
    25 Sep 2023
    Next review due: 
    25 Sep 2026

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