A feeding tube, also known as an enteral feeding tube, is a flexible medical device. It delivers nutrition, fluids, and medications directly into the stomach or small intestine, bypassing the usual oral route. For cancer patients, a feeding tube is a supportive medical intervention. It ensures adequate sustenance when eating or swallowing becomes challenging due to the disease or its treatments. This helps patients maintain nutritional status, which is important for energy levels, healing, and overall well-being.
Reasons for Nutritional Support
Cancer and its treatments can significantly impact a patient’s ability to consume sufficient nutrients orally, leading to a need for nutritional support. Difficulty swallowing, known as dysphagia, is a primary reason, often resulting from tumors or radiation therapy in the head, neck, or esophagus. Radiation can cause inflammation and soreness, making swallowing painful or impossible. Severe nausea and vomiting, common side effects of chemotherapy or radiation, can also prevent adequate oral intake.
Patients may also require a feeding tube for malnutrition or significant weight loss before, during, or after cancer treatment. Maintaining proper nutrition is crucial to help the body fight infection, heal, and tolerate therapies. A feeding tube can also protect or bypass a compromised part of the digestive tract, such as with fistulas or blockages. Furthermore, a feeding tube ensures adequate nutrition in preparation for or recovery from major surgeries, helping patients build strength and heal more effectively.
Common Types of Feeding Tubes
The specific type of feeding tube used depends on the individual’s needs and the anticipated duration of nutritional support. A common short-term option is the nasogastric (NG) tube, a flexible tube inserted through the nose, down the esophagus, and into the stomach. NG tubes are typically used for a few days to several weeks. Another nasal tube, the nasojejunal (NJ) tube, passes through the nose and stomach, extending into the jejunum, a part of the small intestine. NJ tubes are used when the stomach cannot tolerate feeds, such as with persistent vomiting.
For longer-term nutritional support, tubes are typically placed directly into the abdomen. A gastrostomy (G-tube) or percutaneous endoscopic gastrostomy (PEG) tube is inserted through the abdominal wall directly into the stomach. This type is suitable for patients needing a feeding tube for several months or longer. When the stomach cannot be used for feeding, a jejunostomy (J-tube) is placed directly into the small intestine (jejunum) through the abdominal wall. These tubes can deliver nutrition through gravity, a syringe (bolus feeding), or a pump (continuous feeding), depending on the tube type and patient tolerance.
Life with a Feeding Tube
Adjusting to life with a feeding tube involves learning specific care routines to ensure its proper function and prevent complications. Daily care includes cleaning the skin around the insertion site, also known as the stoma, to prevent infection and irritation. Flushing the tube with water is also necessary to prevent blockages and maintain patency. Healthcare teams provide detailed instructions on these hygiene practices and how to monitor for signs of infection, such as redness or swelling.
Administering nutrition and medications through the tube requires careful attention. Liquid formulas, tailored to the patient’s nutritional needs, are delivered via syringe or pump, and medications are typically crushed and diluted before administration. While generally not painful, patients might experience initial discomfort at the insertion site or mild irritation from nasal tubes. Potential challenges can include skin irritation, tube dislodgement, or digestive issues like nausea, cramping, or diarrhea, which can often be managed by adjusting feeding rates or formula.
A feeding tube significantly improves quality of life by ensuring consistent nutrition, which can boost energy levels and improve tolerance to cancer treatments. Many patients can continue to eat and drink orally for pleasure, if medically safe to do so, while still receiving their primary nutritional support through the tube. The healthcare team, including dietitians and nurses, provides comprehensive support and education to help patients and their families manage the tube at home.
Duration of Tube Feeding
The duration a cancer patient needs a feeding tube varies considerably, depending on the underlying reason for its placement and the patient’s recovery trajectory. For many, especially those undergoing intense but temporary treatments, the tube is a short-term measure. It may be used for a few weeks to months to manage acute side effects like severe mucositis or temporary swallowing difficulties following radiation or surgery. The goal is often to transition back to full oral feeding once the patient can safely consume adequate nutrition by mouth.
In other circumstances, a feeding tube may be required for a longer duration or even permanently. This can occur with chronic swallowing issues, advanced disease where oral intake remains consistently insufficient, or irreversible damage to parts of the digestive system. Healthcare providers continually assess the patient’s nutritional status and ability to eat orally to determine the ongoing need for tube feeding. The decision to continue or discontinue tube feeding is made collaboratively by the patient, their family, and the medical team, prioritizing the patient’s health and well-being.