Title

Investigating Four 'Myths' Surrounding Dysphagia in Patients with Metastatic Esophageal Cancer. A Multi-Institutional Study from the North Central Cancer Treatment Group.

Publication/Presentation Date

1-1-2004

Abstract

Eighty-five to 95% of esophageal cancer patients suffer dysphagia. Yet, few studies have focused on this symptom, and four 'myths' persist: (i) dysphagia cannot be measured; (ii) chemotherapy cannot palliate it; (iii) dysphagia predicts a poor prognosis; (iv) dysphagia is associated with a frustratingly insatiable appetite. Forty-four patients with metastatic esophageal cancer participated in this quality of life/translational component of a previously reported clinical trial. All were monitored for chemotherapy efficacy and toxicity and completed questionnaires on dysphagia and appetite at baseline and every 6 weeks. The appetite hormones, leptin and neuropeptide y, were also assessed. Forty-five per cent of patients could easily swallow solid foods; all others had varying dysphagia, thus enabling exploration of these four 'myths.' First, a single-item visual analog scale (Swallowing Scale), demonstrated excellent agreement with a previously validated questionnaire (81% at baseline), thus reminding us that dysphagia is measurable. Second, chemotherapy was associated with a trend towards improved dysphagia (P = 0.059). Third, dysphagia did not predict tumor response or survival. Fourth, dysphagia was not associated with appetite, leptin or neuropeptide y. This study helps to dispel these four 'myths' and underscores the need for further quality of life research on dysphagia.

Volume

17

Issue

4

First Page

292

Last Page

296

ISSN

1120-8694

Disciplines

Medical Sciences | Medicine and Health Sciences

PubMedID

15569365

Peer Reviewed for front end display

Peer-Reviewed

Department(s)

Department of Medicine, Hematology-Medical Oncology Division, Department of Medicine Faculty

Document Type

Article