Swallowing Problem

Hi Dr. Lahav, My father is 71 years old. He was diagnosed a year and a half ago with stage 3B NSCLC (lung cancer). He went through numerous radiotherapy treatments and chemo. A few months ago he started having difficulty swallowing, especially taking solids. The Oncologist recommended that we see an ENT physician, and that’s what we did. The ENT doctor performed the procedure with the optic fiber and couldn’t see much so he sent him for an esophagus X-ray. We don’t know if it’s the tumor that is causing the problem or maybe it’s a tissue damage that was caused by the radiation. What do you recommend that we do besides the X-ray? Do you treat those kinds of problems? This problem is very distressing to him and to us and we would like to address, and try to do something about it as soon as possible. Can we come see you at your clinic? Thanks a lot for your response. Dana

Hi Dana, Possible explanations include: 1. Damage to the esophagus by irradiation. 2. Damage to the nerves of the throat by tumor/irradiation effect. 3. Tumor mass effect on the esophagus. I would repeat careful fiberoptic-video-endoscopic exam of the throat and upper esophagus. And if this won’t give us a clue, I would continue with modified barium swallow and CT scan of the neck and chest. Please feel free to schedule an appointment to my clinic.

Thank you so much for your quick response. I consulted with my dad and he'll do the barium swallow exam he was referred to, and probably come and see you with the results. I know you cannot diagnose online and that all the potential explanations you wrote are only few possible options. Hypothetically, let's assume he has one of the above. Are there any conservative, minimally invasive procedures/solutions to such problems just to relieve or make swallowing just a little bit easier? The reason I'm saying this is because he has been through a lot, and is pretty frail. We want to try to avoid to subject him to major procedures and use a more palliative approach. I really appreciate your response, Dana