How do you optimize nutrition for patients experiencing dysphagia while undergoing chemoradiation therapy for esophageal cancer?

Providing adequate nutrition for patients on treatment for esophageal cancer can be difficult. Evaluation and management should employ a multidisciplinary approach with individualized dietetic advice. In patients with the ability to swallow up-front, we start chemoradiation without employing other methods. Some will have irritation and dysphagia from treatment but swallowing function often stays the same or improves during radiation therapy with tumor response. Stenting can significantly worsen pain and GI AE's so it should not be done prophylactically in patients who are going to receive RT. In patients who can't swallow well enough for adequate nutrition up-front, there are options but none without risk. Enteral feeding rather than parent...