Gastrostomy Feeding Tube (G-tube or PEG) Placement
Question:
I have head and neck cancer. My doctor is recommending a gastrostomy feeding tube (G-tube). Can you discuss how a feeding tube placed can help with nutritional intake during radiation therapy for head and neck cancer?
Answer:
Head and neck cancers present a unique set of challenges in both the treatment of the disease and in support of the patient afflicted with the cancer including nutritional needs.
A major challenge is the nutritional support of the patient. Patients with Head/Neck cancer may be malnourished due to trouble swallowing, or as a result of their surgical resection or radiation therapy. Trouble with swallowing can worsen dehydration and malnutrition and can result in poor wound healing and increase the likelihood of infections. Oral and dental status affects quality of life and oral function, which, in turn, may also affect nutritional intake and general health.
To provide nutrition support of the patient, a gastrostomy tube may be recommended. PEG stands for percutaneous endoscopic gastrostomy, a procedure in which a flexible feeding tube is placed through the abdominal wall and into the stomach. PEG allows nutrition, fluids and/or medications to be put directly into the stomach, bypassing the mouth and esophagus.
Nutritional products designed for tube feeding are formulated to provide all the nutrients the patient will need including proteins, carbohydrates, vitamins, and minerals. Some even contain dietary fiber and other non-nutritional elements. There are many types of tube feeding formulas available to meet all patient needs and preferences, such as Vegetarian, organic, etc.
A PEG feeding tube can be used within hours of placement; it can provide nutrition and hydration to help limit weight loss. A feeding tube can be used at meal times or at a convenient schedule, allowing freedom to travel, and generally go about daily life without interruptions.
A Registered Dietitian at the facility where the G-tube is placed can assess and educate you on your nutritional needs, the type of formula, when and how to take it, how to care for the G-tube and also answer any relevant questions you might have.
There are many support groups available for people with head and neck cancers. The links below may provide a good start.
The original question and answer were generously donated by Diana Dyer, MS, RD a cancer survivor, registered dietitian, organic garlic farmer, and the author of "A Dietitian's Cancer Story: Information & Inspiration for Recovery & Healing from a 3-time Cancer Survivor.
Question and Answer updated by Jyoti Benjamin, MS, RD, CSO, CD, FAND on behalf of the ON DPG
References
- Murayama KM, Johnson TJ, Thompson JS .Laparoscopic gastrostomy and jejunostomy are safe and effective for obtaining enteral access. Am J Surg. 1996 Nov; 172(5):591-4.
- Ahmed KA, Samant S, Vieira F. Gastrostomy tubes in patients with advanced head and neck cancer. Laryngoscope. 2005 Jan; 115(1):44- 7.
- Shiley SG, Hargunani CA, Skoner JM, Holland JM, Wax MK. Swallowing function after chemoradiation for advanced stage oropharyngeal cancer. Otolaryngol Head Neck Surg. 2006 Mar; 134(3):455-9.
- Moor JW, Patterson J, Kelly C, Paleri Prophylactic gastrostomy before chemoradiation in advanced head and neck cancer: a multiprofessional web-based survey to identify current practice and to analyze decision making. Clin Oncol (R Coll Radiol). 2010 Apr; 22(3):192-8.
- Taheri MR, Singh H, Duerksen DR. Peritonitis after gastrostomy tube replacement: a case series and review of literature JPEN J Parenter Enteral Nutr. 2011 Jan;35(1):56-60.
Page updated: April 2019