PEG tube feeding

Patients with advanced head and neck cancer can experience significant difficulties in swallowing as a consequence of the cancer or as a result of treatment. Difficulty swallowing (dysphagia) is more common in cancer of the back of the mouth and throat and in patients having radical treatment such as chemoradiotherapy or surgery followed by radiotherapy.

There are various ways to help give patients the extra nutrition needed to get though treatment. Percutaneous endoscopic gastrostomy (PEG) tubes we first described by Gauderer in 1980 and are a tube placed in to the tummy under local anaesthetic with sedation (please see the patient information leaflet). The other way of getting the tube into the tummy is using xrays to guide its placement radiologically inserted gastrostomy (RIG). PEGS are usually temporary and are moved between 6 to 12 months following treatment. In the Unit only 8% of patients treated by primary surgery for oral and oropharyngeal cancer had a long-term PEG. The major PEG related problems are not those of discomfort, leakage or blockage, but interference with family life, intimate relationships, social activities, and hobbies. More can be done to counsel and support patients with long-term PEG placement. Please ask for additional information.