A Nursing Case Report on Managing End of Life Feeding Challenges in a Farmer with Terminal Esophageal Cancer and Severe Dysphagia

<title>Abstract</title> <p>Background Esophageal cancer is common in the highlands of southern Ethiopia. Hot porridge and steaming coffee are daily staples. Nurses in this region care for patients who cannot swallow their own saliva. They reassure fathers who fear they will not see their children grow. They also face a healthcare system that moves too slowly for cancer. This case report follows the CARE Guidelines. It tells the story of one patient and the nursing care that kept him alive while he waited for surgery. Case Presentation: A 45-year-old male farmer from a rural community in an endemic region of Ethiopia came to our university hospital. He had T1 distal esophageal cancer. Over six months, progressive dysphagia made eating impossible. First, he could not swallow solids. Then he could not swallow liquids. Finally, he could not swallow his own saliva without severe pain. His body mass index was 16.37 kg/m². He was depressed and hopeless. He had watched a neighbor die from the same disease. His history showed risk factors common in his community. He had smoked for seven years. He had chewed khat weekly for ten years. He had consumed scalding-hot foods and drinks throughout his life. Nursing Interventions: The nursing care was not a checklist. It began with sitting beside him and listening to his fears. We gave intravenous fluids every eight hours. We rotated Normal Saline, DNS, and Ringer's Lactate. We added Vitamin B-Complex and dextrose. His esophagus was blocked. He could not eat. The fluids kept his body nourished. We managed his pain with tramadol. We also believed him when he said he hurt. We taught him about his early-stage cancer. This gave him hope. He had thought he would die. Now he understood his cancer was treatable. But we lacked a psychologist for his despair. Staff had no time for long conversations. The surgical schedule was limited to two days per week. Cancer does not wait for schedules. Outcomes: After three days of intensive nursing care, his epigastric pain decreased. His fluid balance stabilized. His vital signs stayed steady. His mucous membranes were moist again. Most importantly, his fear began to ease. He understood that T1 cancer is early and operable. It is not a death sentence. But the waiting continued. His spirit and body weakened slowly. Delayed surgery, no psychological support, and overburdened staff remained problems. Good nursing cannot fix a broken system. Conclusion Nursing care for esophageal cancer patients in resource-limited settings has real impact. It also has real limits. When a patient cannot eat, the nurse feeds them through IV lines. When a patient loses hope, the nurse offers facts that help them hope again. But nurses cannot operate. They cannot create psychologists who do not exist. They cannot make a two-day surgical schedule serve a ward full of cancer patients. Holistic nursing care is not a luxury. It is necessary. Healthcare systems must support the nurses who stand at the frontline of cancer care.</p>