Esophageal cancer is one of the deadliest malignancies and historically carries a dismal prognosis.
Patients with metastatic disease are treated with palliative intent. Palliation is generally done to provide relief of dysphagia and esophageal obstruction. This can be achieved in several ways, including palliative endoscopic dilation, endoscopic stenting along with palliative chemotherapy
Palliative chemotherapy has only a limited role in this setting and only a marginal impact on survival.
In current scenario he has to be managed first to stop his vomiting
and restore his electrolyte imbalance
Chemotherapy can be started only after settling of his general condition.
It does appear a futile exercise to go for chemotherapy at this stage but still we should not deny him the due treatment.