About chemotherapy for oesophageal cancer
This page has information about chemotherapy for cancer of the oesophagus. You can find the following information
- A quick guide to what's on this page
- How chemotherapy works
- How you have chemotherapy
- Chemotherapy before surgery
- Chemotherapy before and after surgery
About chemotherapy for oesophageal cancer
Chemotherapy uses anti cancer (cytotoxic) drugs to destroy cancer cells. How you have your chemotherapy treatment will depend on the particular drug or combination of drugs you are having.
Apart from with very early stage oesophageal cancer, you may have either chemotherapy or combined chemotherapy and radiotherapy (chemoradiation) before surgery. Having treatment before surgery helps to lower the risk of cancer coming back. If you are unable to have surgery, or you do not wish to have it, you may have chemoradiation on its own.
If you have adenocarcinoma of the oesophago gastric junction you may have chemotherapy both before and after surgery. Chemotherapy helps to reduce the size of the cancer, making it easier to remove. And it reduces the chances of the cancer coming back.
If you have advanced oesophageal cancer, you may have chemotherapy to try to shrink the cancer, slow it down or relieve any symptoms you are having. If you have adenocarcinoma of the oesophago gastric junction and your cancer has a large amount of HER2, you may have trastuzumab (Herceptin) with chemotherapy. Trastuzumab is a type of biological therapy.
View a summary of treating oesophageal cancer.
Chemotherapy uses anti cancer (cytotoxic) drugs to destroy cancer cells. They work by stopping the growth of cancer cells. These drugs circulate throughout the body in the bloodstream.
You may have chemotherapy for oesophageal cancer as
- An injection
- Through a drip into a vein in your arm (intravenous infusion)
- Through a pump as a slow continuous infusion
How you have your chemotherapy treatment will depend on the particular drug or combination of drugs you are having. There is information about the different ways of having chemotherapy in the main chemotherapy section.
Doctors call chemotherapy before surgery neo adjuvant chemotherapy. This is the usual treatment for most people who are able to have surgery to remove their cancer. Results from clinical trials show that this treatment can help to lower the risk of your cancer coming back if you have stage 2 or 3 oesophageal cancer. Neo adjuvant chemotherapy also helps to reduce the size of the cancer so that it is easier for the surgeon to remove.
One of the most common combinations of chemotherapy for oesophageal cancer is cisplatin and fluorouracil (5FU). We have more information about this on our page about chemotherapy drugs for oesophageal cancer.
If you have adenocarcinoma of the lower oesophagus or where the oesophagus meets the stomach (oesophago gastric junction), you may have chemotherapy before and after surgery (peri operative chemotherapy). The chemotherapy helps to reduce the size of the cancer making it easier to remove. And it also reduces the chances of the cancer coming back.
Giving chemotherapy and radiotherapy together is called chemoradiation. Doctors give it to some people before surgery for oesophageal cancer to help lower the risk of the cancer coming back. Having chemotherapy and radiotherapy before surgery is called neo adjuvant chemoradiation.
If your cancer hasn't spread but could be difficult to remove, chemoradiation may be able to shrink the cancer. The surgeon may then be able to remove the cancer more easily. Combined chemoradiation before surgery can help both adenocarcinomas and squamous cell cancers of the food pipe.
If you are not able to have surgery, or you do not want it, you may have chemoradiation on its own. You are particularly likely to have this treatment if you have a squamous cell cancer in the top third of your oesophagus. Many specialists think the results of this treatment can be as good as surgery for this type of oesophageal cancer.
Combined chemotherapy and radiotherapy is quite an intensive treatment. The whole course of treatment is hard going, and the side effects can be more severe than chemotherapy or radiotherapy on their own. Your doctor will consider your overall health when deciding if this is a suitable treatment for you. There is information about chemoradiation for oesophageal cancer in this section.
If you have advanced oesophageal cancer, you may have chemotherapy to try to shrink the cancer, slow it down or relieve any symptoms that you have, such as difficulty swallowing. Treatment is usually with a combination of different drugs. You will have some through a drip and take others as tablets. As the aim of the treatment is to make you feel better, rather than as a cure, it is important that the chemotherapy itself doesn’t make you too ill and that you do not have to make too many trips to the hospital.
If you have adenocarcinoma of the oesophago gastric junction and your cancer has a large amount of a protein called HER2, you may have a biological therapy called trastuzumab (Herceptin) with chemotherapy.
We don't yet know much scientifically about how some nutritional or herbal supplements may interact with chemotherapy. Some could be harmful. It is very important to let your doctors know if you take any supplements. Or if you are prescribed any therapies by alternative or complementary therapy practitioners.
Talk to your specialist about any other tablets or medicines you take while you are having active treatment. There is information about the safety of herbal, vitamin and diet supplements in the complementary therapies section.
Some studies seem to suggest that fish oil preparations may reduce the effectiveness of chemotherapy drugs. If you are taking or thinking of taking these supplements talk to your doctor to find out whether they could affect your treatment.
For more about chemotherapy, look at the main chemotherapy section. It explains the treatment in more detail, including
- How it works
- How doctors plan chemotherapy
- Different ways you can have chemotherapy
- General side effects
- Living with chemotherapy
If you would like more information about chemotherapy, ask your chemotherapy nurse or contact our cancer information nurses. They would be happy to help.
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