Internal radiotherapy for oesophageal cancer | Cancer Research UK
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Internal radiotherapy for oesophageal cancer

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This page is about treatment for cancer of the food pipe (oesophagus) with radiotherapy from inside the body. Doctors often call this brachytherapy. You can find the following information

 

A quick guide to what's on this page

Internal radiotherapy for oesophageal cancer

Internal radiotherapy means radiotherapy that you have from a source inside the body. It is also called brachytherapy. Doctors usually use brachytherapy to slow the growth of an oesophageal cancer, rather than to try to cure it.

To have the treatment, you have a radioactive source placed inside your oesophagus for a set time. This means the radiation source delivers a very high dose of radiation directly to the cancer. But because the radiation doesn't travel very far through body tissues, the surrounding tissues get a much lower dose and are not seriously affected.

How you have the treatment

There are 2 main ways of giving this treatment. The doctor may put the radioactive source in place during an endoscopy or with a nasogastric tube. The radioactive material is sealed inside a tube. So it cannot leak into the rest of your body. 

The doctor leaves the radioactive source in place for a period of time that has been precisely worked out by your radiotherapy specialist. This can be less than an hour or up to 2 days. You may have a single treatment or a course of several treatments.
 

CR PDF Icon View a summary of treating oesophageal cancer.

 

 

What this treatment is

Brachytherapy means radiotherapy that you have from a source inside your body, rather than from a radiotherapy machine outside your body (external radiotherapy). Brachytherapy for oesophageal cancer isn't used as often as external radiotherapy.  

Doctors usually use brachytherapy to slow the growth of oesophageal cancer, rather than to try to cure it. For example, you may have the treatment to try to control the cancer after you've had a tube (stent) put into your oesophagus to help with swallowing.

To have the treatment, you have a radioactive source placed inside your oesophagus for a set time. This means the radiation source delivers a very high dose of radiation directly to the cancer. But because the radiation doesn't travel very far through body tissues, the surrounding tissues get a much lower dose and are not seriously affected. 

The high radiation area is limited to about 1cm around the radioactive source.

Diagram showing internal radiotherapy for cancer of the oesophagus

 

How you have the treatment

There are 2 main ways of giving this treatment. You may have

  • Internal radiotherapy via an endoscope
  • Internal radiotherapy via a nasogastric tube

Internal radiotherapy via an endoscope

The doctor may put the radioactive source in place during an endoscopy. An endoscope is like a flexible telescope that goes down your throat. It has a light and a camera, so the doctor can see directly inside the body. You probably had an endoscopy when you first had tests for cancer.

Before the endoscopy, you have a sedative or light anaesthetic to send you to sleep. Once you are drowsy or asleep, your doctor puts the endoscope down your throat, until it reaches the area of the oesophagus that needs treating. 

Then, the doctor puts the radioactive source into place, next to the tumour. The radioactive material is sealed inside a tube. Once the sealed tube is inside you, in the right place, the doctor takes the endoscope out. This can stay in you for up to 2 days.

During your treatment, you will be on the ward. You have to stay in your single room alone until the treatment has finished. Being in a room on your own (isolation) protects other people from radiation. Pregnant women and children are not allowed into your room. Other visitors are only able to stay for a short time each day, or possibly not at all. Speak to your doctor about this before the treatment. 

The amount of time the staff are allowed into your room is also limited. However once the tube is removed, you are no longer radioactive, and you are free to be around other people.

Internal radiotherapy via a nasogastric tube

Another way of putting the radioactive source in place is with a nasogastric tube. This is a tube that goes up your nose, down the back of your throat and into your stomach. Before the procedure your doctor sprays a local anaesthetic spray at the back of your throat, so it is numb. The tube will then be fed through your nose. Once the tube is in, you have a CT scan to make the tube is in the right place.

The nasogastic tube is then connected to the brachytherapy machine after the treatment plan is ready. A small, radioactive, metal ball enters the tube inside you, and gives off a radiation dose to the tumour. This procedure takes up to two hours, with the treatment lasting around 15 minutes. 

The tube is taken out as soon as the treatment is finished, and you are free to go home. You are not radioactive and you're free to be around other people.

 

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Updated: 22 April 2014