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External radiotherapy for oesophageal cancer

Men and women discussing non oesophageal cancer

This page is about external radiotherapy for cancer of the food pipe (oesophagus). Radiotherapy uses high energy rays to kill cancer cells. You can find information about

 

A quick guide to what's on this page

External radiotherapy for oesophageal cancer

Radiotherapy uses high energy rays to kill cancer cells. You may have radiotherapy and chemotherapy together to try to cure an oesophageal cancer, before surgery or instead of surgery. If you have an advanced cancer, you may have radiotherapy on its own. It can shrink the cancer and so relieve some of the symptoms it is causing.

You have external radiotherapy at the hospital radiotherapy department, as an outpatient. The length of your course of treatment depends on whether you are having radiotherapy to try to cure the cancer or to relieve symptoms. Treatment to try to cure the cancer usually lasts for 4 to 6 weeks. But if the radiotherapy is to reduce symptoms, you may have just one or a few treatments. 

Planning radiotherapy

Before you begin your treatment, the radiotherapy team carefully plan your external beam radiotherapy. Your planning appointment may take from 15 minutes up to a couple of hours. You will have a planning CT scan. The scan shows the cancer and the structures around it. After the planning scan you may have to wait a few days or up to 2 weeks before you start treatment. 

Having radiotherapy

Radiotherapy machines are very big. The machine may be fixed in one position or able to rotate around your body to give treatment from different directions. Before your first treatment your radiographers will explain what you will see and hear. You can't feel radiotherapy when you actually have the treatment. It takes anything from 1 minute to several minutes. It is important to lie in the same position each time, so the radiographers may take a little while to get you ready.

External radiotherapy doesn't make you radioactive. It is perfectly safe to be with other people, including children, throughout your course of treatment.
 

CR PDF Icon View a summary of all the pages in the Treating oesophageal cancer section.

 

 

When radiotherapy is used for oesophageal cancer

Doctors often use radiotherapy to treat cancer of the oesophagus. You may have radiotherapy and chemotherapy together (chemoradiation) to try to cure the cancer, before surgery or instead of surgery. Doctors most often recommend chemoradiation instead of surgery for cancers of the upper third of the oesophagus, particularly squamous cell cancers.

If you have an advanced cancer, you may still have radiotherapy. It can shrink the cancer and so relieve some of the symptoms it is causing.

Most radiotherapy is external treatment. That is, the radiation is aimed at the cancer from outside the body. But you can have internal radiotherapy (brachytherapy). This means the radiotherapy source is put inside the oesophagus. 

You can find out about internal radiotherapy for cancer of the oesophagus on another page.

 

How you have external radiotherapy

You have external radiotherapy in the hospital radiotherapy department, usually as an outpatient. The length of your course of treatment depends on whether you are having radiotherapy to try to cure the cancer or to relieve symptoms.

Radiotherapy to try to cure oesophageal cancer is usually a course of treatment over 4 to 6 weeks. Your radiotherapy specialist works out the total dose you need and then that is divided into a number of smaller treatments, called fractions. 

You have one fraction a day, from Monday to Friday, until you have had the total dose. Doctors give radiotherapy this way to balance the side effects with the effect of the treatment on the cancer.

Radiotherapy for symptoms is often given over a smaller number of treatments (fractions) so that you don't have to keep going back to the hospital. You may have one treatment a day for a few days or a few treatments with a few days break between each.

 

Planning your treatment

Before you begin your treatment, the radiotherapy team carefully plan your external beam radiotherapy. This means working out how much radiation you need to treat the cancer and exactly where you need it. Your planning appointment may take from 15 minutes up to a couple of hours. You will have a planning CT scan. The scan shows the cancer and the structures around it.

The 360° photo is of a CT scanner. You can use the arrows to look around the room.

You lie on the scanner couch with the treatment area exposed. The radiographers will put some markers on your skin. You need to lie very still. Once you are in position the radiographers move the couch up and through the scanner. The scanner is a doughnut shape. The radiographers leave the room and the scan starts. It takes up to 5 minutes. You won't feel anything. The radiographers watch from the next door room.

Before the planning appointment you may also have other scans, such as MRI scans. Your treatment team can feed the other scans into the planning scanner.

Ink marks

Once the treatment team has planned your radiotherapy, they may put ink marks on your skin to make sure they treat exactly the same area every day. They may also make pin point sized tattoo marks in these areas. 

We have information about radiotherapy skin markings.

Radiotherapy mask (mould)

If your cancer is in the upper part of your oesophagus, you may need to have a mould (shell) made to keep you perfectly still while you have treatment. 

We have information about making radiotherapy moulds.

After your planning session

You may have to wait a few days or up to 2 weeks before you start treatment. During this time the physicists and your radiotherapy doctor decide the final details of your plan. Your doctor will plan the areas that need treatment and outline areas to limit the dose to or avoid completely. They call this contouring. Then the physicists and staff called dosimetrists plan the treatment very precisely using advanced computers.

 

Having radiotherapy

Radiotherapy machines are very big. The machine may be fixed in one position or able to rotate around your body to give treatment from different directions. Before your first treatment your radiographers will explain what you will see and hear. The treatment rooms usually have docks for you to plug in music players. So you can listen to your own music.

You can't feel radiotherapy when you actually have the treatment. It takes anything from 1 minute to several minutes. It is important to lie in the same position each time, so the radiographers may take a little while to get you ready.

A photo of a linear accelerator, which gives radiotherapy

Once you are in the right position the staff leave you alone in the room for a few minutes. They watch you carefully through a window or on a closed circuit television screen. They may ask you to hold your breath or take shallow breaths during the treatment.

Our page about having external radiotherapy has a video about having radiotherapy that you may want to watch.

External radiotherapy doesn't make you radioactive. It is perfectly safe to be with other people, including children, throughout your course of treatment.

 

More information about radiotherapy

The main radiotherapy section tells you more about radiotherapy including

You can phone the Cancer Research UK nurses on freephone 0808 800 4040. The lines are open from 9am to 5pm, Monday to Friday. They will be happy to answer any questions that you have.

Our general organisations page gives details of people who can provide information about radiotherapy. Some organisations can put you in touch with a cancer support group. 

Our cancer and treatments reading list has information about books, leaflets and other resources about radiotherapy treatment.

If you want to find people to share experiences with online, you could use Cancer Chat, our online forum.

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Updated: 30 September 2014