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Laser treatment and stents for advanced oesophageal cancer

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This page tells you about laser treatment and stents for advanced cancer of the food pipe (oesophagus). There is information about

 

A quick guide to what's on this page

Laser treatment and stents for advanced oesophageal cancer

The main problem for many people with cancer of the oesophagus is difficulty swallowing. This is because the cancer makes the oesophagus narrower. Sometimes a tumour may block the oesophagus completely. Usually you will have chemotherapy to shrink the cancer. But if the chemotherapy doesn't work, or stops working, you might need to have laser treatment or a stent.

Laser therapy

A laser is a very powerful beam of light. Doctors can use a laser to cut through the tumour. It can help with swallowing by clearing the tumour that is blocking your oesophagus. There are usually no side effects from laser treatment. If the tumour grows back, you can have laser treatment again.

You may have external radiotherapy or internal radiotherapy (brachytherapy) after laser treatment to help slow down the growth of the cancer.

Photodynamic therapy (PDT)

PDT is sometimes used instead of laser therapy for difficulty swallowing. A laser is still used, but first you have a drug that makes the oesophageal cancer cells particularly sensitive to light. Then the doctor shines a bright light directly onto the cancer.

What a stent is

Your doctor may suggest that you have a hollow plastic or metal tube put inside your oesophagus to keep it open and help you swallow more easily. The tube is called a stent.

Deciding whether to have these treatments

You will need to talk to your doctor about the treatment options that are most suitable for you. There may be particular reasons why one is better than the other in your case.
 

CR PDF Icon You can view and print the quick guides for all the pages in the treating oesophageal cancer section.

 

 

When laser treatment or stents are used

The main problem for many people with cancer of the oesophagus is difficulty swallowing, because the cancer makes the oesophagus narrower. For a lot of people, this is the reason they go to their doctor in the first place. A tumour may block the oesophagus completely for some people.

Even if your oesophageal cancer cannot be cured, you might need treatment to help you to swallow, and try to give you a better quality of life for longer. Usually you will have chemotherapy to shrink the cancer. But if the chemotherapy doesn't work, or stops working, you might need to have laser treatment or a stent. You have these treatments during an endoscopy. You will usually have a local anaesthetic and sedation before an endoscopy, or possibly a general anaesthetic. An endoscope is a flexible tube with a camera linked to a screen. It is a bit like a telescope. The doctor puts the endoscope tube down your throat. They can see the tumour through the camera, and pass instruments down the endoscope.

 

What laser therapy is

A laser is a very powerful beam of light which heats up the tissues where it is directed. Doctors can use a laser to cut through the tumour. It may help to think of it as a type of surgeon's knife. An advantage of using a laser is that there is very little bleeding. The laser seals any blood vessels as it cuts. The laser does not get rid of the tumour completely, but it does help with swallowing, by clearing the tumour that is blocking your oesophagus.

 

What happens during laser treatment

During your endoscopy, the laser is passed down the endoscopy tube. When it is in the right place, the doctor turns the beam on. The doctor burns away as much of the tumour as possible. The endoscope is then taken out and it takes some time for the sedation to wear off.

 

After laser treatment

There are usually no side effects from laser treatment. So, you may be able to go home that evening. Or your doctor may want you to stay overnight. If you do plan to go home, make sure someone is with you or comes to collect you. You won't be able to drive because you will have had a sedative or anaesthetic. And, for the same reason, you shouldn't go home on public transport by yourself.

If the tumour grows back, you can have the laser treatment again. Sometimes it is necessary to repeat the treatment as often as every 4 to 6 weeks. 

You may have external radiotherapy or internal radiotherapy (brachytherapy) after laser treatment to help slow down the growth of the cancer.

 

Argon plasma coagulation

Argon plasma coagulation is similar to laser therapy. It is also called argon beam diathermy. This uses argon gas and electricity to burn away the cancer. It can help to clear away tumours in the food pipe. Doctors also use it if a stent becomes blocked by tumour. 

 

Photodynamic therapy (PDT)

For difficulty swallowing, photodynamic therapy (PDT) is a different option to laser therapy. In PDT, a laser is still used. But first you have a drug that makes the oesophageal cancer cells particularly sensitive to light. Then the doctor shines a bright light directly onto the cancer. There is detailed information about PDT for advanced oesophageal cancer in this section.

 

What a stent is

Your doctor may suggest that you have a hollow plastic or metal tube put inside your oesophagus to keep it open and help you swallow more easily. The tube is called a stent. 

There are many different types of stent. Most stents used nowadays are self expanding stents, sometimes called spring stents. They expand once they are in place and keep the oesophagus open. Unfortunately, sometimes the tumour can grow across one end of the tube and blocks your oesophagus. If this happens, you may have laser treatment or photodynamic therapy (PDT) to remove the blockage.

 

Deciding whether to have these treatments

You will need to talk to your doctor about the treatment options that are most suitable for you - there may be particular reasons why one is better than the other in your case. It is important that you know all the possible options so that you can discuss them with your doctor. You may want to talk them over with your close family and friends as well as your doctor and nurse. No one can say how much you will benefit from each procedure. But your doctor will have weighed up the possible benefits and risks before suggesting them and will talk these through with you. You may want to take some time to think things over. Don't feel you have to make a decision on the spot.

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Updated: 29 August 2012