Chemotherapy drugs for oesophageal cancer
This page has information about the chemotherapy drugs used to treat cancer of the food pipe (oesophagus), and about their side effects. You can find the following
Chemotherapy drugs for oesophageal cancer
There are a number of different chemotherapy drugs doctors can use to treat oesophageal cancer. These include epirubicin, fluorouracil (5FU), capecitabine, cisplatin, carboplatin, oxaliplatin and paclitaxel. You usually have a combination of 2 or 3 of these drugs.
Which chemotherapy drugs you have depends on the type of oesophageal cancer you have and its stage. You usually have chemotherapy every 3 weeks.
You may have radiotherapy at the same time as having chemotherapy. This is called chemoradiation. You have your radiotherapy every weekday for about 5 weeks.
Side effects of chemotherapy for oesophageal cancer
Chemotherapy has side effects. Which ones you get depend on which drugs you have, the dose of each drug and how you individually react. Common side effects include a drop in the number of blood cells, an increased risk of infection, feeling sick, diarrhoea, hair loss or thinning, a sore mouth and mouth ulcers, and feeling tired and run down.
If you have radiotherapy with chemotherapy some of the side effects may be more severe. Let your doctor or nurse know straight away about any side effects you have so that they can help to reduce them.
You can view and print the quick guides for all the pages in the treating oesophageal cancer section.
Doctors use several different drugs and combinations of drugs to treat oesophageal cancer. Chemotherapy tends to work better when several drugs are given together.
Which drugs you have will depend on the type of oesophageal cancer you have and its stage. Through research, doctors have discovered that particular combinations of chemotherapy work better for adenocarcinomas and other combinations work better for squamous cell cancers of the oesophagus. If you are having chemotherapy for advanced oesophageal cancer, you may have treatment designed to cause as few side effects as possible.
Your doctor or nurse will give you written information about the drugs you are to have.
A number of chemotherapy drugs are commonly used to treat oesophageal cancer. These include
- Epirubicin (E)
- Fluorouracil, also called 5FU (F)
- Capecitabine, also called Xeloda (X)
- Cisplatin, or sometimes carboplatin is used (C)
- Oxaliplatin (O)
- Paclitaxel (Taxol)
Usually you have a combination of 2 or 3 drugs. The different combinations are known by their initials. For example ECF stands for epirubicin, cisplatin and fluorouracil.
Some of the most common combinations for adenocarcinoma of the oesophagus are
- CF or CX - cisplatin and fluorouracil or cisplatin and capecitabine
- ECF - epirubicin, cisplatin and fluorouracil
- EOX - epirubicin, oxaliplatin and capecitabine
If you have squamous cell cancer of the oesophagus, you are likely to have cisplatin and fluorouracil (CF) or cisplatin and capecitabine (CX).
The links above take you to detailed information about these treatments and their side effects.
You have most of these drugs as an infusion through a drip into your arm. However you may need a central line if you are due to have fluorouracil. A central line is a long plastic tube that gives the drugs directly into a large vein in your chest.
You have fluorouracil as a continuous infusion over a few days or a few weeks. The pump is set up in the outpatient department and stays connected to your central line when you go home. You have to take bags of fluorouracil to refill the pump at home. A nurse may visit you at home to change the bags. Or you will need to go back to the hospital to have this done. In some hospitals, you may have to stay in for a few days while you have this treatment.
Capecitabine is the tablet form of fluorouracil. It is replacing fluorouracil in many of the chemotherapy combinations, as taking a tablet is often easier for patients. You usually take this twice a day throughout your course of treatment.
Most drug combinations can be given in the outpatient clinic. If you have cisplatin you need intravenous (IV) fluids before and afterwards to keep your kidneys working normally. This can take 6 to 7 hours in total and so you may need to stay in hospital overnight.
You usually have chemotherapy every 3 weeks. Each 3 week period is called a cycle. You may have between 2 and 6 cycles of chemotherapy.
You may have radiotherapy at the same time as having cycles of chemotherapy. This is called chemoradiation. You have your radiotherapy every weekday for about 5 weeks.
There are different ways of having chemotherapy and radiotherapy. You may just have chemotherapy treatments during your course of radiotherapy. Or you may have a couple of cycles of chemotherapy before you start radiotherapy, as well as during your course of radiotherapy. There is information in this section about the side effects of combined radiotherapy and chemotherapy.
Chemotherapy has side effects. The effects you get depend on
- Which drugs you have
- How much of each drug you have
- How you individually react
Not everyone gets every side effect with every drug. Some people react more than others. And different drugs have different side effects. So we can't tell you exactly what will happen to you. Most side effects only last for the few days that you are actually having the drugs. And there is quite a bit that can be done to help. Here is a list of some common side effects. You can find more information about these in our section on the general side effects of cancer drugs.
- A drop in the number of blood cells
- An increased risk of infection
- Feeling sick
- Hair loss or thinning
- Sore mouth and mouth ulcers
- Feeling tired and run down
Ask your doctor or nurse which of these side effects are most common with the chemotherapy drugs you will be having. Click on the links above for more about each side effect and how to manage it.
Tell your doctor or nurse about any side effects you have so that they can help to reduce them. If you have any signs of infection you must let your medical team know straight away, as you can become very unwell very quickly.
If you would like more information about anything to do with the side effects of chemotherapy, speak to one of our cancer information nurses. They would be happy to help. Or you can contact one of the cancer information organisations from our general organisations page. They often have free factsheets and booklets, which they can send to you.
Chemotherapy courses can seem to go on forever, particularly if you are getting very tired towards the end of your course. But the side effects will gradually go once your treatment has ended.
If you have radiotherapy with your chemotherapy the side effects may be more severe. You can read about the side effects of chemoradiation for oesophageal cancer in this section.
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