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Decisions about your treatment

Find out about how your doctor decides which treatment you need, the types of treatment you might have and treatment by stage.

Deciding which treatment you need

A team of doctors and other professionals discuss the best treatment and care for you. They are called a multidisciplinary team (MDT).

Your treatment depends on

  • where your cancer is in your food pipe
  • how far it has grown or spread (the stage)
  • the type of cancer
  • how abnormal the cells look under a microscope (the grade)
  • your general health and level of fitness

Your MDT will discuss your treatment, its benefits and the possible side effects with you.

Treatment overview

The main treatments are

  • surgery
  • radiotherapy
  • chemotherapy
  • chemoradiotherapy

You have one or more of these treatments depending on the stage of your cancer.

You might also have treatment for symptoms when you’re first diagnosed. This includes treatment to help you swallow because some cancers of the food pipe can block it. Doctors can put a small tube into your oesophagus (stent) to clear the blockage so you can swallow. Treatment for eating problems helps to make you fit enough for your cancer treatment.

If you're not having surgery

Health problems might mean you can’t have surgery, or you could decide you don’t want it. You have tests to check how fit you are before you have any treatment including heart and lung tests.

When surgery isn’t possible, you might have one or more of these treatments

  • chemotherapy
  • radiotherapy
  • chemoradiotherapy - chemotherapy with radiotherapy
  • symptom control

Treatment by stage

Stage 0 cancer

Removing the lining of your oesophagus is the main treatment.

You have this surgery through a tube called an endoscope. This surgery is endoscopic mucosal resection or EMR.

You might also need treatment to destroy any abnormal areas that the doctor couldn’t remove. This includes photodynamic therapy (PDT), which is also called light treatment.

Stage 1 cancer

Surgery is the main treatment.

You might also need these treatments before and after surgery

  • chemotherapy
  • chemoradiotherapy

Stage 2 and 3 cancers

For cancers in the lower part of the oesophagus you have either

  • chemotherapy
  • chemoradiotherapy

You then have surgery to remove all or part of your oesophagus.

Depending on the results of your surgery, you might need more chemotherapy or chemoradiotherapy. This lowers the chances of the cancer coming back.

For cancers in the upper part of the oesophagus you usually have chemoradiotherapy, without surgery.

In the video below we follow Wendy through her treatment for cancer of the oesophagus.

Stage 4 cancer

Treatment aims to control the cancer and maintain a good quality of life. You might have

  • chemotherapy
  • radiotherapy
  • symptom control eg. treatment to help you swallow food
  • trastuzumab (Herceptin) biological therapy for cancers in the gastro oesophageal junction area and the cells have HER2 protein

Clinical trials

Doctors are always looking to improve treatments for oesophageal cancer, and reduce side effects. As part of your treatment, your doctor may ask you to take part in a clinical trial. This might be to test a new treatment or to look at different combinations of existing treatments.

Last reviewed: 
05 May 2016
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    American Joint Committee on Cancer
    Springer, 2010

    Cancer and its management (7th edition)
    Tobias J and Hochhauser D
    Wiley-Blackwell, 2014

    ESMO, oesophageal cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up, Ann Oncol. 2013 Oct;24 Suppl 6:vi51-6.

    Principles and practice of oncology (9th edition)
    De Vita, VT, Lawrence TS and Rosenberg SA.
    Lippincott, Williams and Wilkins, 2011

Information and help

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