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Heat treatment

Cancer in the food pipe (oesophagus) can partly or completely block it and make it difficult to swallow. Heat treatment burns away the cancer cells. This allows you to swallow food and drink more easily.

It’s a treatment for advanced cancer and is also called argon plasma coagulation (APC) or gastroscopy and APC.

You have the treatment in hospital in the endoscopy department or x-ray department. It usually takes about 30 minutes.

Before your treatment

Your doctor or specialist nurse explains what happens and how they do the treatment. They ask you to sign a consent form saying that you agree to have the procedure. You can ask them any questions that you have. Tell them about any medicines you’re taking.

You shouldn’t eat or drink anything except water for 4 to 6 hours beforehand. You stop drinking water 2 hours beforehand.

A nurse might put a small tube called a cannula into a vein in the back of your hand. They go with you to the endoscopy or x-ray department.

Your nurse sprays a local anaesthetic on the back of your throat. The nurse or doctor usually also injects medicine to make you sleepy into the tube in your hand. The medicine is a sedative.

Having treatment

You lie on a hard couch or trolley.  You might not remember any of the procedure if you’ve had a sedative.

Your doctor gently puts a long flexible tube called an endoscope into your mouth and down into the food pipe. The tube has a light and a small camera on the end so they can see the cancer.

They position the end of the tube close to the tumour. The end of the tube releases argon gas and an electrical spark. The spark heats the gas to a very high temperature to destroy the cancer cells.

This takes a few minutes.

Diagram showing heat treatment for oesophageal cancer

 

After clearing the blockage your doctor takes the endoscopy tube out.

After treatment

If you only had throat spray you can go home very soon afterwards. You shouldn’t eat or drink for half an hour because the throat spray numbs your throat and you could choke.

If you had sedation you stay in the endoscopy department or x-ray department until it wears off. This might take a couple of hours. You can then go home but you need someone to go with you and stay with you until the next day.

You can’t eat or drink for the first 4 to 6 hours. Your nurse tells you when you can start drinking. Then you can build up to eating soft foods or normal foods again. A dietitian or your nurse can advise you on what to eat.

Side effects

Soreness and pain

You might have a sore throat. Taking painkillers for a few days helps.

Tell your nurse or doctor if you still have pain.

A bloated tummy (abdomen)

You might feel bloated for a few hours. Sucking peppermints can help.

Bleeding

You might have some slight bleeding in the food pipe. It might give you a metallic taste in your mouth. This usually gets better over a few days.

Your nurse will give you mouthwashes. Tell them if you cough up blood.

A hole in the food pipe

Damage to the food pipe can tear it or make a hole (perforation). This is very rare. 

In the first 3 days after having treatment, tell your doctor or nurse straight away if you

  • have difficulty breathing
  • get severe chest pain
  • vomit blood
  • can’t keep food or drinks down

If the tumour comes back

You can have heat treatment again if the tumour grows back. Or your doctor might suggest other treatments.  

Last reviewed: 
30 Oct 2019
  • Guidelines for the management of oesophageal and gastric cancer
    British Society of Gastroenterology (BSG), 2011

  • Oesophago-gastric cancer: assessment and management in adults  [NG83]
    National Institute for Health and Clinical Excellence (NICE)
    Published January 2018

  • Oesophageal cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up
    F. Lordick and others
    Ann Oncol. 2016 27 Suppl 6: v50-v57

  • Oesophageal cancer
    J Lagergren and others
    The Lancet Vol 390, November 25th 2017

  • An audit of the care received by people with Oesophago-Gastric Cancer in England and Wales 2018 Annual Report Version 2: March 2019
    The Royal College of Surgeons of England and Healthcare Quality Improvement Partnership

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