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Chemotherapy for advanced cancer

Find out about chemotherapy for advanced oesophageal cancer and how you have it.

What is advanced cancer

Advanced oesophageal cancer is a cancer that began in the food pipe (gullet) and has spread to another part of the body.

What is chemotherapy?

Chemotherapy uses anti cancer (cytotoxic) drugs to destroy cancer cells. The drugs circulate throughout the body in the bloodstream.

Aim of chemotherapy

Chemotherapy for advanced oesophageal cancer can relieve symptoms. It can also control the cancer and improve your quality of life for a time, but it can’t cure the disease.

Types of chemotherapy

Usually you have a combination of 2 or 3 drugs, the most common types are

Other drugs you might have include

Some people have cancer that develops at the point where the food pipe (oesophagus) joins the stomach. This is called gastro oesophageal junction (GOJ) cancer and it can behave differently to oesophageal cancer. For GOJ cancer that has spread, chemotherapy combinations include

  • ECX – epirubicin, cisplatin and capecitabine
  • EOX – epirubicin, oxaliplatin and capecitabine

For advanced GOJ cancers that have a HER2 protein, combinations include

  • trastuzumab (Herceptin) and CF (cisplatin and fluorouracil)
  • trastuzumab  and CX (cisplatin and capecitabine)

How you have chemotherapy

Into your bloodstream

You have the treatment through a drip into your arm. A nurse puts a small tube (a cannula) into one of your veins and connects the drip to it.

You might need a central line. This is a long plastic tube that gives the drugs into a large vein, either in your chest or through a vein in your arm. It stays in while you’re having treatment, which may be for a few months.

You have capecitabine as a tablet.

You must take tablets according to the instructions your doctor or pharmacist gives you.

Whether you have a full or empty stomach can affect how much of a drug gets into your bloodstream.

You should take the right dose, not more or less. Never stop taking a cancer drug without talking to your specialist first.

Where you have chemotherapy

You usually have treatment into your bloodstream at the cancer day clinic. You might sit in a chair for a few hours so it’s a good idea to take newspapers, books or electronic devices to help to pass the time. You can usually bring a friend or family member with you.

You have some types of chemotherapy over several days. You might be able to have some drugs through a small portable pump that you take home.

For some types of chemotherapy you have to stay in a hospital ward. This could be overnight or for a couple of days.

Before you start chemotherapy

You need to have blood tests to make sure it’s safe to start treatment. You have these either a few days before or on the day you start treatment. You have blood tests before each round or cycle of treatment.

Your doctors and pharmacists work out your chemotherapy dose based on your blood cell levels, and your weight, height and general health.

Side effects

Common chemotherapy side effects include:

  • feeling sick
  • loss of appetite
  • losing weight
  • feeling very tired
  • a lower resistance to infections
  • bleeding and bruising easily
  • diarrhoea or constipation
  • hair loss
Contact your doctor or nurse immediately if you have any signs of infection such as a temperature higher than 37.5C or generally feeling unwell. Infections can make you very unwell very quickly.

Side effects depend on:

  • which drugs you have
  • how much of each drug you have
  • how you react

Tell your treatment team about any side effects that you have.

When you're at home

Chemotherapy for [node:field_cancer_type] can be difficult to cope with. Tell your doctor or nurse about any problems or side effects that you have. The nurse will give you telephone numbers to call if you have any problems at home.

Information and help

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About Cancer generously supported by Dangoor Education since 2010.