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Chemotherapy treatment

When, where and how you have chemotherapy for oesophageal cancer as well as the different types with their possible side effects.

When you have it

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.

Before surgery

You’re likely to have chemotherapy before surgery if you have stage 2 or 3 oesophageal cancer. This is called neo adjuvant treatment. It aims to

  • reduce the size of the cancer so it’s easier for the surgeon to remove
  • lower the risk of the cancer coming back

Before and after surgery

You may have chemotherapy before and after surgery (peri operative chemotherapy) if you have adenocarcinoma of the lower oesophagus or where the oesophagus meets the stomach (oesophago gastric junction).

Having chemotherapy after surgery might reduce the chances of your cancer coming back.

Advanced cancer

You may also have chemotherapy if you have advanced oesophageal cancer.

Types of Chemotherapy

Usually you have a combination of 2 or 3 drugs,the most common types are For adenocarcinoma of the oesophagus, other common combinations include Other drugs that you may have include

How you have chemotherapy

Into your bloodstream

You have the treatment through a drip into your arm or hand. 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.

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.

Last reviewed: 
05 May 2016
  • Guidelines for the management of oesophageal and gastric cancer
    WH Allum and others 
    Gut. 2011 Nov;60(11):1449-72.

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

  • Preoperative chemotherapy for resectable thoracic esophageal cancer (Cochrane Review)
    R Malthaner and D Fenlon
    The Cochrane Library, Issue 2, 2004. Chichester, UK: John Wiley & Sons, Ltd. updated 2015

  • Cancer and it’s management (7th edition)
    J Tobias and D Hochhauser
    Wiley-Blackwell, 2014

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