Heat and laser treatments for oesophageal cancer

A cancer in the food pipe (oesophagus) can partly or completely block it and make it difficult to swallow. You might have treatment to burn away the cancer cells.

Your doctor might use:

  • laser therapy
  • heat treatment (also called argon plasma coagulation or APC)

These don't get rid of the cancer completely but do allow you to swallow food and drink more easily. They are treatments for advanced cancer.

You have these treatments 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 then ask you to sign a consent form saying that you agree to have the procedure. Do 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 before the procedure.

A nurse puts 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.

The nurse or doctor injects medicine to make you sleepy into the tube in your hand. Or you might have a general anaesthetic which means you are asleep during the treatment. 

Having treatment

While you’re very sleepy or asleep your doctor puts a long flexible tube called an endoscope into your mouth and down into your oesophagus. The tube has a light and a small camera on the end so your doctor can see the blockage.

Laser therapy

They position the end of the tube close to the tumour and direct a laser at it. A laser is a very powerful beam of light that heats up the cancer cells and burns them away.

Heat treatment (argon plasma coagulation)

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.

Diagram showing heat treatment for oesophageal cancer

Both treatments take a few minutes. Your doctor then takes the endoscopy tube out.

After treatment

You stay in the endoscopy or x-ray department until the sedative or anaesthetic wears off. You might wear an oxygen mask for a short time. You may need to stay in hospital overnight. If you can go home that evening you need someone to go with you and stay with you until the next day.

Eating and drinking

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 can advise you on what to eat.

Heat and laser treatments can cause swelling. This can make it difficult to swallow for the first few days.

Side effects

Soreness and pain

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

Tell your doctor or endoscopy department if your pain doesn’t get better.

Bleeding or coughing

You might have some slight bleeding in the oesophagus and have an unpleasant taste in your mouth. If you have laser treatment you may also cough up small pieces of tumour. This usually gets better over a few days.

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

A bloated tummy (abdomen)

After heat treatment you might feel bloated for a few hours. Sucking peppermints can help.

A hole in the oesophagus

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

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 or laser treatment again if the tumour grows back. Or your doctor might suggest other treatments to help relieve your symptoms.  

  • Oesophago-gastric cancer: assessment and management in adults 
    National Institute for Health and Care Excellence (NICE), January 2018

  • National Oesophago-Gastric Cancer Audit
    The Royal College of Surgeons of England, 2022

  • Oesophageal cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up
    R Obermannova and others
    Annals of Oncology, 2022. Volume 33. Pages 992-1004

  • Oesophageal cancer
    J Lagergren and others
    The Lancet, 2017. Volume 390. Pages 2383-2396

Last reviewed: 
25 Sep 2023
Next review due: 
25 Sep 2026

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