Oesophageal cancer treatment

Laser-sensitive chemicals are injected into the tumor site. A laser beam then targets the chemicals to destroy the tumor. This therapy is more commonly utilised for treatment of more pre-cancers in high risk regions or when surgery is not possible for palliative purposes.

This utilises a radio frequency generator via a probe (device), the energy is transmitted to the target tissue causing it to heat up. The heat destroys the target tissue and the body replenishes it with normal cells.

This therapy involves direct thermal injury to precancerous cells. The body then recovers and replenishes the area of injury with normal cells.

Depending on the type of tumor, chemotherapy which involves the use of drugs to kill cancer cells, is most often combined with radiation therapy.

Adjuvant chemotherapy for resectable oesophageal cancer

Following surgical resection of oesophageal cancer, most patients will be offered adjuvant chemotherapy to reduce the risk of recurrence after surgery. Adjuvant chemotherapy has been shown to improve outcomes in patients with resected oesophageal cancer compared with no adjuvant treatment.

Chemotherapy for unresectable oesophageal cancer

Chemotherapy is typically used in the first-line treatment of oesophageal cancer that can’t be surgically removed. Patients with unresectable oesophageal cancer and who are in good general health, are typically offered chemotherapy as a treatment.

Radiotherapy uses ionising radiation to damage the deoxyribose nucleic acid (DNA) of cancerous cells, causing them to die. Radiotherapy is not commonly used in the treatment of oesophageal cancer but may be considered for some patients.

Radiotherapy can be given to treat symptoms related to cancer that are causing problems. These can happen because the growth of the tumour narrows the gullet, causing swallowing difficulties, or it can cause pain or bleeding. Radiotherapy can relieve this pressure by shrinking the tumour.

External radiotherapy

External beam radiotherapy is given from a radiotherapy machine outside the body.

This treatment is normally given as a number of short, daily treatments in a radiotherapy department. These are called treatment sessions

Internal radiotherapy (brachytherapy)

Brachytherapy is where radioactive implants such as seeds, pellets or wires that are put near or inside the tumour. The radioactivity only affects tissue that is very close to the implant. This means the tumour is treated, but healthy areas around it get much less radiotherapy. Areas of the body that are further away are not affected at all

Sometimes patients will begin treatment for oesophageal cancer with radiation therapy along with chemotherapy. This combination treatment is called chemoradiation. Having chemotherapy and radiotherapy together can make the side effects of treatment worse. It may not be suitable for people who have other health problems. Your cancer doctor or specialist nurse can give you more information about chemoradiation and its possible side effects.

If a tumour is blocking the oesophagus, it can make it hard to swallow, this is called dysphagia. In order to make it easier for you to swallow, your doctor may recommended that you get an oesophageal stent. The stent is a hollow tube that’s placed in your oesophagus in the area of the tumour to hold the area open. The stent expands to allow fluid and food to pass into the stomach more easily. A stent also prevents food and saliva going into the lungs and causing infection.

On the day of the procedure your doctor will use an endoscope to look into your oesophagus. An endoscope is a flexible tube with a camera that goes through your mouth into your oesophagus. The doctor will place the stent with a fluoroscopy (a real-time X-ray). After the stent is in the right position, you will be recovered and sent home. It is important to follow the instructions given to you when you leave hospital about slowly introducing food. The stent does not treat the cancer but will allow you to eat and drink more normally.