Radiation therapy for oesophageal cancer
Also known as radiotherapy, this treatment uses a controlled dose of radiation, such as focused x-ray beams, to kill or damage cancer cells. The radiation is targeted at the cancer, and treatment is carefully planned to do as little harm as possible to healthy body tissue near the cancer.
Learn more about:
- How it is given
- Side effects of radiation therapy
- What is chemoradiation?
- Video: What is radiation therapy?
Radiation therapy may be given alone or combined with chemotherapy (see chemoradiation). Chemoradiation is often used before surgery to shrink large tumours and destroy any cancer cells that may have spread. If you have chemoradiation, you’ll have a break of 4–12 weeks between radiation therapy and surgery to allow the treatment to have its full effect.
Radiation therapy, with or without chemotherapy, is used as the main treatment for oesophageal cancer that has not spread to other parts of the body and cannot be removed surgically.
Before starting treatment, you will have a planning appointment that will include a CT scan. The technician may make some small permanent tattoos or temporary marks on your skin so that the same area is targeted during each treatment session.
You will usually have treatment as an outpatient once a day, Monday to Friday, for 4–5 weeks. If radiation therapy is used palliatively, you may have a short course of 1–10 sessions. Each treatment takes about 20 minutes and is not painful. You will lie on a table under a machine that delivers radiation to the affected parts of your body. Your doctor will let you know your treatment schedule.
Some people will develop temporary side effects during or shortly after treatment. The lining of the oesophagus can become sore and inflamed (oesophagitis). This can make swallowing and eating difficult. In rare cases, you may need a temporary feeding tube to help you get enough nutrition. Other possible side effects include fatigue, skin redness, loss of appetite and weight loss. Most side effects improve within four weeks of treatment finishing.
Very rarely, long-term side effects can develop. The oesophagus can develop scar tissue and get narrower (known as oesophageal stricture). Stretching the walls of the oesophagus (dilatation) can make it easier to swallow food and drink. Radiation therapy can also cause irritation and swelling (inflammation) in the lungs, causing shortness of breath.
For more on this, see our general section on Radiation therapy.
Chemoradiation for oesophageal cancer
Treatment with radiation therapy and chemotherapy is known as chemoradiation. The chemotherapy drugs make the cancer cells more sensitive to radiation therapy.
Oesophageal cancer may be treated with chemoradiation before surgery to shrink the cancer and make it easier to remove. Chemoradiation may also be used as the main treatment when the tumour can’t be removed safely with surgery, or if the doctor thinks the risk with surgery is too high.
If you have chemoradiation, you will usually have chemotherapy a few hours before some radiation therapy appointments. Your doctor will talk to you about the treatment schedule and how to manage any side effects.
My diagnosis of oesophageal cancer came as a complete shock. I had chemotherapy and radiation therapy to shrink the tumour, and then went home to recover for six weeks before surgery.John
Video: What is radiation therapy?
Watch this short video to learn more about radiation therapy.
Podcast: Making Treatment Decisions
Download a PDF booklet on this topic.
Dr Spiro Raftopoulos, Gastroenterologist, Sir Charles Gairdner Hospital, WA; Peter Blyth, Consumer; Jeff Bull, Upper Gastrointestinal Cancer Nurse Consultant, Cancer Services, Southern Adelaide Local Health Network, SA; Mick Daws, Consumer; Dr Steven Leibman, Upper Gastrointestinal Surgeon, Royal North Shore Hospital, NSW; Prof Michael Michael, Medical Oncologist, Lower and Upper Gastrointestinal Oncology Service, and Co-Chair Neuroendocrine Unit, Peter MacCallum Cancer Centre, VIC; Dr Andrew Oar, Radiation Oncologist, Icon Cancer Centre, Royal Brisbane Hospital, QLD; Rose Rocca, Senior Clinical Dietitian: Upper Gastrointestinal, Nutrition and Speech Pathology Department, Peter MacCallum Cancer Centre, VIC; Letchemi Valautha, Consumer; Lesley Woods, 13 11 20 Consultant, Cancer Council WA.
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