Your treatment for oesophageal cancer depends on:
- the type of oesophageal cancer you have
- where the cancer is in the oesophagus – in the upper, middle or lower oesophagus
- the stage of the cancer
- your general health
- your personal choices.
You might have treatment to cure the cancer. If a cure is not possible, the aim of treatment is to control the cancer and help with the symptoms.
Your cancer doctor and specialist nurse will explain the treatments they think are best for you. They can help you make decisions about your treatment.
Preparing for treatment
Diet before treatment
After you have been diagnosed with oesophageal cancer, you will be referred to a hospital dietitian. You might have difficulty eating and may have lost weight. A dietitian can give you advice on eating well and help you stop losing weight. This helps you prepare for treatment.
While you are waiting for treatment, it is important to eat as well as possible. Your GP can give you food supplements to help increase the amount of calories you have. This may help slow down weight loss. This is important to help you to cope better with the treatment and keep your physical fitness and strength.
It may help to try eating softer foods. Foods like soup, ice cream, jelly and custard may be easier to swallow. You may also find it easier to manage small, soft meals 4 or 5 times a day, rather than 2 or 3 bigger meals. You can also use a food mixer to blend foods you like, to help you eat more. If you cannot swallow anything, tell the hospital straight away.
We have more information about maintaining your weight.
If you feel well enough, it can help to try to get more physically active before your treatment. Keeping active, such as going for regular, short walks, can improve your energy levels. It may also help speed up your recovery after an operation.
If you smoke, you should try to stop before your treatment. We have more information about giving up smoking.
The treatment you are offered will depend on your individual situation.
Your cancer doctor will talk to you about the treatment options that might be best in your situation.
Endoscopic mucosal resection (EMR)
If you have a very early-stage oesophageal cancer, you may be offered a treatment to remove the cancer using an endoscope. This is called an endoscopic mucosal resection (EMR), or an endoscopic sub-mucosal dissection (ESD).
Your cancer doctor may offer you this treatment if the tumour is very small and is only affecting the inner lining of the oesophagus. An EMR may also be offered if there are very abnormal cell changes to the lining of oesophagus (pre-cancerous changes).
You may have chemotherapy and a course of radiotherapy before the operation. This is called chemoradiation. You may have this treatment if the cancer has spread nearby (locally advanced), or is too large to be removed with an operation. Chemoradiation can help shrink the tumour, so it can be removed with an operation.
You may not be able to have surgery because of other health problems. Or you might choose not to have it. If you do not have surgery, you may be offered chemoradiation instead. If you are not well enough to have chemotherapy, you might be offered radiotherapy on its own.
Advanced-stage oesophageal cancer is when the cancer has spread beyond the oesophagus. This may be to lymph nodes or other parts of the body, such as the liver, lungs or stomach. If you have advanced oesophageal cancer, you may be offered chemotherapy. This can help control the cancer and improve symptoms. You might be given radiotherapy to help relieve symptoms such as pain.
Sometimes a targeted therapy drug called trastuzumab is given with chemotherapy to treat advanced oesophageal cancer. Targeted therapy drugs target something in or around the cancer cell that is helping it grow and survive.
If you have difficulty swallowing your cancer doctor may suggest:
- Putting a tube into the oesophagus. This can help keep it open, so food can pass through more easily. This is called a stent.
- Laser therapy may be used to help with swallowing difficulties.
- You might have a treatment to help stretch the oesophagus.
- Your cancer doctor may recommend you have a feeding tube to make sure you are getting enough food. We have more information on feeding tubes.