What is chemotherapy?

Chemotherapy uses anti-cancer (cytotoxic) drugs to destroy cancer cells. It may be used on its own, or with surgeryradiotherapy or a targeted therapy drug.

When chemotherapy is used for oesophageal cancer

Chemotherapy can be given in different ways depending on the type of oesophageal cancer you have.

Chemotherapy for adenocarcinoma may be given:

Chemotherapy for squamous cell carcinoma may be given:

  • with radiotherapy (chemoradiation)
  • on its own, or with targeted therapy (palliative chemotherapy).

Perioperative chemotherapy

When chemotherapy is used both before and after surgery, it is called perioperative chemotherapy. This treatment shrinks the tumour to make surgery more effective. It also reduces the chance of the cancer coming back. You usually have chemotherapy for 2 to 3 months before the operation, and again for 2 to 3 months after it.

Chemoradiation

This is when you have chemotherapy at the same time as radiotherapy.

Chemoradiation may be given before surgery to help shrink the tumour. This is called neo-adjuvant treatment. Or it can be used as the main treatment. This is called definitive chemoradiation

Palliative chemotherapy

Chemotherapy can be used as the main treatment if the cancer:

  • cannot be removed by surgery
  • has spread to other parts of the body (advanced cancer).

You may have more than one course of chemotherapy. It can help control the cancer and reduce symptoms. Some people with adenocarcinoma have a targeted therapy drug called trastuzumab as well as chemotherapy. You will have tests first to see if trastuzumab is a suitable treatment for you.

Chemotherapy drugs used to treat oesophageal cancer

The chemotherapy drugs most commonly used to treat oesophageal cancer are:

Other chemotherapy drugs may also be used.

Combination chemotherapy treatments

Usually, you have a combination of two or more drugs. The drugs you have will depend on whether you have an adenocarcinoma or a squamous cell carcinoma. The treatments are sometimes named after the initials of the drugs included.

Common combinations for both types of oesophageal cancer are:

  • cisplatin with either 5FU or capecitabine (a tablet form of 5FU)
  • carboplatin and paclitaxel.

Other common combinations used to treat adenocarcinoma of the oesophagus are:

  • ECF, which uses epirubicin, cisplatin and 5FU
  • EOX, which uses epirubicin, oxaliplatin and capecitabine
  • FLOT, which uses 5FU, leucovorin, oxaliplatin and docetaxol.

How chemotherapy is given

You usually have chemotherapy treatment in a chemotherapy day unit. This means you can go home on the same day. If you have it as an inpatient, you only need a short stay in hospital.

You have the chemotherapy drugs given into a vein (intravenously) or as tablets. Oesophageal cancer is sometimes treated with a combination of both.

We have more information about how chemotherapy is given.