Chemotherapy for oesophageal cancer

Chemotherapy uses anti-cancer (cytotoxic) drugs to destroy cancerous cells. If you have oesophageal cancer, you may be given chemotherapy before you have surgery. Chemotherapy drugs can help shrink a tumour and make it easier to remove.

Sometimes chemotherapy treatment is given after surgery. This is used to destroy any cancer cells that may have been left behind following the operation.

If cancer has spread to other parts of the body, chemotherapy may be used to shrink the tumour and improve any symptoms the cancer my cause. This is called palliative chemotherapy and aims to help maintain a good quality of life.

There are several drugs that can be used to treat oesophageal cancer. These are often combined and treatment may consist of two or more drugs.

What is chemotherapy?

Chemotherapy uses anti-cancer (cytotoxic) drugs to destroy cancer cells. Cytotoxic means toxic to cells.

These drugs disrupt the way cancer cells grow and divide, but they also affect normal cells.

When chemotherapy is given

Chemotherapy is often given before an operation to remove an oesophageal cancer. This is sometimes called neoadjuvant chemotherapy. It can shrink the tumour, making it easier to remove. If there’s a possibility that the cancer has spread somewhere else in the body, giving chemotherapy earlier may increase the chance of controlling it.

Chemotherapy can sometimes be given after surgery to reduce the chances of the disease coming back. It works by destroying any cancer cells that might be left behind after the operation. This is called adjuvant chemotherapy.

Chemotherapy may also be used if the cancer has spread to other parts of the body. This aims to shrink the tumour to improve symptoms and maintain a good quality of life. This is called palliative chemotherapy. In some people, the chemotherapy will help. For others, the chemotherapy will not shrink the cancer and they will have the side effects of treatment with little benefit.

It’s important to discuss the benefits and side effects of chemotherapy with your cancer specialist. If you have a cancer that has spread, and you decide that you don’t want to have chemotherapy, your doctor can still prescribe medicines to help control symptoms.

The drugs used

The chemotherapy drugs most commonly used are:

Other chemotherapy drugs may also be used.

Combination of drugs

Usually a combination of two or more drugs is given. A common combination used to treat adenocarcinoma of the oesophagus is the ECF regimen. This contains the drugs epirubicin, cisplatin and 5FU.

Capecitabine is a tablet form of 5FU. If this is used instead of 5FU, the combination is known as the ECX regimen.

Another combination is called the EOX regimen and uses the drugs epirubicin, oxaliplatin and capecitabine. EOX is sometimes called the EEX regimen.

Squamous cell carcinoma of the oesophagus is commonly treated with a combination of cisplatin and 5FU.

Back to Chemotherapy explained

Your feelings

You may experience difficult feelings while having chemotherapy treatment. Talking these over can be helpful.

Where can you have chemotherapy?

You usually have chemotherapy in a chemotherapy day unit or clinic. If your treatment is more complex, you may need to stay in hospital.