Chemotherapy for oesophageal cancer

Chemotherapy treatment is when anti-cancer (cytotoxic) drugs are used to destroy cancer 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 to destroy any remaining cancer cells and to reduce the risk of cancer coming back.

If the cancer has spread to other parts of the body, chemotherapy may be used to shrink the tumour to relieve any symptoms and improve quality of life.

There are several chemotherapy drugs that can be used to treat oesophageal cancer. Treatment often combines 2 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.

The “chemo” word is scary. But it’s just medicine. I had 3 cycles, and whilst it wasn’t fun, nor was it unbearable. The overriding memory was boredom and some tiredness.

Mark


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 is a possibility that the cancer has spread somewhere else in the body, having chemotherapy before surgery may increase the chance of controlling it.

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

You may also have chemotherapy if the cancer has spread to other parts of the body. It aims to shrink the tumour to improve symptoms and quality of life. This is called palliative chemotherapy. For 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 is important to discuss the benefits and side effects of chemotherapy with your cancer specialist. If the cancer has spread, and you decide that you do not want to have chemotherapy, your doctor can prescribe other medicines to help control your symptoms.


Chemotherapy drugs used to treat oesophageal cancer

The chemotherapy drugs most commonly used are:

Other chemotherapy drugs may also be used.

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. Common combinations 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:

  • the ECF regimen (epirubicin, cisplatin, and 5FU)

  • the EOX regimen (epirubicin, oxaliplatin, and capecitabine).

Back to Chemotherapy explained

When is chemotherapy used?

Chemotherapy is used to kill cancer cells in the body. Your doctor will explain if chemotherapy is advised for you.

How do chemotherapy drugs work?

Chemotherapy drugs work by stopping cancer cells reproducing. The drugs can also affect healthy cells, causing side effects.