Side effects of radiotherapy to the oesophagus

Radiotherapy can cause side effects. These may be mild or more troublesome. Most will gradually improve when treatment finishes. General effects include feeling tired or sick, but radiotherapy to the oesophagus can also cause more localised side effects. Your oncologist can discuss possible side effects with you and suggest treatments to improve them.

Possible side effects include:

  • Skin changes – The skin around the treatment area can get dry and sore.
  • Sore throat and difficulty swallowing – If your throat becomes very sore, you may have difficulty swallowing.
  • Dry mouth – Radiotherapy can affect your saliva and give you a dry mouth.
  • Loss of appetite – You may not feel like eating during treatment. A dietitian can support you and help you maintain your weight.
  • Feeling sick – Radiotherapy to the oesophagus can cause you to feel sick (nausea) and be sick (vomit).
  • Hair loss – If you have hair on the area where the radiation is given (the chest), some may fall out.
  • Tiredness – You will need to rest more than usual during treatment as it can cause fatigue. Maintaining a little bit of activity when you feel able to will help improve your energy levels.

About radiotherapy side effects

Radiotherapy can cause general side effects, such as feeling sick (nausea) and tiredness (fatigue). It is also likely to make the inside of your oesophagus inflamed. This can cause temporary soreness when you swallow. These side effects can be mild or more difficult. This depends on the dose and length of your radiotherapy treatment. 

It is not unusual to feel worse before you start to feel better. This can be a very difficult time. You may feel low or even depressed for a while. Your clinical oncologist can advise you about what to expect and what can help with the side effects. 

Once your course of treatment ends, these side effects should improve gradually. But, it is important to tell your doctor if they continue. 

Radiotherapy does not make you radioactive. It is perfectly safe for you to be with other people, including children, throughout your treatment.

I remember the nurses saying that the effects got worse around week three, but things would soon get better after finishing the radiotherapy. If you’re having problems dealing with them, you can always call the nurses – they’re there to help and answer any questions you might have, so do contact them if you want to.


Skin changes

During your radiotherapy, you will need to take extra care of the skin in the area that is being treated. This is because the area being treated sometimes gets dry and irritated, or the treatment may cause a skin reaction.

Before your treatment starts, the staff in the radiotherapy department can give you advice on how to look after your skin.

Because of the skin changes, you will need to ask your specialist team whether you should avoid swimming during treatment. They can also tell you when you can go swimming again after your treatment.

We have more information about managing skin reactions.

Sore throat and difficulty swallowing

Towards the end of treatment, radiotherapy can make your throat very sore. You may not be able to swallow properly for a while. The soreness can last for a few weeks after radiotherapy ends. Your doctor can give you medicines to help. The pain may affect your ability to eat enough, so you may need to see a dietitian. They can talk to you about how you can supplement your diet with high-calorie, nutritious drinks.

Some people have a feeding tube put into their stomach before the radiotherapy starts. The tube may either be put into the nose and passed down the oesophagus (called a nasogastric tube) or through the skin (called a gastrostomy tube). Liquid food can be given through the tube.

Your doctor can talk to you about whether you might need a feeding tube. They can give you information about the type of tube to be used. You will also have support from a dietitian. A speech and language therapist can help you with any swallowing difficulties you may have.

We have more information about feeding tubes and how they are used.

Dry mouth

Sometimes, radiotherapy to the upper end of the oesophagus may reduce the amount of spit (saliva) your salivary glands produce. This effect may be temporary but is sometimes permanent. It may make your mouth dry, which can make eating difficult.

We have more information about how to cope with a dry mouth.

Loss of appetite

During radiotherapy, you may not feel like eating very much. But it is important to try to maintain your weight. Your dietitian can advise on ways to build up your diet and maintain or gain weight.

Feeling sick

Radiotherapy and chemotherapy can cause you to feel sick (nausea) and be sick (vomit). This can usually be treated with anti-sickness drugs (anti-emetics). Your doctor can give these to you.

Hair loss

When radiotherapy is used to treat oesophageal cancer, it can affect hair on the area. If you have hair on your chest, some of it may fall out.

Tiredness (fatigue)

Radiotherapy can make you feel tired. In some people, this continues for several months after treatment. During your treatment, you will need to rest more than usual, especially if you have to travel a long way for your treatment each day. But it is good to do gentle exercise, such as walking, when you feel able to. Once your treatment is over, try to increase your activity gradually and balance rest periods with gentle exercise. This can help build up your energy levels.

Back to Radiotherapy explained

Before your radiotherapy

Before you start radiotherapy, your team will explain what your treatment involves and how it may affect you.

Your radiotherapy team

You will meet many different specialists from your radiotherapy team. You may see them before, during and after radiotherapy treatment.