Chemotherapy 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:

• both before and after surgery (perioperative chemotherapy)
• with radiotherapy (chemoradiation)
• on its own, or with targeted therapy (palliative chemotherapy).

Chemotherapy for squamous cell carcinoma may be given:

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

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

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.

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.