Esophageal Cancer Radiation Therapy

Radiation therapy (also called radiotherapy) uses high-energy x-rays to kill cancer cells. It affects cells only in the treated area.

Radiation therapy is usually given with chemotherapy to treat esophageal cancer. It is commonly given before surgery. Radiation may also be given to palliate symptoms of esophageal cancer, such as trouble swallowing, bleeding or pain. Treatments are usually 5 days a week for several weeks.

IMRT (Intensity Modulated Radiation Therapy) is a type of radiation therapy that targets tumors with greater precision than conventional radiation therapy. This allows the radiation oncologist to minimize the amount of radiation that is delivered to adjacent organs such as heart, lungs, and spinal cord.

Side effects depend mainly on the dose and area treated by radiation. External radiation therapy to the chest and abdomen may cause difficulty with swallowing, heartburn-like symptom, or discomfort in the stomach or the intestine. You may have nausea and experience decreased appetite. Your health care team can give you medicines to prevent or control these problems.

You are likely to be tired during radiation therapy, especially in the later weeks of external radiation therapy. You may also continue to feel tired for a few weeks after radiation therapy is completed. Having enough rest is important, but doctors usually advise patients to try to stay as active as they can.

Radiation therapy can lead to problems with swallowing. For example, sometimes radiation therapy can cause inflammation of the esophagus and make it painful for you to swallow. Or, the radiation may cause the esophagus to narrow. If radiation therapy leads to a problem with swallowing, it may be hard to eat well. Often it is necessary for patients to have a feeding tube placed temporarily in their stomach to help them maintain proper nutrition. Ask your health care team for help getting good nutrition. See the Nutrition section for more information.

You may want to ask your doctor these questions before having radiation therapy:

• When will treatment start?
• When will it end?
• How often will I have treatments?
• Will I need to stay in the hospital?
• What can I do to take care of myself before, during, and after treatment?
• How will I feel during treatment?
• Will I be able to drive myself to and from treatment?
• How will we know the treatment is working?
• How will I feel after the radiation therapy?
• Are there any lasting effects?