What is radiotherapy?

Doctors often use radiotherapy to treat cancer of the oesophagus. You may have radiotherapy and chemotherapy together to try to cure the cancer, instead of surgery. Doctors most often recommend this type of treatment for cancers of the upper third of the oesophagus, particularly squamous cell cancers. There has been some research into using radiotherapy before surgery to try to shrink the cancer and lower the risk of it coming back. A review of this research in 2005 suggested that it didn't seem to help, so your specialist is unlikely to recommend this.

If you have a cancer that can't be removed with surgery, you may still have radiotherapy. It can shrink the cancer and so relieve any symptoms it is causing.

Most radiotherapy is external treatment. That is, the radiation is aimed at the cancer from outside the body. But you can have internal radiotherapy. This means the radiotherapy source is put inside the oesophagus. There is information about internal radiotherapy for cancer of the oesophagus in this section of CancerHelp UK.

For external radiotherapy treatment, you have to go to the hospital radiotherapy department. The length of your course of treatment depends on whether you are having radiotherapy to try to cure the cancer or to relieve symptoms.

Radiotherapy to try to cure oesophageal cancer is usually a course of treatment over 4 to 6 weeks. Your radiotherapy specialist works out the total dose you need and then that is divided into a number of smaller treatments, called fractions. You have one fraction a day, from Monday to Friday, until you have had the total dose. Doctors give radiotherapy this way to balance the side effects with the effect of the treatment on the cancer.

Radiotherapy for symptoms is often given over a smaller number of treatments (fractions) so that you don't have to keep coming back to the hospital. You may have one treatment a day for a few days or a few treatments with a few days break between each.

Your specialist has to plan your radiotherapy very carefully. At your first visit you lie under a large machine called a simulator. The doctor uses this to work out where to give your treatment to kill the most cancer cells and miss as much healthy body tissue as possible. The radiographer makes a pinprick tattoo on your skin and uses it to line up the radiotherapy machine every day when you have your treatment. Sometimes more marks are made with felt pen. If so, you must be careful not to wash them off! If they start to fade, your radiographer will mark them in again.

The actual treatment only takes a few minutes. The radiographer will help position you on the couch and make sure you are comfortable. You will be left alone for the minute or two the machine is switched on. But the staff will be able to hear you through an intercom, so call if you need them. The treatment does not hurt. You will not be able to feel it at all. You must lie very still for the few minutes it takes to treat you.

Having external radiotherapy does not make you radioactive. It is perfectly safe to be with other people, including children, throughout your treatment course.

The main radiotherapy section in CancerHelp UK will tell you more about radiotherapy including

• What radiotherapy is
• How doctors plan radiotherapy
• Possible radiotherapy side effects