The type of treatment you’re offered depends on the type and stage of your oesophageal cancer. If your cancer is in the early stage and hasn’t spread to other parts of your body, your consultant may recommend surgery to remove part of or your entire oesophagus. You may also be offered chemotherapy and radiotherapy.
But if the oesophageal cancer is more advanced, or there are specific conditions involved (such as Barrett's oesophagus) surgery may not be recommended for you and other options will be discussed with you.
If the oesophageal cancer is caught early and hasn’t spread to any other organs, surgery may be an option. Surgery for oesophageal cancer is a major operation that will remove some or all of your oesophagus, so it’s important that your consultant makes sure you are fit enough to make a good recovery.
Endoscopic mucosal resection (EMR)
If you have high grade Barrett's oesophagus, or a very early stage cancer that only affects the inside lining of the oesophagus (the mucosal layer), it may be possible to remove the cancer using endoscopic mucosal resection (EMR), where a tube called an endoscope is pushed gently down your throat to see inside your oesophagus and remove the cancer.
Your consultant specialist may suggest chemotherapy on its own or given before your surgery to treat oesophageal cancer. When chemotherapy is given before surgery it is called neo adjuvant chemotherapy, and is commonly used to treat oesophageal cancer. You may be offered chemotherapy following surgery and this can help to reduce the risk of cancer returning.
If the oesophageal cancer has spread to other parts of your body (this is advanced oesophageal cancer), you might be given chemotherapy on its own, which will help to control or reduce the cancer and it effects.
Combined chemotherapy and radiotherapy
In certain cases, you might be offered chemotherapy and radiotherapy together, which is also called chemoradiation. This may be given to you before surgery to help shrink the cancer, which then makes it easier to cut out.
If you are can’t have surgery, or you simply don’t want surgery, you might be able to have chemoradiation on its own, especially is you have squamous cell cancer that is near the top of your oesophagus, as chemoradiation is often effective for this type of cancer.
In some cases, you may be given radiotherapy on its own if you are unable to have chemotherapy or surgery – this is common for advanced oesophageal cancer.
Biological therapies, sometimes known as targeted therapies, are treatments that act on processes in the cells. They can interfere with the growth of some types of cancer cells. They can also slow the growth of new blood vessels to the tumour.
Laser treatment and stents
If the cancer is blocking your and making it difficult for you to swallow, it’s likely you will need treatment to clear the blockage. To treat this, sometimes laser treatment is used to burn away the tumour, or a tube called a stent is inserted that allows food and drink to pass through the oesophagus.
Radiofrequency ablation (RFA)
This treatment uses heat to destroy the cancer cells and is occasionally used to treat very early oesophageal cancers.
Photodynamic therapy (PDT)
This is also called a light sensitising treatment, and involves the use of lasers with a light sensitive drug to destroy cancer cells. PDT may be given to try to prevent high-grade Barrett's oesophagus developing into cancer, or if you can’t have an endoscopic mucosal resection (EMR) or surgery.
Paying for your treatment
You have two options to pay for your treatment – your costs may be covered by your private medical insurance, or you can pay for yourself. Check with your private medical insurer to see if your diagnostic costs are covered under your medical insurance policy. If you are paying for your own treatment the cost of the procedure will be explained and confirmed in writing when you book the operation.
Ask the hospital for a quote beforehand, and ensure that this includes the consultant fees and the hospital charge for your procedure.
Want to know more?
If you’d like to read more about oesophageal cancer, treatment or living with oesophageal cancer, please visit cancerresearchuk.org.uk.