Radiotherapy uses high-energy rays to destroy cancer cells while causing the least possible damage to normal cells.
Radiotherapy can be given in two different ways:
- From outside the body, which is the most common way of treating esophageal cancer.
- From the inside, by placing a radioactive material near or in the tumor. It is not commonly used to treat esophageal cancer.
External radiotherapy is given in combination with chemotherapy to treat esophageal cancer. It is sometimes given in place of surgery or occasionally before an operation to reduce the size of the tumor.
If the cancer is more advanced, radiotherapy can be given alone to reduce the size or the tumor and help control symptoms.
The treatment is given in the hospital's radiotherapy department. Each treatment lasts 10-15 minutes and takes place every weekday, with weekends set aside to rest.
Your doctor will discuss your treatment and the possible side effects with you.
Radiation Therapy Planning
Radiotherapy must be carefully planned in order to ensure that it is as effective as possible.
On your first visit to the radiotherapy department, you will have a CT scan done or you will lie down below a machine that will take x-rays of the area to be treated.
You may have small marks made on your skin (tattoos) to help the technician find the position more precisely so that the rays can be directed to this area. These marks must remain visible throughout the treatment. These are extremely small permanent marks, and you won't have these done without your consent.
At the beginning of each session, the technician will carefully place you so that you are comfortable, as you must remain still during the treatment. Radiotherapy isn't painful. During the treatment you will stay in the room alone, though you can talk to the technician monitoring you from an adjacent room.
Internal radiotherapy (brachytherapy)
To administer brachytherapy, a radioactive source is place inside the tumor. This delivers a high dose of radiotherapy to the tumor.
Your nearby organs should not be affected because the radiation does not travel far.
The radioactive source is left in for a time that ranges from 30 minutes to a couple of hours depending on the amount of radiation you need.
This means treatment can be administered directly to the tumor over a short period of time instead of directing external radiation at a wider area over a longer period of time.
There are two ways of administering internal radiotherapy:
- Through an endoscope
- Through a nosogastric tube—a thin, flexible plastic tube inserted through the nose, the back part of the throat, and into the stomach.
Your doctor will explain in greater depth how this treatment is given.
Internal radiotherapy causes pain when swallowing which may last for a couple of days after the treatment.
If you have to stay in the hospital while the radioactive source is placed inside you, your family members and friends will only be able to visit you for short periods per day.
Children and pregnant women should not visit while you are having this type of radiotherapy.
The hospital staff will explain this to you more fully.