Radiation therapy for esophageal cancer

The exact treatment for esophageal cancer will depend on the stage of the tumor and your overall health and shape. The treatment plan will be made in collaboration with several specialists.

Radiation combined with chemotherapy
Radiation treatment can be given together with chemotherapy. We call this chemoradiation. The goal of the chemotherapy is to make the cancer cells more sensitive to the radiation treatment, which can increase its effects. These drugs will be administered through IV.

If we expect that you will need surgery after your treatment, you will receive 23 radiation sessions and 5 chemotherapy treatments. If you will not need surgery after the radiation, you will receive 28 sessions, 25 of which will be preceded by a low dose of chemotherapy through IV.

Radiation to alleviate symptoms
If your esophageal cancer has advanced or spread through the body, or if your health does not allow for intensive treatment, we can adapt the treatment. You will receive 5 to 13 radiation sessions.

Newest techniques and latest advancements

Our Radiation Oncology department is continuously working on the development of new techniques using the most advanced technology currently available - both in diagnostic imaging, preparation, and radiation itself. This allows us to deliver the most effective treatment possible to you, while sparing as much healthy tissue as possible.

Consultation with your radiation oncologist

You will meet with your radiation oncologist to discuss your situation and the treatment that best fits you, its goal, expected outcome preparation, execution, and side effects.

Multidisciplinary team meeting

Your situation, test results and medical history will be discussed in a multidisciplinary team meeting consisting of specialists such as gastroenterologists, surgeons, and radiation oncologists, in order to find the treatment that best fits you. Your radiation oncologist will discuss the results with you.

Research

We are constantly working to improve and develop radiation treatment through research. If your radiation oncologist knows of a trial that you may qualify for, he or she will let you know. You will receive more information to make an informed decision. Your participation is voluntary. if you decide not to participate, you will be treated according to the latest protocols and developments.

Preparation

You will have a CT as a preparation for the treatment. You will be taking the same position you would during radiation treatment: on your back. We will administer an IV for a contrast solution. You can eat and drink as usual before your treatment.

Your radiation oncologist will project laser lines on the skin. You will receive small tattooed dots on these lines in order to deliver the radiation to the same spots during your next session.

We will provide information about the treatment during your preparatory consultation. There will be plenty of room to ask questions.

Radiation treatment planning

Your radiation oncologist will draw the placement of the radiation field on these CT scans. He or she will calculate the optimal external beam radiation using special software: the treatment planning. It is important to ensure that the field receives the correct dose and that the surrounding tissue is spared as much as possible.

Radiation

Radiotherapy lab technicians ensure that you are positioned correctly on the table. The beams on your body will overlap with the tattooed dots on your body.

We will often check whether your position is still correct by using a CT scanner attached to the machine. This allows us to make small adjustments to your position in order to ensure that the radiation matches the tumor shape as closely as possible. The lab technicians will follow the treatment on monitors. The radiation machine can revolve around you to find the right angle for the treatment.

The delivery of the radiation itself will take a few minutes. The total time of the treatment will be approximately 15 minutes. The beams won’t hurt, although you will start to notice the effects of the radiation.

Check-ups with your radiation oncologist

During your treatment you will regularly meet with your radiation oncologist to discuss the progress and ask any questions you may have. Your radiation oncologist will offer advice on how to deal with the side effects you are experiencing and prescribe medication if needed. You will also hear about the next step after your treatment.

Side effects

The side effects you will experience depend on your personal situation, overall shape and health, and the area that is receiving the treatment. Your practicing physician will discuss the side effects you can expect with you.

When treating the esophagus, you may experience problems in the passage of food through the esophagus. Your radiation oncologist and dietician will offer you support. The treatment will also cause fatigue.

You may notice the acute side effects after two or three weeks of treatment. These will increase in severity over the course of your treatment and may linger for months after its end. Some side effects may be permanent. Your practicing physician will discuss which side effects you can expect.

What you can do

If your symptoms, situation, and overall health allow, we recommend daily exercise to improve your recovery. You could consider walking or biking, or exercise under the supervision of a physical therapist. We also recommend continuing your day to day activities as much as possible.

General nutritional guidelines apply during treatment.

Please consult your practicing physician if you wish to continue taking additional vitamins or supplements during your treatment.

Follow-up care

If you would like extra care during or after your treatment, please ask your radiation oncologist or physician assistant to the NKI Survivorship Center. Our physical therapists, occupational therapists, social workers, and psychologists are experienced in care for cancer patients and would love to offer additional support during and after your treatment.