Chemotherapy

What is chemotherapy?

Chemotherapy works by preventing cancer cells from replicating.

The drugs which are commonly used in oesophageal and gastric cancer are:

• Epirubicin
• Cisplatin
• Fluorouracil (5FU)
• Capecitabine (oral form of 5FU)
• Oxaliplatin

In oesophageal and gastric cancer chemotherapy is often given before surgery (neoadjuvant treatment).

The aim of giving chemotherapy before surgery is to reduce the size of the tumour and to eliminate any cancer cells which may have escaped from the main tumor site.

Depending on the results from the surgery and patient recovery, further chemotherapy is often given after the surgery as well (adjuvant chemotherapy).

How long does it take?

Chemotherapy before surgery usually involves 3 “cycles” of treatment. Each cycle takes about 3 weeks. Depending on your blood tests there maybe a break between cycles. After completion of chemotherapy there is a period of 5-8 weeks before the surgery to allow the blood to recover.

Where is treatment given?

The chemotherapy will be overseen by a consultant oncologist. We will try to ensure your treatment is in a convenient location and will help you find a consultant.

How will I know if it is working?

Patients often report an improvement in their symptoms after the first cycle of treatment. For example, in oesophageal cancer, a patient’s ability to swallow may get better with treatment. This is a good sign and suggests a response to the chemotherapy.

After completion of treatment, a CT scan will be performed to assess the response. This will determine whether surgery of further chemotherapy is required.

Can I work during treatment?

The effects of chemotherapy are extremely variable. Many patients do continue to work during treatment.

What are the side effects?

Unfortunately, healthy cells also take up chemotherapy drugs. These healthy cells can usually repair themselves and the effects stop once the treatment has finished.

The common side effects of treatment include:

• Infection
• Nausea
• Loss of appetite
• Tiredness
• Sore mouth
• Diarrhoea
• Hair loss
• Numbness and tingling
• Soreness to hands and feet
• Blood clots

What happens if I stop treatment?

Some patients tolerate chemotherapy poorly. If this happens then an early reassessment will be performed and a decision will be made on the next appropriate course of treatment.