What is Chemotherapy?

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Chemotherapy uses drugs to kill cancer cells or stop them from growing. It’s usually given through an IV (drip) or as pills. Examples of chemotherapy regimens used in oesophageal and gastric cancer are FOLFOX, CAPOX, docetaxel and irinotecan.

 

Specific chemotherapy information can be found at Macmillan-chemotherapy

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Chemotherapy infusions involve a combination of specialist drugs bespoke to each individual patient. We do not describe the various drug combinations here because each patient’s circumstances differ, meaning their Consultant Oncologist will decide which treatments are best suited for each patient.

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One infusion and rest period are normally referred to as a ‘cycle’. Typically, four, fortnightly cycles are given, the average treatment periods lasting for 8 weeks. However, treatment plans do vary, and four, 3-week cycles, lasting 12 weeks are not uncommon.  Tablets may also be prescribed, to be taken at home daily throughout the treatment period.

 

How Does It Work?

 

Chemotherapy attacks rapidly dividing cells, including cancer cells. It aims to shrink tumours and slow cancer growth.

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Does chemotherapy work?

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In most cases, yes. 

 

In the past, chemotherapy earnt a bad reputation for being an extremely unpleasant treatment. While killing cancerous cells it also caused sickness and damage to a healthy body. But over the last decade new drugs and therapies have become much more focussed and tailored to different types of cancer with much reduced side effects despite in most cases remaining very effective in shrinking tumours.

 

Understandably, chemotherapy is a daunting prospect but be assured that it works very well and is definitely worth it. 

 

How will impact my quality of life?

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Chemotherapy can be tough, but it’s essential for treating cancer. Your medical team will help manage side effects and support you. If you have specific questions, you should contact your CNS or medical team.

 

What does Chemotherapy involve?

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Treatment usually requires a combination of drugs to be administered in liquid form by ‘intravenous infusion’, and others to be taken orally in tablet form. Infusions are administered in a hospital setting and typically take half a day to complete. A ‘course’ or ‘cycle’ of infusions is usually scheduled once a week over a 6–9-week period. Tablets are taken at home with specific instructions that must be followed. Clinicians will take blood samples throughout the treatment plan to monitor how the patient is doing, and ensure that the therapy is not causing any problems and that the patient remains well throughout.

 

Once the chemotherapy has finished a follow-up computed tomography (CT)  scan will be arranged to measure the reduction in the size of the tumour as part of the preparations for surgery.

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In one typical case over a 9-week chemotherapy treatment plan the tumour shrunk by nearly 400% making it much easier to remove during the operation, and it was also easier to swallow and eat normally again after only four weeks of infusions and tablets. For many, chemotherapy is a vital part of the treatment. 

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After chemotherapy has finished, be prepared for a few weeks of ‘waiting’ for a follow-up scan and then an appointment with your specialist. This can feel frustrating after weeks of treatment followed by another hiatus. Be assured that these are not delays but a time for you to recover from chemotherapy and hopefully, eat well and put on a little bit of weight. A welcomed break ahead of the next phase of your treatment plan. 

 

What are the common side effects of chemotherapy?

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Side effects vary between the drugs prescribed, however, the two most common side effects after an infusion or taking tablets are mild nausea and fatigue. Additional medication is prescribed to help reduce the sensation of nausea. These drugs are usually very effective. Resting during treatment is the sensible thing to do which helps sustain energy levels for longer. It is best to be driven to and from hospital after infusions.

 

Hair loss is not strongly associated with chemotherapy drugs prescribed for oesophageal cancers; however, up to 20% of patients will experience some hair loss. Ask your oncologist about this before chemotherapy is prescribed. Something called a ‘cold cap’ can be worn to help reduce hair loss. While they can be mildly uncomfortable to wear, feedback from patients suggest they do work. Hair always grows back.

 

Other possible and temporary side effects include loss of appetite; a reduced sensation of taste; mild tingling sensations in the fingertips, tongue and feet; more acute sensations of hot and cold; and mild headaches. Appetite and taste tend to recover quickly after treatments have finished but mild tingling in the feet, for example, may persist for weeks or months afterwards.

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Side effects vary slightly from person to person, and whilst they can affect your energy and well-being it is normal to fully recover afterwards.