This leaflet provides information on a course of chemotherapy and radiotherapy treatment for cancer of the oesophagus (gullet). It will explain what the treatment is and when and how it will be given. It will also tell you about common side effects that you may experience. Contact telephone numbers and details of how to obtain further information are given at the end of the leaflet.
This leaflet should be read alongside the ‘General information for patients receiving chemotherapy’ leaflet, and the booklet about your radiotherapy. If you haven’t received these then please ask your nurse for copies.
Why am I having cisplatin and 5 fluorouracil
chemotherapy with radiotherapy?
Your doctor has recommended this treatment because it has been found to be particularly effective in treating your type of cancer.
Radiotherapy and chemotherapy treatments can give better results when given together than with either treatment given alone. The aim of the treatment is to destroy any cancer cells in or near your tumour, and any cancer cells that may have moved to other parts of your body.
How often will I have my treatment?
The chemotherapy part of your treatment consists of two drugs:
For this treatment to be most effective, it is given at specific time intervals. These are known as cycles. It is usual to have up to 6 cycles of this chemotherapy at 3 weekly intervals. You will have 2 cycles before you start your radiotherapy. Your chemotherapy will be given on week 1, 4, 7 and 10. Your radiotherapy will be given during week’s 7-11.
This is shown in the diagram.
| Weeks | |||||||||||
| 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 | 12 |
| C | - | - | C | - | - | C | - | - | C | - | - |
| - | - | - | - | - | - | R | R | R | R | R | - |
C = chemotherapy
R = radiotherapy
Will I need to stay in hospital for this treatment?
To receive this treatment you will need to stay in hospital for 4 - 5 days for each cycle of chemotherapy. You will be admitted to the chemotherapy in-patient unit at Velindre Cancer Centre.
Will I need any tests before I have my chemotherapy?
You will need a series of blood tests before you start your chemotherapy. One of these blood tests helps us to check that your kidneys are working well enough to cope with the chemotherapy.
How will my treatment be given?
Your chemotherapy is given through a drip into a vein in the back of your hand or arm. You will remain connected to the drip during your stay in hospital. The drip will be attached to a portable stand with wheels so you will be able to move around the ward area. If you need help a nurse will be available.
The cisplatin is given on the first day of each cycle. The 5-FU is given continuously over the next 4 days.
How will my radiotherapy be given?
You will receive 25 treatments, one each day Monday to Friday. Each daily treatment is called a fraction, and takes just a few minutes. You will not feel anything during your treatment, but you will hear a buzzing sound from the machine.
Your radiotherapy booklet contains information about how your radiotherapy treatment is planned, how it is given and the possible side effects you may experience. If you would like further information about your radiotherapy please speak to your radiographers.
Can I bring relatives and friends with me?
You are welcome to bring someone to stay with you during your treatment. Space is limited so there is not usually room for more than one person. Treatment areas are not suitable for young children.
What are the possible side effects associated with my chemotherapy?
There are a number of possible side effects which can occur with this chemotherapy. The doctors, nurses and pharmacists can give you advice or answer any questions you may have.
Hair loss
You should not lose your hair with this chemotherapy. However, some patients experience some hair thinning.
Sickness
Nausea and vomiting are uncommon these days as we will give you anti-sickness medicines which are usually extremely effective. If you are sick more than once in 24 hours despite taking regular anti-sickness medicine when you are at home after your chemotherapy treatment, contact Velindre Cancer Centre for advice. The telephone number is at the end of the leaflet.
Infection
You are at an increased risk of picking up infections because your white blood cells which help fight infections can be reduced by this treatment.
If you develop an infection whilst your white blood cells are low, you are at risk of sepsis, this can be life threatening.
Contact Velindre Cancer Centre immediately if you develop any signs of infection, for example flu like symptoms or a temperature above 37.5°centigrade or below 35.5°centigrade. The telephone number is at the end of the leaflet.
Diarrhoea
You may have diarrhoea. If this occurs it is important that you drink plenty of fluids. Medication is available to control diarrhoea. If you have 4 or more bowel movements above what is normal for you please contact Velindre Cancer Centre immediately. The telephone number is at the end of the leaflet.
Tiredness and fatigue
Chemotherapy can make you feel more tired than usual. It is important to listen to your body and rest if you need to, but carry out your normal activities if you feel able. Some people find it beneficial to take gentle exercise as well as taking rest.
Sore mouth
Your mouth may become sore or you may notice small ulcers. Please follow the advice on caring for your mouth in the general chemotherapy leaflet. Your doctor may prescribe mouthwashes or medication to prevent or clear any infection.
Effect on your kidneys
Cisplatin can affect the way your kidneys work. The blood test which you have before your chemotherapy will check how well your kidneys are working at the start of treatment. We will also monitor you carefully by taking regular blood tests throughout your treatment.
We always give cisplatin with plenty of fluids in the drip to reduce the effect on your kidneys. It is also important that you drink plenty of fluids for at least 2 days after each treatment. We suggest a cup or glass of fluid every hour during the day and evening.
Blood clots
A diagnosis of cancer can increase your risk of developing a blood clot (thrombosis), and having cancer treatment may increase this risk further. It is important to tell your doctor immediately if you have symptoms such as pain, redness and swelling in your leg, or breathlessness and chest pain.
Blood clots can be very serious. However, most clots can usually be successfully treated with drugs to thin the blood. Your doctor or nurse can give you more information
Other side effects
Cisplatin may damage the nerves of your hands and feet. You may experience some numbness or changes in sensation such as tingling or pins and needles. Although this is very rare it is important that you tell your doctor if this happens so that we can modify your treatment before this side effect becomes permanent.
Cisplatin may also damage the nerves responsible for hearing, although this is rare. If this occurs you may experience some loss of hearing which may be permanent.
Very rarely some people having this chemotherapy experience heart problems such as angina or palpitations. If you have a heart condition or you take any heart medication, please tell your doctor before you start chemotherapy.
Women sometimes find that chemotherapy treatment affects their periods. They could become heavier, lighter or even stop altogether.
It is important you do not become pregnant or father a child whilst having chemotherapy treatment as chemotherapy could damage the unborn baby.
This chemotherapy can increase your skin’s sensitivity to the sun. It is best to avoid strong sunlight, wear a hat and use a sun block.
Sometimes cancer drugs can have very serious side effects which rarely can be life threatening. It is important to inform Velindre cancer centre if you are concerned about any side-effects.
Manufacturer’s patient information leaflets
Velindre leaflets provide information about very common and commonly reported side-effects (we are unable to list all of the common side effects), for more information regarding these and the less common side-effects please refer to the manufacturers patient information leaflets, obtained from Velindre pharmacy and/or on the internet at www.medicines.org.uk. Sometimes patients may find these leaflets difficult to read however. Please ask if you would like a copy from your doctor or from Velindre pharmacy
Contact telephone numbers
Velindre Cancer Centre 029 2061 5888
Ask for the treatment helpline if you are unwell at home and need immediate advice at any time of the day or night. For example you should phone if you:
Pharmacy department 029 2061 5888 ext 6223
Monday – Friday 9am – 5pm for queries about your medicines
Tenovus freephone 0808 808 1010
cancer helpline
Information and 029 2061 5888 ext 6428
Support Radiographers
This information is also available in Welsh
This leaflet was written by health professionals. The information contained in this leaflet is evidence based. It has been approved by doctors, nurses and patients. It is reviewed and updated every 2 years.