Chemotherapy for esophageal cancer is used before surgery to shrink tumors and after surgery to kill any remaining cancer. It’s also used to relieve symptoms for people with late stage cancer.

Chemotherapy is a powerful treatment for many types of cancer, including esophageal cancer. It’s not a cure for the cancer on its own, but it’s an important part of esophageal cancer treatment.

Chemotherapy for esophageal cancer may be used:

  • before tumor-removal surgery to shrink the tumor and make it easier to remove
  • after tumor-removal surgery to kill any remaining cancer cells
  • to relieve symptoms for people with late stage esophageal cancer

Chemotherapy is typically given through an intravenous (IV) injection. Sessions of chemotherapy last for 2–3 weeks, and total treatment time is typically 3–6 months. The exact times and number of treatments will vary depending on the chemotherapy medications you’re prescribed and on the dose.

Keep reading to learn more about how chemotherapy is used to treat esophageal cancer and how effective it is.

Chemotherapy can be used in multiple ways and for multiple stages of esophageal cancer. Common uses of chemotherapy for esophageal cancer include:

  • Before surgery: Chemotherapy used before surgery is called neoadjuvant chemotherapy. It’s often done with the goal of shrinking an esophageal tumor so that there’s less to remove during surgery. It can lower the odds of cancer returning after surgery.
  • After surgery: Chemotherapy used after surgery is called adjuvant chemotherapy. It’s done with the goal of killing any cancer cells left behind after surgery or that have spread beyond the original tumor. Often, adjuvant chemotherapy is done along with radiation therapy.
  • For late stage cancers: Chemotherapy can also be used for late stage esophageal cancers that have spread and can no longer be removed with surgery. At this stage, chemotherapy isn’t typically used to cure cancer. Instead, it’s done with the goal of relieving your symptoms and increasing survival length.

How curable is esophageal cancer?

As is true for all cancers, esophageal cancer has the most successful treatment outcomes when it’s found early. Other factors that influence survival include your response to treatment, overall health, and age at the time of receiving the diagnosis.

According to the American Cancer Society, the overall 5-year relative survival rate for esophageal cancer was 21% between 2012 and 2018. The 5-year relative survival rate for people who received a diagnosis in an early stage was 47%.

Keep in mind that these rates are based on data collected in the past. Cancer treatments are continuously improving, and it’s possible that actual current survival rates for esophageal cancer are higher than these numbers indicate.

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Chemotherapy is typically effective and helpful against esophageal cancer but can have different outcomes at different stages. For instance, chemotherapy used to shrink an early stage tumor before surgery is significantly more likely to lead to long-term survival than chemotherapy used in late stage esophageal cancer to relieve symptoms.

The timing of chemotherapy can also have an effect on success. As a rule, chemotherapy used before surgery has the strongest links to increases in positive outcomes.

This doesn’t mean that chemotherapy after surgery or in late stage esophageal cancer doesn’t help. It simply means that data suggest that chemotherapy might be the most effective when given early in treatment.

Typically, chemotherapy is given as an IV infusion or injection, although some chemotherapy medications can be taken as capsules that you swallow. You’ll receive chemotherapy at a doctor’s office, cancer center, infusion center, hospital, or other medical facility.

Sometimes, chemotherapies are delivered as oral medication (pills) that are taken at home on a daily or weekly basis.

You might have what’s called a central venous catheter (CVC) inserted before you begin chemotherapy treatments. A CVC looks like the end of an IV line, but it’s made to be left in place for weeks or months.

CVS can include ports or peripherally inserted central catheter (PICC) lines.

Once your CVC is in place, you won’t need a needle inserted every time you need chemotherapy or another medication. It will simply be placed into your CVC. Additionally, CVCs can be used to draw blood for lab work. You can read more about CVCs here.

A cycle of chemotherapy is often 2–3 weeks long. You might have chemotherapy every day, a few days a week, or only once during that cycle, depending on the chemotherapy drugs being used.

The total length of chemotherapy depends on the type of chemotherapy and how you respond to it. Chemotherapy given before or after surgery is typically done for around 3–6 months. Chemotherapy durations for late stage esophageal cancer will vary.

Chemotherapy is known to cause side effects. Not everyone experiences every side effect. Side effects can be mild or severe and can depend on the type of chemotherapy medication you receive, how high your dose is, how long your treatment is, and more.

Common side effects include:

  • nausea
  • vomiting
  • mouth sores
  • diarrhea
  • constipation
  • loss of appetite
  • hair loss
  • increased infections
  • fatigue
  • easy bleeding and bruising

Other, less common side effects can also occur. These are more likely with certain chemotherapy medications than others. Your cancer team can discuss the side effects that you might experience.

Less common side effects include:

Chemotherapy is one of several treatment options for esophageal cancer. Typically, a doctor will put together a treatment plan that uses several types of treatment together.

In recent years, immunotherapy has been a new addition to common esophageal cancer treatments. Today, along with immunotherapy and chemotherapy, esophageal cancer treatment often includes:

Chemotherapy is a standard and important part of esophageal cancer treatment. It’s used at various points and stages throughout esophageal cancer. This includes before tumor-removal surgery, after tumor-removal surgery, and as a symptom-relieving treatment for people with late stage esophageal cancer.

Chemotherapy treatments done before surgery are linked to the highest odds of long-term survival.

Chemotherapy can have side effects, including nausea, vomiting, lack of appetite, and hair loss. Not everyone experiences side effects, and the side effects you do experience can depend on your chemotherapy medication, the dose, and the duration of your treatment.