Radiation therapy is an important part of treatment for all stages of esophageal cancer. It is usually combined with chemotherapy.

Radiation therapy involves using radiation to destroy cancer cells. It’s often combined with other treatments like chemotherapy or surgery.

Esophageal cancer leads to more than 16,000 deaths each year in the United States.

Chemotherapy and radiation therapy administered together before surgery is the standard treatment for early-stage esophageal cancer. Chemotherapy combined with radiation therapy is often the primary treatment for cancer that has spread beyond the esophagus.

Read on to learn more about how radiation therapy treats esophageal cancer.

Two types of radiation therapy are used to treat esophageal cancer.

External beam therapy

External beam therapy is the main type of radiation therapy used to treat esophageal cancer. It involves directing radiation from an external machine at your cancer to destroy cells.

Doctors are investigating a new type of radiation therapy for treating esophageal cancer called proton therapy. There’s promising evidence that it may cause fewer side effects than traditional radiation therapy while helping reduce side effects.

Internal radiation therapy

Internal radiation, also called brachytherapy, involves inserting a tube down your throat to place a radioactive substance near your cancer. It’s not commonly used to treat esophageal cancer but may help ease trouble swallowing.

Doctors administer two types of internal radiation therapy:

  • High dose brachytherapy: The radioactive material is left in your throat near the cancer for a few minutes.
  • Low dose brachytherapy: A material with less radioactivity is placed near the cancer for 1–2 days. You’ll need to stay in the hospital during treatment.

Radiation therapy can increase the chances that doctors can cure your cancer if the radiation is combined with other treatments like chemotherapy or surgery.

Doctors use radiation therapy:

  • combined with chemotherapy to treat people who can’t receive surgery
  • with chemotherapy to shrink a tumor before surgery
  • after surgery with chemotherapy to kill cancer cells that might have been missed
  • to reduce symptoms of advanced esophageal cancer

Radiation therapy can damage healthy cells and cause many side effects. You can weigh the pros and cons of these with your care team.

You may experience:

Side effects are often worse if chemotherapy is administered at the same time.

Esophageal cancer is most likely to be cured if it’s caught in the early stages. Radiation therapy can potentially help maximize your chances of survival.

In a 2019 study, researchers found that radiation therapy was a safe and effective treatment for controlling an aggressive type of cancer called small cell carcinoma of the esophagus. Half of the people in the study with cancer contained to their esophagus or the surrounding area lived for at least 36.8 months.

Here’s what to expect before, during, and after external beam radiation therapy:

Before the procedure

Before you start radiation therapy, you’ll have an initial appointment where your doctor pinpoints the spot the radiation therapy needs to be directed. You’ll likely have imaging tests taken during this period, such as a computed tomography (CT) scan.

You may have a semi-permanent ink or tattoo placed on your skin to guide your therapy. These marks may be made on a plastic mask that you wear during your treatment.

During the procedure

Receiving external beam radiation therapy is similar to getting an X-ray, but each session takes longer.

Your radiation therapist will help you get into the proper position and place shields in certain areas. They will then leave the room and turn on the machine. You shouldn’t feel any pain during the procedure and can continue communicating with your therapist through an intercom.

After the procedure

You can usually go home immediately after receiving external beam radiation therapy. You may have to stay in the hospital for a few days if you receive low dose brachytherapy, though this is not common for this type of cancer.

Radiation therapy is an important part of treatment for esophageal cancer. Most people who are in good enough health to receive radiation therapy are a candidate.

Who should avoid it?

People who may be ineligible for radiation therapy include those with:

  • poor general health
  • poor heart or lung function
  • massive esophageal bleeding
  • an esophageal fistula

People who are pregnant are also ineligible.

Other standard treatments for radiation therapy include:

Here are some frequently asked questions people have about radiation therapy for esophageal cancer.

What is the long-term survival after radiation therapy for esophageal cancer?

The 5-year relative survival rate in the United States for esophageal cancer that is confined to the esophagus is 47%, but only 6% for cancer that has spread to distant tissues.

How many radiation treatments are needed to treat esophageal cancer?

The standard radiation dosage for trying to cure esophageal cancer is 50.4 gray (gy) administered over 28 treatments combined with chemotherapy. Most people who receive radiation therapy have it 5 days per week.

How long does radiation treatment for esophageal cancer take?

Each session of external radiation typically lasts about 15–30 minutes. The actual treatment only takes a few minutes.

Radiation therapy is an important treatment for all stages of esophageal cancer. It’s often combined with surgery and chemotherapy to try to cure the cancer.

Radiation therapy may be administered alone with chemotherapy if surgery isn’t an option or to reduce symptoms of esophageal cancer considered incurable.