General Surgery

Chemotherapy and Radiotherapy


Chemotherapy works by preventing cancer cells from replicating.

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

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).


Radiotherapy can be used in addition to chemotherapy before surgery to enhance local effect. It is also used with chemotherapy as a definitive treatment when surgery is not appropriate.

Radiotherapy uses high-energy rays to destroy cancer cells. Treatment courses depend on the location, type, size of the cancer and the intention of the treatment.

Frequently Asked Questions

Chemotherapy before surgery usually involves 3 to 4 “cycles” of treatment, lasting between 9 and 12 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.

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.

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

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