Treatment Types

Radiation therapy involves the precise use of high energy X-rays to treat cancer safely and effectively. Radiation oncologists are cancer doctors who use radiation to cure cancer, control cancer growth or relieve symptoms, such as pain or bleeding. In most cases, photon therapy is used to treat cancer and can deliver high doses of radiation therapy to the cancer while sparing nearby organs. Some cases may use proton therapy to treat cancer. Proton therapy may be helpful in decreasing radiation therapy dose to surrounding organs.

Radiation works by damaging the DNA of cancer cells so the cancer is unable to grow. When these cells die, the body naturally eliminates them from your body. Healthy cells can also be affected by radiation, but these normal cells can repair themselves in ways that cancer cells cannot.

Radiation is often used in combination with surgery and chemotherapy to treat esophageal and stomach cancers.

• Stomach cancer is treated primarily with surgery along with chemotherapy. Chemotherapy (with or without radiation) can be used before and/or after surgery for stomach cancer, depending on the location and stage of your cancer.
• Esophageal cancer is also treated primarily with surgery. Radiation and chemotherapy are often given prior to surgery to improve cure. Sometimes, radiation and chemotherapy are used together without surgery for curative treatment.
• Other agents, such as immunotherapy or targeted drug therapy, may be used for your treatment. Your medical oncologist will be able to answer questions about whether these agents may be right for you.
• If cure is not possible, chemotherapy is often used to control cancer that has spread throughout the body. Radiation may also be used in this setting to relieve pain, obstruction or difficulty swallowing.

External beam radiation is the most common way to deliver radiation for esophageal and stomach cancers. Beams of high energy X-rays come from a machine, known as a linear accelerator, and are directed at the tumor. Advances in imaging and computer technology have made external beam radiation therapy more effective in destroying tumors and sparing normal healthy tissue.

Proton therapy is sometimes used instead of X-rays (photons) to treat cancers of the esophagus and stomach. Protons may help reduce the dose to the normal organs surrounding a cancer in certain situations, but whether this ultimately reduces side effects for a patient with stomach or esophageal cancer is unknown at this time.

• Before beginning treatment, you will be scheduled for a planning session, also known as a “simulation,” to map out the area to be treated. The simulation involves a CT scan and landmarks placed on your skin (often tiny tattoos or stickers) to allow the radiation therapists to precisely position you each day.
• The scan is then used by the doctor and the treatment team to precisely map out the radiation treatments and ensure the treatments are delivered safely and effectively.
• To minimize side effects, a small amount of radiation is usually given daily, five days a week, over five to six weeks. By giving daily radiation treatments, tumor cells will start to die because they are unable to repair themselves between treatments. The daily doses will build up to enough radiation dose to kill the tumor. Normal cells have the ability to repair themselves each day between treatments.