Oesophageal radiotherapy – at the end of your treatment course

This leaflet provides information for patients who have finished their course of radiotherapy to the oesophagus. It is important that you look after yourself over the next few weeks during this period of recovery. If you have any questions or worries not covered here, please do not hesitate to call a member of your treatment team.

Side effects

By the end of a course of radiotherapy, many patients will have developed some side effects. It is quite normal for these to continue after your treatment has finished. In some cases they will become more severe before they get better. Typically your side effects, including tiredness and fatigue, will start to reduce after 10 - 14 days.

Below are some general guidelines we recommend you follow.

Fatigue

Fatigue is feeling extremely tired and it is very common in people with cancer. For some, fatigue lasts a long time after treatment. However, most patients start to see an improvement in the weeks to months following treatment.

• It can be hard to be active when you feel tired all the time. But being active can help to reduce fatigue, for example a short walk or some gentle gardening.
• It is important that you listen to your body and tailor your activities accordingly.
• Remember, it is fine to rest when you need to.

Pain or difficulty swallowing and eating

Radiotherapy can cause severe inflammation and soreness in the oesophagus.

• If you are still taking food by mouth, adopt a softer diet making good use of soups, gravies and sauces. Full fat milk, rice pudding, yogurts and ice-cream are good to try.
• Supplement drinks like Fortisip® can also help.
• Regular soluble paracetamol and Gaviscon® / Peptac® suspensions may help to reduce discomfort. These are available over the counter.
• Other prescription medications may be useful. Please contact a member of your team to discuss.

Reduced appetite

Your appetite may be lower than normal and you may have altered taste.

• Try eating small regular meals throughout the day.
• Stronger tasting foods may help with taste changes.
• Try to eat high calorie and nutritious foods.

Increase in secretions

You may notice an increase in clear secretions from the oesophagus. This is a normal side effect of radiotherapy. The secretions may be thicker than normal saliva and difficult to clear.

• Sip water throughout the day.
• Saltwater rinses can be useful to keep the mouth clean.

Breathlessness and cough

Radiotherapy in the chest area may cause an irritating cough and mild shortness of breath due to its local inflammatory effect on lung tissue.

• Cool drinks, lozenges or simple cough linctus can help with a cough.
• Codeine or morphine drugs may help to suppress a cough, particularly if your sleep is being disrupted. Please contact your team to discuss.

Skin reaction

You may have a radiotherapy skin reaction. Red or itchy skin in the treated area may worsen over the next 14 days before it settles. Continue to bathe the area gently with tepid water and an unscented soap. Diprobase® or E45® can be used to moisturise the skin and reduce itching.

Follow-up clinic appointments

It is normal for patients to be followed up in the oncology clinic after a course of radiotherapy. The frequency of follow-up appointments will depend on you and the type of cancer you have been treated for. During your follow-up you might see a clinical nurse specialist, advanced practice radiographer or a doctor. In some circumstances, you may be offered a telephone appointment. If you are worried about any aspect of your recovery, please contact one of the team rather than wait until your next appointment.

Follow-up scans

We don’t tend to scan at the end of treatment to see if the radiotherapy has worked. This is because radiotherapy continues to have a beneficial effect on the tumour for some weeks afterwards. Radiotherapy also causes inflammation in the surrounding tissues meaning that scans at this time are not helpful. If a post treatment scan is required, then it would normally be performed three months after the completion of treatment. This will be discussed with you at your first follow-up appointment.

What about your emotional health?

Once your treatment ends you may find yourself filled with emotions and this happens to a lot of people. Your most recent focus has been getting through the treatment and now that it is finished you may have thoughts, emotions and feelings that can be overwhelming at times. This is a period when you might turn to people around you for strength and comfort. This support can come from family, friends, your treatment team, or cancer support centres.

Contact numbers

Rachel Kirby - Macmillan advanced practitioner, thoracic oncology
Direct line: 01223 596199
Bleep: 154-626 via hospital reception (01223 245151)

Clinical Nurse Specialist, Upper GI Cancer
Direct Line: 01223 596383
Bleep via hospital reception: 01223 245151

Radiotherapy Reception, Addenbrooke's
Telephone: 01223 216634

Oncology Reception, Addenbrooke’s
Telephone: 01223 216551
Bleep: 216-552

Addenbrooke’s emergency 24-hour helpline for oncology patients
Telephone: 01223 274224

Feedback

We welcome and value your feedback on our services. If you would like to make any comments about your treatment, or feel we can improve the service, please fill in a comment card which can be found in a box on the wall at the radiotherapy reception.

Sources of further information and support

Privacy & dignity

Same sex bays and bathrooms are offered in all wards except critical care and theatre recovery areas where the use of high-tech equipment and / or specialist one to one care is required.