Chemotherapy (chemo) uses anticancer medicines to kill cancer cells. The medicines are made to attack and kill cancer cells, which grow quickly. Some normal cells also grow quickly. Because of this, chemo can also harm those cells. This can cause side effects.

Chemo is part of the treatment for many people with esophageal cancer if they’re healthy enough to tolerate it. It might be used in the following situations: 

• Chemo (with radiation) may be used as the main treatment for some people with early stage esophageal cancer, before surgery. In some cases it may be used as the only treatment.

• For people with advanced esophageal cancer, chemo is often used to try to shrink the cancer. Or it is used to keep it under control for as long as possible. This can also often help ease symptoms such as pain.

Before treatment starts, you will meet with a medical oncologist. This is a doctor who specializes in treating cancer with medicines, such as chemo. The doctor will discuss your treatment options with you and explain what to expect. 

Depending on the specific chemo medicines you’re taking, you may get them in one of these ways: 

• IV (intravenous). The medicine is given through a small needle that’s been put into a vein. The medicine may drip in slowly over several hours. Or it may be given more quickly over a few minutes.

• Oral. You swallow these medicines as pills.

Chemo is often given in an outpatient setting. That means that you get it at a clinic, healthcare provider's office, or hospital, and you can go home after the treatment is given. Less often, you may need to stay in the hospital during treatment. Your healthcare provider will watch you for reactions during your treatments. Chemo treatments may last for a while. So you may want to bring something that is comforting to you, such as music to listen to. You may also want to bring something to keep you busy, such as a book or mobile device.

To reduce the damage to healthy cells and to give them a chance to recover, chemo is given in cycles. Each cycle consists of 1 or more days of treatment, followed by some time to rest. Cycles normally last 3 or 4 weeks. Your healthcare provider will discuss your chemotherapy schedule with you.

These are some of the chemo medicines used to treat esophageal cancer:

• Capecitabine

• Cisplatin

• Carboplatin

• Docetaxel

• Epirubicin

• Fluorouracil

• Irinotecan

• Oxaliplatin

• Paclitaxel

• Vinorelbine

• Trastuzumab

Two or more of these medicines are often combined as the first treatment. Some people may only receive 1 medicine. These include people who aren’t healthy enough to get 2 medicines. Or people who have already gotten chemo for their esophageal cancer.

In some cases, chemo might be combined with a targeted therapy medicine, which works in a different way.

Side effects of chemo are different for everyone. They vary based on the medicines you receive. Below is a list of the some of the most common side effects from chemotherapy. Ask your healthcare provider what side effects to watch for.

It's important to know which medicines you're taking. Write your medicines down, and ask your healthcare team how they work and what side effects they might have.

Talk with your healthcare providers about what signs to look for and when to call them. For example, chemotherapy can make you more likely to get infections. Make sure you know what number to call with questions. Is there a different number for evenings and weekends?

It may be helpful to keep a diary of your side effects. A written list will make it easier for you to remember your questions when you go to your appointments. It will also make it easier for you to work with your healthcare team to make a plan to manage your side effects.