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Chemotherapy is generally used on advanced cancers, and can be effective in reducing tumours. Chemotherapy is treatment with strong drugs that destroy cancer cells. The drugs are often given by injection or drip, and this sometimes involves a hospital stay. Chemotherapy can have side-effects because the drugs used cause some damage to healthy cells as well, and these can include hair loss, tiredness, feeling sick, vomiting and a lowering of immunity. People's sex lives can also be affected. There are medicines which can help reduce some of these unwanted effects.

Endoscopic procedures are often used in treating early cancer of the oesophagus, (generally T1 cases), and also in palliative care. One such procedure is Photo-dynamic Therapy (PDT) Laser treatment.

In PDT, photosensitive drugs are injected into the patient. These drugs are activated when subjected to a special light via an endoscopy, thus producing cancer-killing free radicals. It is a very simple and effective treatment. A further endoscopy is required to check results 2 days after the first treatment.

Standard white light emitting endoscopy allows detailed visualisation of the gastrointestinal tract by picking up the light reflected from mucosal surface tissue to create a colour picture of the subject. Biopsies are taken from areas of inflammation or suspicion in the oesophagus and stomach.

It has long been noted by scientists that cells with malignant or pre-malignant changes taking place will fluoresce differently to healthy cells when visualised by green autofluorescence. Xillix has managed to harness aspects of this fluorescence technology to an extent that a product that is now being marketed to clinicians which claims to be able to detect premalignant changes more accurately than white light endoscopy. The company?s LIFE-GI System aims to highlight the premalignant changes preceding gastrointestinal cancers. Initial trials with the equipment appear to increase the detection of premalignant cells by 180%. Ochre has helped to purchase a LIFE-GI system that is now in use at Gartnavel Hospital in Glasgow.

Endoscopes are also used to administer laser treatment and for stenting.

Radiotherapy uses high energy rays to destroy cancer cells. Treatment can be given either from outside the body or from within by placing a radioactive material close to the tumour. Receiving radiotherapy does not usually involve a hospital stay, but a series of visits instead. The treatment is painless, but there can be side-effects. Some people feel tired and low, or get swellings, and many get a skin reaction similar to sunburn in the area being treated. Most side-effects should disappear soon after treatment has ended, but very rarely they can be severe and long-term.

Surgery is used where endoscopic treatment is not possible. In the case of oesophageal cancer it is generally a major operation, but it is one of the most effective ways to get positive results.

Surgical treatment aims to remove all or as much as possible of the cancer growth. You will probably want to discuss exactly what will happen with your doctor. Some hospitals have specialist nurses who can discuss the operations and their effects with you.

In most cases, pre-operative chemotherapy or chemoradiotherapy will be undertaken, and in many cases a course of chemotherapy and/or radiotherapy will be given after the surgery.