External beam radiotherapy for oesophageal cancer can cause side effects which may happen during treatment, shortly after, or much later. Early side effects (also called acute) usually occur during or soon after treatment Side effects vary from person to person, so it’s hard to predict exactly when they will start, how severe they will be, or when they will end. If you have any concerns, speak with your healthcare team—they are there to help.
You may experience side effects or symptoms not listed here, as everyone’s treatment is different. Some side effects might also be caused by other parts of your cancer treatment. Research and support for managing side effects and long-term effects of radiotherapy are continually improving.
Joining a support group can help you share experiences, feel less alone, and cope with the physical and emotional effects of treatment. If you need more support or have any side effects, talk to your treatment or clinical team.
This page looks at early side effects.
How likely am I to get early side effects?
Before treatment you will discuss and sign a consent form with your clinical oncologist or therapeutic radiographer. They will tell you what to expect, and you can ask questions and discuss any concerns you have about late effects. It’s important to know what you are consenting to and can help to take someone with you.
You can read different radiotherapy consent forms (HERE) based on the specific area being treated. These consent forms are packed with useful information about early and late side effects.(1)
By signing the consent form, you are saying you understand that you might get early and late side effects. Your team will use words like Expected, Common, Less Common and Rare.
This table shows what these words mean.
| Wording on the consent form | % chance of side or late effect | How many patients will get this? |
|---|---|---|
| Expected | 50 to 100% | Between half and all patients |
| Common | 10 to 50% | Up to half of all patients |
| Less common | Less than 10% | Fewer than one in ten patients |
| Rare | Less than 1% | Fewer than one in 100 patients |
Early side effects (during or soon after treatment)
- Feeling very tired or fatigued: You might feel very tired during and after your treatment. It’s important to get plenty of rest but sometimes you will still feel really tired, even with lots of sleep. Some tiredness can be caused by having cancer and having cancer treatment, and some can be caused by travelling to and from hospital every day for treatment.
- Pain and soreness: Radiotherapy can make your mouth, throat and oesophagus sore, and painful, making it hard to swallow. It is less common to get mouth ulcers but this can happen. This usually starts a few weeks into your treatment. It might be hard to eat because swallowing can hurt or you might feel your throat feels very tight, or like there is a lump in it. A dietitian can help you find ways to keep eating well. Your treatment team can recommend painkillers, mouthwashes, and some cases to help. This usually improves 4 to 6 weeks after treatment ends.
- : You may experience pain or discomfort in your abdomen or chest area. This is where digestive acids come into contact and irritate the area already sore from treatment. Speak to your clinical team who can prescribe medications to help.
- Changes in appetite: Food and drink might taste different, like sweet things tasting salty or metallic. This can make eating less enjoyable. These changes are usually temporary but can sometimes be permanent. Talk to your dietitian for tips on dealing with taste changes and keeping a good appetite.
- Increased saliva or mucous production
- Feeling sick: You may at times feel sick or be sick. Or feel discomfort in your tummy similar to feeling bloated.
- Skin reactions: You might notice a change in colour, swelling, itching, or changes in the texture of your skin where you’re treated. For people with lighter skin tones these changes can be pink, red or darker than the surrounding area. People with brown and black skin tones might have colour changes such as maroon, purple, yellow or grey pigment changes. Or the skin can look darker than the surrounding area. These changes usually improve after treatment, but this can take 4 to 6 weeks in some cases.
- Voice changes (hoarseness): Your voice might become hoarse if the voice box gets irritated and swollen from the treatment. Rest your voice and let your treatment team know if it becomes a problem.
- Breathing difficulty: Radiotherapy can cause inflammation and swelling in the neck area, leading to breathing problems. In rare cases, this swelling can cause noisy breathing. If you have trouble breathing, seek medical help straight away.
- Hair loss: you might lose hair in the area where you are treated. Often, this grows back over time.
Less common and rare side effects
- Fistula: This is where an abnormal connection forms between your food pipe and your airway.
- Pneumonia: This is a chest infection that requires treatment, if you are worried about this please speak to your clinical team immediately.
What can help with these early side effects?
Here are some ideas you can try to make you feel better.
- Resting: Get lots of sleep this helps with the body’s recovery and take breaks if you feel tired.
- Diet: Try soft foods that are high in protein and energy. Avoid foods that are spicy or hot (temperature) and take advice from your treatment team. Some people find ice cream soothing and foods that are warm (temperature) can help. It can also help to eat smaller meals more often. Ask to see a dietician if you need more support with eating.
- Skin reactions: Your treatment team can suggest creams to soothe your skin. Sometimes, extra care is needed if the skin breaks down in the treatment area. Wear loose clothing and stay out of the sun. Talk to your team about washing, shaving and caring for your skin in your treatment area. You might have to change your normal routine during treatment and for a short time after, especially if you develop a radiation skin reaction.
- Keeping active: Gentle movement can help you feel better, both during and after treatment. Your treatment team can tell you what is safe for you to do.
- Drinking fluids: Drinking plenty of fluids such as water, juice and squash can help with fatigue and tiredness caused by your treatment. It can also help flush out toxins in your body caused by treatment. You can try diluted juice if you don’t like water.
- Get help: Work with dietitians, physiotherapists and other specialists to manage eating problems and other side effects. It may be necessary to stay in hospital to help you manage your side effects.
- Stay in touch: Always communicate with your treatment team about any side effects or concerns. They are there to help you feel better and support you throughout your treatment.
- Alcohol use: Please follow the NHS guidelines on safe drinking levels and any instructions you get from your team on what is right for you, your diagnosis and your treatment. If in doubt, please ask your team.
- Stop smoking: If you are looking to stop or reduce smoking, there are services available to help you.
- Sexual changes: Talk to your team if you are experiencing issues with sex and cancer and they can offer advice.
