Esophageal squamous cancer starts in the flat cells that line the lower part of your esophagus. It is the most common type of esophageal cancer. The lining of your esophagus is called the epithelium. Most esophageal cancers start in the epithelium. The two main types of esophageal cancer are squamous cell carcinoma and adenocarcinoma. Most squamous cell esophageal cancers start near the throat, but they can grow anywhere in the esophagus. Adenocarcinomas start in glandular tissue that lines the esophagus. These cancers often grow faster than squamous cell esophageal carcinomas. They also are less likely to spread to other parts of the body.
Barrett’s esophagus often develops in people who have long-lasting chronic gastroesophageal reflux disease (GERD). In this condition, the squamous cells of your esophagus are replaced with a type of columnar epithelium that resembles the lining of the small intestine. This change, known as intestinal metaplasia, increases your risk of getting adenocarcinoma of the esophagus. Barrett’s esophagus also makes it more likely that you will have a squamous cell carcinoma of the esophagus.
In some cases, squamous cell esophageal adenocarcinoma can recur after treatment. This is a serious problem because it can lead to obstruction of the esophagus, which can cause difficulty eating and drinking and pain in the throat.
You can take steps to reduce your risk of esophageal cancer. These steps include not smoking and avoiding heavy alcohol use. Maintaining a healthy weight and consuming a balanced diet with plenty of fruits and vegetables can also help. You should also talk to your doctor about a screening program for esophageal cancer.
Screening may find a small tumor before it causes symptoms. Doctors can then remove the tumor. Sometimes this is the only treatment needed. But doctors can also treat cancer that has spread to other parts of the esophagus or to other parts of the body.
The most common type of esophageal squamous cancer is stage I, which means the cancer is only in the mucosa layer or thin muscle layer of the esophagus wall. They can treat some of these cancers with a procedure called endoscopic mucosal resection (EMR) or ablative therapy, which destroys the abnormal lining of the esophagus. They might also recommend a combination of chemotherapy and radiation therapy.
Doctors can treat advanced esophageal squamous cell carcinoma by using the immunotherapy drugs pembrolizumab (Keytruda) and nivolumab (Opdivo). They give these medicines together with other chemotherapy or the immune-boosting drug ipilimumab (Yervoy). Which medicines you get depends on your cancer’s PD-L1 expression. PD-L1 is a protein that helps cancer cells to escape from the immune system. Doctors can also use a vaccine that targets HPV. This vaccine can prevent some strains of the human papilloma virus (HPV), which is associated with certain types of esophageal cancer.
