Esophageal Squamous Cell Carcinoma

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Overview

Esophageal squamous cell carcinoma (ESCC) is among the most deadly forms of human malignancy characterized by late stage diagnosis, metastasis, therapy resistance and frequent recurrence. Clinical management of ESCC remains challenging and the disease presently lacks approved targeted therapeutics.

Causes

Smoking, heavy alcohol use, and Barrett esophagus can increase the risk of esophageal cancer.

Anything that increases your risk of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesn’t mean that you will not get cancer. Talk with your doctor if you think you may be at risk. Risk factors include the following:

– Tobacco use.

– Heavy alcohol use.

– Barrett esophagus: A condition in which the cells lining the lower part of the esophagus  have changed or been replaced with abnormal cells that could lead to cancer of the  esophagus. Gastric reflux (heartburn) is the most common cause of Barrett esophagus.

– Older age.

Prevention

You can take steps to reduce your risk of esophageal cancer. For instance:

Quit smoking. If you smoke, talk to your doctor about strategies for quitting. Medications and counseling are available to help you quit. If you don’t use tobacco, don’t start.

Drink alcohol in moderation, if at all. If you choose to drink alcohol, do so in moderation. For healthy adults, that means up to one drink a day for women and up to two drinks a day for men.

Eat more fruits and vegetables. Add a variety of colorful fruits and vegetables to your diet.

Maintain a healthy weight. If you are overweight or obese, talk to your doctor about strategies to help you lose weight. Aim for a slow and steady weight loss of 1 or 2 pounds a week.

Treatment

– Novel immunotherapeutic agents have changed the way we treat ESCC.
– Locally advanced ESCC is treated with radiochemotherapy with or without surgery depending on localization and stage.
– In absence of complete pathological response after radiochemotherapy and R0 resection adjuvant immunotherapy is indicated.
– Tumor proportion score (TPS) and combined positive score (CPS) should be evaluated in advanced disease.
– As approved in Europe, patients with advanced TPS ≥1% or CPS ≥10 ESCC should be treated with first-line immunochemotherapy.