Lung and Esophageal Cancer Care

Chest pain, coughing, trouble swallowing and vomiting don't necessarily mean a lung or esophageal cancer diagnosis is in your future. But wondering if that persistent cough is a symptom of something bigger can steal joy from your life.

• Symptoms of esophageal cancer may include difficulty swallowing (dysphagia), chest pain or discomfort, unintentional weight loss, hoarseness, chronic cough, acid reflux, and indigestion or heartburn that doesn't improve with medication.
• Symptoms of lung cancer can vary but may include persistent cough, coughing up blood, shortness of breath, chest pain, hoarseness, unexplained weight loss, and fatigue. However, it's important to note that lung cancer may not cause noticeable symptoms in its early stages, which can make it difficult to diagnose.

Being proactive about your symptoms is the best way to protect your well-being. Catching cancer early is the first step in getting proper treatment. That’s why we work hard to make the screening process as simple as possible.

If you’re 55 years of age or older and have smoked at least one pack of cigarettes a day for 30 years (or two packs a day for 15 years), you may be eligible to take part in our Lung Health Program. As a participant, you’ll be connected with a personal Lung Care Coordinator who will guide you through the screening process, which encompasses the latest in genetic counseling, imaging and minimally invasive diagnostic testing, including:

• Biopsy
• CT scan
• Endoscopy (esophageal cancer)
• Sputum cytology
• X-ray

You want to stop wondering and start living without worry. We want that for you, too. The first step is screening. If your screening shows cancer, we'll begin to treat it immediately. And, if you're clear, we'll talk to you about your risk of lung and esophageal cancers and preventive measures so you can continue to live your healthiest life.

Both lung cancer and esophageal cancer are staged based on the extent of the disease, which helps determine prognosis and guide treatment decisions.

Stages of Lung Cancer (Non-Small Cell Lung Cancer - NSCLC):

• Stage 0: Also known as carcinoma, cancer cells are only present in the top layers of cells lining the air passages and have not invaded deeper into lung tissue.
• Stage I: Cancer is localized to the lung and has not spread to nearby lymph nodes or other distant organs.
• Stage II: Cancer has spread to nearby lymph nodes or structures within the chest, such as the chest wall or diaphragm, but has not spread to distant organs.
• Stage III: Cancer has spread to lymph nodes near the affected lung or to nearby structures such as the heart or major blood vessels. Stage III lung cancer is further divided into:
• Stage IIIA: Cancer has spread to lymph nodes on the same side of the chest as the primary tumor.
• Stage IIIB: Cancer has spread to lymph nodes on the opposite side of the chest or above the collarbone.
• Stage IV: Also known as metastatic lung cancer, cancer has spread to distant organs such as the liver, bones or brain.

Stages of Esophageal Cancer:

• Stage 0: Cancer is only present in the innermost layer of cells lining the esophagus and has not spread to deeper layers or nearby lymph nodes.
• Stage I: Cancer is localized to the esophagus and may have spread to nearby lymph nodes but has not invaded nearby structures or spread to distant organs.
• Stage II: Cancer has invaded deeper layers of the esophageal wall or nearby structures but has not spread to distant organs. Stage II esophageal cancer is further divided into:
• Stage IIA: Cancer has invaded the muscularis propria layer of the esophagus.
• Stage IIB: Cancer has invaded the adventitia layer of the esophagus or nearby structures such as the trachea or bronchi.
• Stage III: Cancer has spread to lymph nodes near the esophagus or to structures adjacent to the esophagus. Stage III esophageal cancer is further divided into:
• Stage IIIA: Cancer has spread to lymph nodes near the esophagus.
• Stage IIIB: Cancer has spread to lymph nodes in the neck or upper chest or to nearby structures such as the trachea, bronchi, or aorta.
• Stage IV: Also known as metastatic esophageal cancer, cancer has spread to distant organs such as the liver, lungs, or bones.

Staging for both lung cancer and esophageal cancer involves a combination of imaging tests (such as CT scans, PET scans and MRI scans) and procedures (such as endoscopy or bronchoscopy) to assess the extent of the disease. The stage of cancer plays a critical role in determining the appropriate treatment approach and predicting outcomes.

It can be hard to stay confident in the midst of a cancer diagnosis. But at AdventHealth, we want to help you find hope through the ever-evolving advancements in cancer care. Every day, our nationally renowned lung and esophageal cancer program is working to get you the most innovative technologies and therapies available by participating in hundreds of clinical trials to discover the newest treatments for lung and esophageal cancer, including mesothelioma and squamous carcinomas. It’s why we’re consistently at the forefront of our field.

You provide the unwavering spirit that inspires us. In turn, we provide you with a network of specialists trained in treating the following types of cancer:

• Esophageal cancer
• Lung cancer
• Mediastinal tumors
• Mesothelioma and malignant mesothelioma
• Squamous carcinoma

No matter your diagnosis, you can be sure that we'll be by your side, using all the knowledge and skill we have to help heal your body, ease your mind and minister to your spirit.

Lung and esophageal cancers take their toll on your whole being. But you can find strength knowing we have leading expertise in the three essential tiers of treatment: surgery, radiation and chemotherapy. With a multidisciplinary set of highly specialized surgical procedures and a combination of treatments, we can offer you the best chance at a full recovery. Lung and esophageal cancer treatment options include:

Esophageal Cancer:

• Surgery: Surgical removal of the tumor may be an option for early-stage esophageal cancer. Types of surgery include:
  • Esophagectomy: Removal of part or all of the esophagus
  • Esophagogastrectomy: Removal of the lower portion of the esophagus and part of the stomach
  • Minimally invasive surgery: Techniques such as laparoscopic or robotic-assisted surgery may be used to reduce recovery time and complications
• Chemotherapy: Chemotherapy uses drugs to kill cancer cells or stop them from growing. It may be given before surgery (neoadjuvant chemotherapy) to shrink the tumor or after surgery (adjuvant chemotherapy) to kill any remaining cancer cells.
• Radiation therapy: Radiation therapy uses high-energy beams to target and destroy cancer cells. It can be used alone or in combination with surgery and chemotherapy.
• Targeted therapy: Targeted therapy drugs target specific molecules involved in cancer growth. They may be used in combination with chemotherapy for advanced or metastatic esophageal cancer.
• Immunotherapy: Immunotherapy drugs help the immune system recognize and attack cancer cells. They may be used in combination with chemotherapy or alone for certain types of esophageal cancer.
• Palliative care: Palliative care focuses on relieving symptoms and improving quality of life for individuals with advanced or metastatic esophageal cancer. It may include pain management, nutritional support, and other supportive care services.

Lung Cancer:

• Surgery: Surgical removal of the tumor may be an option for early-stage non-small cell lung cancer (NSCLC). Types of surgery include:
  • Lobectomy: Removal of a section (lobe) of the lung
  • Pneumonectomy: Removal of an entire lung
  • Segmentectomy or wedge resection: Removal of a smaller portion of the lung
• Chemotherapy: Chemotherapy is often used in combination with surgery for NSCLC or as the primary treatment for advanced or metastatic lung cancer. It may also be given concurrently with radiation therapy (chemoradiotherapy) for locally advanced disease.
• Radiation therapy: Radiation therapy may be used alone for early-stage lung cancer in individuals who are not candidates for surgery or in combination with chemotherapy for locally advanced disease. It can also be used to relieve symptoms of advanced or metastatic lung cancer.
• Targeted therapy: Targeted therapy drugs target specific genetic mutations or proteins present in cancer cells. They are used for certain types of NSCLC, such as those with EGFR mutations or ALK rearrangements.
• Immunotherapy: Immunotherapy drugs, such as checkpoint inhibitors, help the immune system recognize and attack cancer cells. They are used for advanced or metastatic NSCLC and certain types of small cell lung cancer (SCLC).
• Palliative care: Palliative care focuses on symptom management and improving quality of life for individuals with advanced or metastatic lung cancer. It may include pain management, supportive care services, and psychosocial support.

We’ll consult with you every step of the way so you’re always informed and prepared for what comes next. And if your treatment requires a lifestyle change, like quitting smoking, we'll give you the tools and support you need to leave old habits in the past and press on toward a healthier future.