Surgery for Lung cancer

Surgery for lung cancer is usually curative treatment but suitable only for fit patients who can tolerate surgery and have small cancers which have not spread to other parts of the body.

Before surgery can take place, patients need to have a number of tests to check their general state of health and lung function. These may include an electrocardiogram (ECG), echocardiogram, exercise test and full lung function assessment.

During surgery, surgeons usually make a cut (incision) in the chest wall and remove a section or all of the affected lung. They may also remove nearby lymph nodes if they think that cancer may have spread to them.

In some cases, an alternative to this approach, called video-assisted thoracoscopic surgery (VATS), may be suitable. VATS is a type of keyhole surgery, where small incisions are made in the chest. A small fibre-optic camera is inserted into one of the incisions so the surgeon can see images of the inside of your chest on a monitor.

There are three types of lung cancer surgery:

  • Wedge resection or segmentectomy – where a small piece of the lung is removed. This procedure is only suitable for a small number of patients, as it is only used if your doctors think your cancer is small and limited to one area of the lung. This is usually very early-stage non-small-cell lung cancer.
  • Lobectomy – where one or more large parts of the lung (called lobes) are removed. Your doctors will suggest this operation if the cancer is just in one section of one lung.
  • Pneumonectomy – where the entire lung is removed. This is used when the cancer is located in the middle of the lung or has spread throughout the lung.

Patients will probably be able to go home 5 to 10 days after their operation. However, it can take many weeks to recover fully from a lung operation.

After the operation, patients will be encouraged to start moving about as soon as possible. Even if they have to stay in bed, they will need to keep doing regular leg movements to help their circulation and prevent blood clots from forming. A physiotherapist will show them breathing exercises to help prevent complications.

When patients go home, they will need to exercise gently to build up their strength and fitness. Walking and swimming are good forms of exercise that are suitable for most people after treatment for lung cancer.

Sometimes, oncologists may recommend a course of chemotherapy or radiotherapy to reduce the risk of cancer recurrence in the future.

Possible complications after surgery:

As with all surgery, lung surgery carries a risk of complications. These are estimated to occur in one out of five cases. These complications can usually be treated using medication or additional surgery, which may mean they need to stay in the hospital for longer. Examples of complications of lung surgery are:

  • inflammation or infection of the lung (pneumonia)
  • excessive bleeding
  • a blood clot in the leg (deep vein thrombosis), which could potentially travel up to the lung (pulmonary embolism)