Surgery for lung cancer

People with early non-small cell lung cancer (NSCLC) (stage 1 or 2) will generally be offered surgery to remove the tumour. How much of the lung is removed depends on several factors:

• the location of the cancer and its size
• your general wellbeing and fitness
• how your lungs are working (lung function).

Because lung cancer causes vague symptoms in the early stages, it is usually diagnosed at a later stage. Surgery is not suitable for most people with late-stage lung cancer. If there is fluid in the lung cavity (called pleural effusion) that keeps coming back, you may have surgery (pleurodesis) to control this.

Learn more about:

• Types of lung surgery
• Removing lymph nodes
• How the surgery is done
• What to expect after surgery

Types of lung surgery

Surgery for lung cancer may remove all or part of a lung.

Lobectomy

One lobe of a lung is removed.

Pneumonectomy

One whole lung is removed.

Wedge resection

Only part of a lobe is removed.

Removing lymph nodes

During surgery, lymph nodes near the cancer will also be removed to check whether the cancer has spread. Knowing if the cancer has spread to the lymph nodes also helps the doctors decide whether you need further treatment with chemotherapy or radiation therapy.

How the surgery is done

There are different ways to perform surgery for lung cancer. Each method has advantages in particular situations – talk to your surgeon about the best approach in your case.

VATS

Lung cancer surgery can often be done using a keyhole approach. This is known as video-assisted thoracoscopic surgery (VATS). In this approach, the surgeon makes a few small cuts (incisions) in the chest wall. A tiny video camera and operating instruments are passed through the cuts, and the surgeon performs the operation from outside the chest. A keyhole approach usually means a shorter hospital stay, faster recovery and fewer side effects.

Thoracotomy 

If a long cut is made between the ribs in the side of the chest, the operation is called a thoracotomy. This may also be called open surgery. You will need to stay in hospital for 3–7 days.

What to expect after surgery

	Tubes and drips You will have several tubes in place, which will be removed as you recover. A drip inserted into a vein in your arm (intravenous drip) will give you fluid, medicines and pain relief. There may be one or two tubes in your chest to drain fluid and help your lungs expand again. There may be a tube placed into your bladder to check how much urine you pass.
	Pain You may have some pain or discomfort after surgery, but this can be controlled. Managing the pain will help you to recover and move around more quickly and allow you to do your breathing exercises. Pain will improve when tubes are removed from the chest. Pain relief may also help clear phlegm from your chest.
	Recovery time You will probably go home after 3–7 days, but it may take 6–12 weeks to get back to your usual activities. Your treatment team will explain how to manage at home. Walking can improve fitness, clear your lungs and speed up recovery.
	Exercises for breathlessness Gentle exercises as part of a pulmonary rehabilitation program will help improve breathlessness and reduce the risk of developing a chest infection. The hospital physiotherapist will show you how to do these exercises. To continue with a pulmonary rehabilitation program after you leave hospital, talk to your surgeon or visit Lung Foundation Australia.

See our general section on Surgery for more information about surgery and recovery,