Surgery

People with early stage non-small cell lung cancer (NSCLC) (stage I and stage II) will generally have surgery to remove the tumour.

How much of the lung is removed depends on the location of the cancer, its size, your general well-being and fitness, as well as your lung function. See the next page for an illustration of the types of surgery.

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Types of lung surgery

There are several types of lung surgery, including: 

Lobectomy

Lobectomy
A lobe of the lung is removed.

Pneumonectomy
One whole lung is removed.

Wedge resection
Only part of the lobe is removed.


Removing lymph nodes

During surgery, nearby lymph nodes will also be removed to see 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 radiotherapy.


How the surgery is done

The surgery can be done in different ways. If a cut is made between the ribs in the side of the chest, the operation is called a thoracotomy. You will need to stay in hospital for 3–7 days.

It’s becoming more common for surgery to be done with a keyhole approach. This is known as video-assisted thoracoscopic surgery (VATS). It involves making three to four cuts in the chest wall, known as ports, and inserting a small video camera and operating instruments that allow the surgeon to perform the operation from outside the chest. A keyhole approach usually means a shorter hospital stay, faster recovery and fewer side effects.

Call Cancer Council 13 11 20 for more information or to get a copy of the Understanding Surgery booklet, or download a digital copy here.

Read more about how the surgery is done

What to expect before surgery

If you smoke, your medical team will advise you to stop before you have surgery. If you continue to smoke during treatment, you may not respond to treatment as well as people who don’t smoke. Also, the side effects may be worse. See your doctor or call the Quitline on 13 7848 (13 QUIT) to find out about quitting products.


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 temporary tubes in your chest to drain fluid and/or air from your chest cavity.

Pain – This is common after surgery, but 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 relief may also help clear phlegm from your chest.

Recovery time – You will probably go home 3–7 days after the operation. It may take 6–12 weeks to resume your usual routine and activities. The recovery time depends on the type of surgery and your fitness. Your doctor, nurses and physiotherapist will talk to you about how to manage at home. Walking will improve your fitness, clear your lungs and speed up recovery.

Breathlessness – This is common if you’ve had part of your lung removed, especially if your lung function was poor before surgery, or if you have had a whole lung removed (pneumonectomy). Gentle exercises as part of a pulmonary rehabilitation program will help improve breathlessness and reduce the risk of developing a chest infection. To find a pulmonary rehabilitation program, ask your surgeon for details or visit lungfoundation.com.au.

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This information was last reviewed in November 2016.
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