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.

Learn more about:

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

Overview

How much of the lung is removed depends on several factors:

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

Surgery is not suitable for most people with late-stage lung cancer.

If there is fluid in the pleural cavity (called pleural effusion) that keeps coming back, you may have minor surgery (pleurodesis) to control this. Read more on this procedure.

Types of lung surgery

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

	Lobectomy This is the most common type of surgery for lung cancer. In a lobectomy, one of the lobes of the lung is removed. About 30–50% of the lung will be removed.
	Pneumonectomy If the cancer is in more than one lobe of a lung, or near where the airways enter the lung, a pneumonectomy may be done. In this procedure, a whole lung is removed. It’s possible to still breathe normally with one lung.
	Segmentectomy For some early-stage lung cancers that are on the edge of the lung, a segmentectomy may be used. In this procedure, a small part of the lobe is removed. In cases where a patient is very unwell, however, a wedge resection may be considered. A wedge resection removes only a very small amount of the lobe.

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 2 ways to perform surgery for lung cancer, and both require a general anaesthetic. Each type of surgery has advantages in particular situations – talk to your surgeon about the best option for you.

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 in a vein in your arm (intravenous drip) will give you fluid and medicines. There may be tubes in your chest to drain fluid and help your lungs expand; and a tube in your bladder to check how much urine you pass.
	Pain You may have some pain, but this can be controlled. Managing the pain will allow you to do breathing exercises and help you to recover. Pain will improve when tubes are removed from the chest.
	Recovery time You will probably go home after 3–7 days, but it may take 4-8 weeks after VATS or 6-12 weeks after thoracotomy to get back to your usual activities. Walking can improve fitness, clear your lungs and speed up recovery.
	Exercises for breathlessness A pulmonary rehabilitation program can help improve breathlessness and reduce the risk of chest infection. A physiotherapist will show you how to do exercises. To continue rehabilitation after you leave hospital, talk to your surgeon or visit Lung Foundation Australia. See more simple strategies to ease breathlessness at home.

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

→ READ MORE: Radiation therapy for lung cancer

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