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:
- Types of lung surgery
- Removing lymph nodes
- How the surgery is done
- What to expect after surgery
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.
Surgery for lung cancer may remove all or part of a lung.
LobectomyThis 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.
PneumonectomyIf 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.
SegmentectomyFor 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.
Most hospitals in Australia have programs to reduce the stress of surgery and improve your recovery. Called enhanced recovery after surgery (ERAS) or fast track surgical (FTS) programs, they provide information about what to expect each day after surgery. Read more information about preparing for treatment.
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.
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.
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.
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.
Tubes and dripsYou 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.
PainYou 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 timeYou 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 breathlessnessA 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.
Podcast: Making Treatment Decisions
A/Prof Brett Hughes, Senior Staff Specialist Medical Oncologist, Royal Brisbane and Women’s Hospital, The Prince Charles Hospital and The University of Queensland, QLD; Dr Brendan Dougherty, Respiratory and Sleep Medicine Specialist, Flinders Medical Centre, SA; Kim Greco, Nurse Consultant – Lung Cancer, Flinders Medical Centre, SA; Dr Susan Harden, Radiation Oncologist, Peter MacCallum Cancer Centre, VIC; A/Prof Rohit Joshi, Medical Oncologist, GenesisCare and Lyell McEwin Hospital, Director, Cancer Research SA; Kathlene Robson, 13 11 20 Consultant, Cancer Council ACT; Peter Spolc, Consumer; Nicole Taylor, Lung Cancer and Mesothelioma Cancer Specialist Nurse, Canberra Hospital, ACT; Rosemary Taylor, Consumer; A/Prof Gavin M Wright, Director of Surgical Oncology, St Vincent’s Hospital and Research and Education Lead – Lung Cancer, Victorian Comprehensive Cancer Centre, VIC.
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