Surgery is one of many different lung cancer treatment options. It is used to treat non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC). Surgery is most often performed to treat cases of localized cancer that has not spread to both lungs or other organs in the body — typically early stages of NSCLC and limited-stage SCLC.

Lung cancer surgery also offers the best chance at curing cancer if the entire tumor can be removed. Your oncologist and thoracic surgeon (who specializes in lung surgeries) should discuss your options and create a treatment plan for you.

Preparing for Lung Cancer Surgery

Before surgery can be performed, your doctor will typically run several tests to determine if you are healthy enough for surgery. Surgical procedures can be complex and have serious effects on the body. Your overall health can affect your recovery from surgery as well.

First, your doctor will want to look at where the tumor is located and if cancer has spread to the nearby lymph nodes or the other lung. This step is used to determine whether surgery is an option in the first place before the preoperative testing.

Your doctor will test your lung function to check if you have enough healthy lung tissue to support you after surgery. One example of a lung function test is spirometry, which measures the amount of air you inhale and how quickly you exhale.

Other tests will likely be performed to check your heart and other organs, which also need to be healthy for surgery. These tests can include blood work to check liver and kidney function, as well as an echocardiogram (EKG), which measures your heart rhythm.

Different imaging and lung tests can be performed, including:

• Computed tomography (CT) scan
• Chest X-ray
• Mediastinoscopy, which looks for cancer spread to the airways and lymph nodes
• Bronchoscopy, which looks for blockages or tumors in the airways (bronchi)
• Thoracoscopy, which looks for cancer spread to the chest wall and between the lungs

Surgical Approaches

Your thoracic surgeon will typically use one of a few approaches to surgery, depending on their skill set and your specific cancer case.

A thoracotomy is an invasive surgery in which a cut (incision) is made on the back and side of the chest along the ribs. The chest wall muscles are moved apart to allow access to the lungs.

There are also options for minimally invasive surgery that use only one to four small incisions along the chest. The thoracic surgeon will then use special instruments with cameras attached to them to perform the surgery. These methods are known as video-assisted thoracic surgery (VATS) and robotically assisted thoracic surgery (RATS).

Your doctor and thoracic surgeon may also work with a radiation oncologist, who performs radiation therapy. Radiation therapy uses high-powered X-rays to damage the DNA in cancer cells, which kills them. Radiation therapy can be used before surgery to shrink tumors, making it easier to operate on them. Radiation can also be used after surgery to kill any remaining cancer cells that were not removed to help prevent the tumor from growing back.

Types of Lung Cancer Surgery

Lung cancer surgery can be performed in a few different ways, depending on the location and size of the tumor, its staging, and the thoracic surgeon. Types of lung cancer surgery include:

• Lobectomy
• Pneumonectomy
• Sleeve resection
• Segmentectomy

Lobectomy

In the human body, the left lung has two lobes, and the right lung has three lobes. A lobectomy removes one of the lobes that contains the tumor. A bilobectomy removes two lobes and is only performed if the lung tumor is in the right lung and the lobes are next to each other.

The lobectomy is the most common lung cancer surgery and is preferred for treating NSCLC.

Pneumonectomy

Pneumonectomy is the removal of the entire lung that contains the tumor. This procedure is usually performed if the tumor is located near the center of the chest or if the tumor cannot be removed with a lobectomy.

Sleeve Resection

A sleeve resection (sleeve lobectomy) removes both the lung lobe and part of the main airway (bronchus) that contains the tumor. Then, the ends of the airway are reattached to the remaining nearby lobes to save that part of the lung. A sleeve resection is used as an alternative to a pneumonectomy.

Segmentectomy

Within the lung lobes, there are between three and five lung segments. A thoracic surgeon can remove segments without affecting the nearby lung lobes with a segmentectomy (also known as a wedge resection). The procedure is used if a person’s lung function is affected and they cannot tolerate the removal of an entire lobe.

Recovery From Lung Cancer Surgery

After surgery, you can expect to spend five to seven days in the hospital recovering. You will generally have one or more tubes attached to your chest that help drain fluid from the area. Once the area has healed and the fluid decreases, the tubes will be removed.

The total recovery and healing process will likely take several weeks to months, depending on the surgical procedure you had. Your chest and ribs may be sore, and your range of motion may be limited. If your lungs are otherwise healthy, you can typically return to normal activities after you have healed.

Read more about lung cancer surgery recovery time.

Talk With Others Who Understand

MyLungCancerTeam is the social network for people with lung cancer and their loved ones. Members come together to ask questions, give advice, and share their stories with others who understand life with lung cancer.

Are you living with lung cancer? Share your experience in the comments below, or start a conversation by posting on MyLungCancerTeam.