Surgery is a common lung cancer treatment, and one type of surgery is a pneumonectomy. This procedure involves removing the entire lung affected by cancer and, if needed, some surrounding structures. It is possible to live with one lung after a pneumonectomy, and this surgery can offer some people with lung cancer the best chance of cure.

What Is a Pneumonectomy?

A pneumonectomy is the surgical removal of an entire lung to treat lung cancer, trauma, or other conditions and diseases. Either the left or the right lung can be surgically removed, depending on which is affected.

A pneumonectomy is performed only in cases where other, smaller lung surgeries (such as a lobectomy) can’t remove all the cancer. A pneumonectomy may be done if there are multiple lung tumors or the tumors are located near the center of the lung and cannot be removed easily.

A pneumonectomy can be done to treat both non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC). This surgery may be performed if the lungs are affected by issues such as these:

• Spread (metastasis) of other types of cancer to the lungs
• Tuberculosis
• Congenital disease
• Traumatic injury
• Fungal infection
• Bronchiectasis, a chronic condition in which the airways are permanently widened and damaged
• Irreversible damage to a lung with blocked airways

Pneumonectomy Procedure

A pneumonectomy is a highly involved surgical procedure. Your doctor and health care team will want to prepare you as best as possible to ensure a positive outcome.

Before Surgery

Before thoracic surgery, which involves the lungs and chest, your doctor will typically perform a physical examination and a series of tests to determine your lung health and function. If you smoke, you will be asked to quit before surgery.

You will likely have imaging tests done to help your doctor look at your lungs. These and other tests before surgery can include:

• Chest X-ray
• Chest CT scan
• Electrocardiogram (ECG or EKG)
• Blood tests
• Lung function tests to check how well the other lung is working before surgery

During Surgery

You will be asleep under anesthesia during the procedure, so you will not feel any pain. The thoracic surgeon, who specializes in chest and lung surgeries, will make a cut between two ribs (known as a thoracotomy). This incision will run from the side of your chest, under your arm, and around to your back.

The surgeon will separate the two ribs along the cut and then deflate the lung to remove it. Some lymph nodes also may be removed. Examining the lymph nodes can help your doctor determine if the cancer has spread further.

In some cases, your surgeon may perform an extrapleural pneumonectomy. During this procedure, the surgeon removes the entire affected lung, part of the diaphragm, part of the sac covering the heart, and the pleura (the membrane lining the chest and lungs).

After the lung is removed, the surgeon will close the cut with stitches and apply a dressing over the area. A chest tube might be left in to help drain fluid from the area where the lung had been. Once you have healed, the drainage tube will be removed.

Recovery From a Pneumonectomy

Immediately after surgery, you will be put into a recovery room to wake up from the anesthesia. You will then be given pain medication and oxygen. Once you have recovered from the anesthesia, you will be moved to a hospital room to be monitored for several days. During this time, you will be given breathing exercises to strengthen your remaining lung and help remove fluid that may have collected during surgery.

You will likely be sore because the surgeon cut through major structures in the chest. This soreness is normal, and your health care team may prescribe pain medication to take home.

You will also likely be more tired than usual, since your body will be recovering from an intensive procedure. You should gain back your strength over the next several weeks.

Can You Function With One Lung?

After a pneumonectomy, the remaining lung will begin to perform all the functions that both lungs did before. You will still be able to breathe in enough oxygen, and the lung will help remove carbon dioxide from your body.

Eventually, the remaining lung may expand into the space where the other lung was, shifting toward the heart. However, the remaining lung will not replace the function of the removed one — your lung capacity will be about half of what it was before. This capacity is enough to go about your normal, daily activities, but more intense activities will likely become difficult or impossible.

Risks and Side Effects of a Pneumonectomy

As with any surgery, pneumonectomy brings certain risks. Although many people recover well after the procedure, it is a fairly high-risk surgery. Complications that may occur include:

• Shock
• Respiratory failure
• Pneumonia or other infections
• Pulmonary embolism, or a blood clot in the lung
• Negative reactions to anesthesia

You may also experience shortness of breath and mild chest pain after the surgery, especially during strenuous activity. Your doctor will advise you on what is appropriate for after your procedure in terms of exercise and other activities.

How Effective Is a Pneumonectomy for Treating Lung Cancer?

A pneumonectomy is an effective way to remove lung cancer and the affected lung tissue. As long as the cancer has not spread to nearby lymph nodes or the other lung, a pneumonectomy can put a person into remission and improve their life expectancy.

In cases of cancer that keeps coming back, a pneumonectomy can offer the best chance at survival. Researchers with one study found that the five-year survival rate of 28 people who had a pneumonectomy to treat recurrent NSCLC was 43.1 percent.

One MyLungCancerTeam member shared about their pneumonectomy, saying, “In 1987, I underwent a complete pneumonectomy and one of my lungs was totally removed. I only have one lung, and for 34 years everything was OK. But in 2021, the biopsy results showed a carcinoid and carcinoma in my lung.”

Although removing the entire affected lung offers the best chance for treating lung cancer, it is still possible that the disease will come back. Fortunately, several other effective treatment options are available, which can improve outlook and life expectancy.

Talk With Others Who Understand

MyLungCancerTeam is the social network for people with lung cancer and their loved ones. More than 6,000 members come together to ask questions, give advice, and share their stories with others who understand life with lung cancer.

Have you had a pneumonectomy to treat your lung cancer? Do you have suggestions for anyone else facing this situation? Share your experience in the comments below, or start a conversation by posting on MyLungCancerTeam.