Surgery for Lung Cancer
Chest and lung surgery may be part of your treatment for lung cancer. There are many factors that go into deciding whether surgery is the best treatment for you. These include the type and stage of lung cancer you have and your lung function. Lung cancer surgery recovery and survival rates also depend on the type and stage of lung cancer. In general, the survival rate is higher for early stage lung cancer than later stage tumors that have had time to spread. Surgical recovery time is 2 to 6 weeks for minimally invasive surgery and up to 8 weeks for lung surgery requiring thoracotomy. Surgical oncologists and specialized thoracic surgeons perform lung cancer surgery.
The three main types of lung cancer are non-small cell, small cell, and lung carcinoid tumor. Surgery may be the main treatment for early stage non-small cell and carcinoid lung cancers.
If the cancer is at a more advanced stage but has not spread outside your lung, you may have chemotherapy or radiation therapy before surgery to shrink the tumor. You may also have chemotherapy or radiation after surgery to kill any cancer cells left behind.
The type of surgery is related to the amount of lung you need removed. If your lungs are healthy, you can live well with most or even all of one lung removed. If you have poor lung function before surgery, you may not be able to have as much lung removed.
The four basic types of surgery for lung cancer are:
Wedge resection. This operation removes just your tumor and some lung tissue around the tumor.
Segmental resection. This removes a segment of your lung that includes the tumor. Your right lung has 10 segments. Your left lung has eight.
Lobectomy. This type of surgery removes the lobe of your lung that includes the tumor. Your right lung has three lobes. Your left lung has two. A bilobectomy removes two lobes from your right lung.
Pneumonectomy. This procedure removes your entire lung.
There are different ways to do the different types of surgery. Also, some procedures are done before surgery to help diagnose and stage your cancer. Here are the basics:
Bronchoscopy. This procedure can help diagnose your cancer. It involves a flexible telescope with a camera. The scope goes through your nose or mouth into your lung. Your surgeon may remove pieces of lung tissue to examine under a microscope (biopsies).
Mediastinoscopy. This procedure helps stage the cancer, to see how far the cancer has spread. It uses a long, thin telescope that's put through a small incision above your collarbone. This lets your surgeon biopsy lymph nodes in the middle of your chest.
Video-assisted thoracoscopic surgery (VATS). VATS is minimally invasive surgery for early stage cancers. The surgeon uses long, thin instruments and a telescopic video camera. The surgeon can see video from inside your chest on a TV screen during the operation.
Thoracotomy. This is a type of surgery for removing advanced stage or larger cancers. The surgeon makes a long incision, usually under your shoulder blade. The surgeon opens your chest and spreads your ribs to do this surgery.
If you have VATS or thoracotomy, you will have tubes in your chest after the operation. These are to drain air and fluid. You will get medications for pain. Hospital caregivers will check your heart rate, blood pressure, and oxygen level often. It will be important to do deep-breathing exercises and to cough frequently. A respiratory therapist will show you how to do all the exercises.
Doctors will remove your drains before you go home. A hospital stay after a thoracotomy is 4 to 6 days. It can be 1 to 4 days after VATS. Recovery time is shorter for VATS compared to thoracotomy.
What your surgeon finds during your surgery may be important for deciding on treatment after surgery. Your surgeon will explain the surgical results and how they might affect your prognosis.
There are lots of options when it comes to surgery for lung cancer. Learn as much as you can about your type and stage of cancer. Work with your surgeon to weigh all the risks and benefits. Together, you can make the choices that give you the best chance of surviving lung cancer.