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What Happens During Lung Cancer Surgery

The word “surgery” might be uncomfortable or even frightening to hear, but surgery has provided excellent outcomes for thousands of lung cancer patients nationwide. Lung cancer surgeries vary, but in general, surgeons try to pinpoint the diseased, cancerous areas, sparing as much of your healthy lung tissue as possible.

Whether you have surgery for lung cancer, and what type of surgery you need, will vary depending on the type, location, and stage of your disease. It might involve the removal of small or large sections of the lung, and might be paired with another treatment, such as radiation. This can help shrink the tumor before your surgery and increase the odds that your operation will be successful.

Before surgery, your physician will give you specific instructions to prepare. For example, if you are weak or underweight, you might need to start eating a high-protein, high-calorie diet before surgery. This can help prepare your body for the operation.

If You Have Non Small Cell Lung Cancer:

Surgery has a very good chance of curing lung cancer in about 15% to 25% of all patients. In order to be a candidate for surgery, the tumor must be in a location where it can be removed completely and you must be healthy enough to have an operation. Fortunately, newer methods for evaluating patients and less invasive surgical techniques allow more patients than ever to undergo surgery to cure their cancer.

These less invasive techniques include:

  • Video-assisted thoracic surgery (VATS), in which the surgeon places a tiny camera inside you to see the interior of your chest cavity, then uses special tools to remove the tumor.
  • Robotic-assisted surgery, in which the surgeon uses a scope plus special robotic “hands” that a computer guides to your tumor with extra precision. Robotic-assisted surgery can be especially useful when tumors are in hard-to-reach locations.

In our practice at Fox Chase, we perform 90% of lung cancer operations using these less invasive surgical techniques. This can mean less pain and a quicker recovery after surgery.

With minimally invasive approaches, Fox Chase surgeons can operate on patients that sometimes were refused surgery elsewhere. This is because the faster recovery time is important for patients who might be in poor health.

For example, this type of surgery may be beneficial in patients who have poor lung function. Minimally invasive surgery might make it possible to remove a small segment of their lung rather than a larger area, which would be the approach with traditional surgery. Removing a smaller segment of the lung is actually more complex, but it’s routinely done at Fox Chase.

Our pulmonary and critical care specialists also work with patients before surgery to improve their breathing. Because of their skill, we have been able to remove lung cancers in many patients who were denied surgery by other doctors who told them their lung function was not good enough.

Another advantage to minimally invasive surgery: If your doctor recommends additional treatment after surgery, such as radiation, patients who have undergone minimally invasive surgery can often start such beneficial treatment sooner.

Fox Chase Cancer Center’s thoracic surgeons are regional and national leaders in performing complex surgeries for patients with lung cancer. They are highly skilled in both traditional surgery and less invasive techniques, including robotic surgery. Most procedures at Fox Chase are done with less invasive video-assisted thoracoscopic (VATS) surgery.

If You Have Small Cell Lung Cancer:

Your physician may recommend surgery if the cancer is found in one lung and in nearby lymph nodes only. Because small cell lung cancer is usually found in both lungs, surgery alone is not often enough. You may receive chemotherapy, radiation, or both to shrink the tumor beforehand, which can increase the odds of a successful surgery.

During surgery, the surgeon will also remove lymph nodes to find out if they have cancer in them. Sometimes, surgery is also used in diagnosis of cancer: A surgeon may remove a sample of lung tissue to find out the exact type of lung cancer.

As with non small cell lung cancer, you might receive adjuvant therapy after surgery — chemotherapy, radiation, or both to kill any cancer cells that might be left. This can lower the risk of cancer returning.

Types of Surgery

Some of the specific procedures we offer, either through standard or less invasive surgery, include:

  • Lobectomy: Surgery to remove a whole lobe (section) of the lung. There are three lobes on the right and two on the left. This is the standard of care for most lung cancers, since it removes the largest potential area for lung cancer tumors.
  • Wedge resections: Surgery that removes a small, wedge-shaped portion of the lung containing the cancerous cells, along with healthy tissue that surrounds the area. The surgery is performed to remove a small tumor or to diagnose lung cancer. It is often used for patients who will suffer from decreased lung function if too much of the lung is removed.
  • Segmentectomy (segment resection): Removal of a larger portion of the lung lobe than a wedge resection, without removing the whole lobe.
  • Sleeve resection: Surgery to remove a lobe along with part of the bronchus (air passage) that attaches to it. The remaining lobe(s) is then reconnected to the remaining segment of the bronchus (airway). This procedure preserves part of a lung, and is an alternative to removing the lung as a whole (pneumonectomy).
  • Pneumonectomy: Surgery to remove one whole lung. If there are no other options to remove advanced cancer, this procedure is done if the patient will be able to function without one lung after the surgery.

Even if the surgeon removes all the cancer that can be seen at the time of the surgery, some patients may be given chemotherapy or radiation therapy after surgery to kill any cancer cells that are left. Treatment given after the surgery that lowers the risk that the cancer will come back is called adjuvant therapy.

Recovery from Lung Cancer Surgery

After surgery, you will be given medication for pain control. When you’re ready to be discharged from the hospital, you’ll be given instructions for how to take care of yourself at home, including:

  • Instructions for pain control, such as when and how to take medications
  • Activities to avoid
  • Caring for your incision site, and how to prevent infection
  • How soon you can return to work

Generally, about a week or two after you go home, you’ll return for a follow-up appointment with your surgeon. If your surgery was more involved, you might need more than one follow-up visit. Your surgeon might remove stitches. He or she will also examine your incision and ensure that you are healing correctly. Your total recovery time could take several weeks, depending on your illness, age, and health.

“We have grown to have one of the largest groups in thoracic surgery in Philadelphia. All of our surgical team members are dedicated and excellent in their profession. We provide the full gamut of thoracic surgery, including a specific interest in minimally invasive, robotic surgery. We have one of the highest-volume robotic programs in the country.” — Abbas El-Sayed Abbas, MD, MS, FACS, Chief, Division of Thoracic Surgery

What To Do Next:

Request an appointment online, or call 888-FOX-CHASE. For general information or to ask us a question, please visit our Contact Us page.

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