Surgery for lung cancer

People with early NSCLC (stage 1 or 2) will generally be offered surgery to remove the tumour.

Learn more about:

• Overview
• Types of lung surgery
• Removing lymph nodes
• How the surgery is done
• What to expect after surgery

Overview

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 advanced lung cancer.

If there is fluid in the pleural cavity (called pleural effusion) that keeps returning, you may have surgery (pleurodesis) to control this, or need to insert a catheter. Read more on this procedure.

Types of lung surgery

Surgery for lung cancer may remove all or part of a lung.

	Lobectomy This is the most common type of surgery for lung cancer. In a lobectomy, one of the lobes of the lung (about 30–50% of the lung) is removed.
	Pneumonectomy If 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 operation, a whole lung is removed. It’s possible to still breathe normally with one lung.
	Segmentectomy For some early-stage lung cancers that are on the edge of the lung, a segmentectomy may be used. In this operation, 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 tiny piece of the lobe.

Removing lymph nodes

During surgery, the 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 helps the doctors decide whether you need further treatment with chemotherapy or radiation therapy.

How the surgery is done

There are 2 main 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.

VATS

Lung cancer surgery can often be done using a keyhole approach. This is known as video-assisted thoracoscopic surgery (VATS). The surgeon will make 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.

Thoracotomy 

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.

Sometimes the surgeon may need to change from a VATs approach to a thoracotomy during the surgery.

See our general section on Surgery for more information about surgery and recovery.

→ READ MORE: What to expect after surgery

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