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  6. Types of Lung Cancer Treatment
  7. Surgery

Lung Cancer Surgery

Surgery may be the only step in lung cancer treatment, the first step or it may follow other treatments.

Lung cancer surgery is an option for some patients depending on the type, location and stage of their lung cancer and other medical conditions. Attempts to cure lung cancer with the surgery involve removing the tumor along with some surrounding lung tissue and often lymph nodes in the region of the tumor. Removing the tumor with lung cancer surgery is considered the best option when the cancer is localized and unlikely to have spread. This includes early stage non-small cell lung cancers and carcinoid tumors. 

What to Expect

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Surgery—What to Expect? This animated video explains different types of surgery for lung cancer and provides tips and guidance for patients preparing to have a procedure. Generously supported by Intuitive

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When facing lung cancer, your doctor may recommend surgery. Knowing what to expect can ease some of the anxiety that comes with cancer treatment. Every person’s journey is different so be sure to speak with your doctor if you have any questions.

Before surgery:

Before surgery, lung function tests can help doctors determine the type of procedure they might perform and if you are healthy enough for surgery.

Ask your doctor for guidelines of what to eat or drink before surgery and for medications to help ease potential discomfort.

If you smoke, it is important to quit smoking before surgery to help your body recover.

Recovery can take a lot out of you so it's important to get plenty of support.

You might want to arrange for transportation to and from appointments help with errands and time off work during your recovery.

During Surgery:

Once you are in the operating room you will receive anesthesia and the area around the incision site will then be shaved and cleaned to help prevent infection

There are two main types of lung cancer procedures. A thoracotomy is when surgery is performed through an incision or cut between the ribs. Minimally invasive surgery involves the use of a camera and instruments to access the lung through small incisions between the ribs.

Two types of minimally invasive surgery are video-assisted thoracoscopic surgery and robotic-assisted surgery.

A Video-Assisted Thoracoscopic Surgery is when a small tube with a video camera on the end is inserted through a smaller incision.

Robotic-assisted surgery can be thought of as an extension of the surgeon’s eyes and hands. The robotic surgical system has multiple arms that hold instruments and one arm that holds a camera.

During robotic-assisted surgery, your surgeon will sit at a console next to you and operate through a few small incisions using tiny instruments, including a camera which offers high definition visualization.

Your surgeon fully controls the instruments on the robotic surgical system. The robotic-assisted surgical system translates every hand movement your surgeon makes in real-time bending and rotating the wristed instruments.

Minimally invasive surgery provides a clear magnified view with a camera. The hospital stay is often shorter though sometimes similar compared to the length of stay with an open thoracotomy.

In both types a diseased part of the lungs is removed. In rare cases, a whole lung is removed. Ask your doctor which surgery is recommended for you.

After surgery:

After surgery you will be moved to the recovery area and once stable to a hospital room.

Grogginess and pain are common and you may receive medication to help. Drainage tubes that were inserted during surgery will likely be removed in a few days.

A respiratory therapist might visit you and offer therapy to help improve your lung function. Before you leave the hospital make follow-up appointments and ask for recovery instructions.

Your doctor may recommend physical therapy or pulmonary rehabilitation to help you build lung strength and endurance.

As you become more active, you may notice shortness of breath. Talk to your doctor about this or any discomfort you might have. Find out if there are symptoms for which you should contact your doctor immediately.

Every person's recovery time and experience is different. But focusing on one's well-being is important for every person going through treatment. That includes getting the supportive care you need to help you with your recovery leaning on others for support to help you rest and keeping in touch with your doctor throughout the process.

Knowledge is power. By being proactive during treatment you put the power in your own hands.

Learn more at lung.org/cancer-surgery.

The American Lung Association is solely responsible for content.

Key Points

  • Surgery is not an option for all lung cancer patients.
  • Surgery involves removing part of or the entire lung.
  • Prepare for surgery by watching the What to Expect video above and using this worksheet to stay organized.

How Is Lung Cancer Surgery Performed?

There are two commonly used approaches to removing portions of the lung. The choice depends on the location, size and stage of the lung tumor and the expertise of the surgeon.

  • Thoracotomy
    This is an incision on the side of the chest and follows the curve of your ribs. It typically involves dividing some of the muscles of the chest wall and uses an instrument to gently spread between two ribs to provide the surgeon access to the lung. The muscles are repaired when the incision is closed.
  • Minimally invasive surgery
    This approach typically involves 1 to 4 small incisions to access the inside of the chest. The surgeon uses a camera to visualize the lung and special instruments to perform the surgery. This is known as thoracoscopy or video-assisted thoracoscopic surgery (VATS) and can also be done with the assistance of a surgical robot.

Types of Procedures

  • Lobectomy
    • The right lung is divided into three lobes; the left lung has two lobes.
    • Lobectomy is the removal (resection) of the lobe of the lung affected by lung cancer. This is the most commonly performed lung cancer surgery.
    • A bilobectomy is the removal of two lobes and is only done for tumors of the right lung where the tumor involves two adjacent lobes. This can result in a right upper and middle bilobectomy or a right middle and lower bilobectomy.
    • A lung cancer surgery called a sleeve lobectomy is also sometimes done. These tumors typically involve one lobe as well as the main bronchus to that lung. A sleeve resection starts with the removal of the cancerous lobe and a portion of the main bronchus to that lung. The remaining end of the main bronchus is then rejoined with the bronchus to any unaffected lobe(s). When done a sleeve lobectomy avoids the need for a pneumonectomy (see below).
  • Segmentectomy
    • Each lung lobe is made up of two to five lung segments.  Surgeons can remove one to four segments of certain lobes and save uninvolved tissue.
  • Wedge Resection
    • A wedge resection is the removal of a small, wedge-shaped part of the lung tissue surrounding the cancerous tumor.
  • Pneumonectomy
    • Pneumonectomy is the removal of the entire lung affected by cancer. This lung cancer procedure is usually done if the cancer cannot be fully removed with the lobectomy or if the lesion is centrally located.

Possible Lung Cancer Surgery Side Effects

Each type of lung cancer treatment option has possible side effects.It is important to know the potential side effects and ways to cope with them before beginning lung cancer treatment. You might experience:

  • Pain
  • Possible complications from the lung cancer surgery

Discuss concerns, possible side effects and any effects that you experience with your surgeon. Download a list of suggested questions.

Next: Manage Side Effects

  • Surgery: What to Expect Worksheet

    Download

Reviewed and approved by the American Lung Association Scientific and Medical Editorial Review Panel.

Page last updated: October 28, 2021

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