There are many types of lung cancer surgery options, depending on the nature of the patient's diagnosis. Lung cancer is rarely a single tumor that hasn't spread to other areas of the body, including the lymph nodes. Surgery is typically recommended for early stage non small cell lung cancer.
If your oncology team has recommended lung cancer surgery as a treatment option for you, you may have more questions about what is involved with the procedure. Below is a highlight of and general guide to the various types of lung cancer surgery options, along with recovery expectations for each.
Types of Lung Cancer Surgery
Depending on the precise diagnosis for each patient, there are several types of lung cancer surgery that can be a recommended course of treatment. The specialists and oncology teams will determine what type of surgery is best for each individual case, sometimes based on the size, location, and progression of the cancer. Most of the procedures below will also include removal of multiple lymph nodes in the lungs/chest for pathologic examination. It is important to consult with a thoracic surgeon experienced in performing various types of lung cancer surgeries to determine the best approach for you.
This type of lung surgery may be recommended when it's best to remove a lung entirely. A pneumonectomy may be used for patients who present tumors centered in the chest or when other types of operations are not ideal. A surgeon may opt for a traditional pneumonectomy in which only the affected lung is removed. An extrapleural pneumonectomy may be recommended for mesothelioma patients. It involves the removal of additional tissue from around the heart, part of the diaphragm, or chest cavity membranes.
Recovery Expectations: With either type of pneumonectomy procedure, a patient can expect to lose half of his or her original breathing capacity. It will be a slow path to a full recovery, but patients can be hopeful of resuming normal daily activities. The remaining lung will strengthen and eventually over-compensate for the loss, to allow for better breathing. Many patients, however, will continue to experience shortness of breath during exercise or increased activity.
The lungs are made up of three lobes on the right side and two lobes on the left. A lobectomy is a type of lung cancer surgery in which one of these lobes is removed. During this procedure, also called a thoracotomy, the surgeon will enter through the chest. Many oncologists prefer this type of operation as they can often remove a lobe where tumors are presenting together in a pinpointed or clustered area.
Recovery Expectations: Returning home after a lobectomy and resuming normal activities will take some time. Many patients, often frustrated with their initial fatigue or shortness of breath, overexert themselves early in recovery because they don't 'feel' like they've had a major procedure. It's important to have patience and stay positive with little, daily improvements in lung function as you recover.
Segmentectomy (Wedge Resection)
In some cases, a tumor may present in one of the lobes of the lung, but a lobectomy isn't necessary. When it's doable, it may be recommended to perform a segmentectomy. This procedure refers to the removal of the tumor only, and not the entire lobe. Some oncologists refer to it as a wedge resection, as it relates to the partial removal of a lobe.
Recovery Expectations: During the post-op period, a patient will be closely monitored for complete recovery of the patient's lung function. This particular procedure is considered more common, as it is also recommended for non-cancerous tumor removal as well. Patients report less pain and shorter recovery times. Surgeons report having positive outcomes.
Some lung cancers present in the airways of the lungs directly. For these types of tumors, sometimes a sleeve resection surgery is a recommendation. Much like the name indicates, the tracheobronchial sleeve resection procedure involves surgically severing along the airway, both above and below the tumor to first remove it. The airway is then reconnected, similar to a shortened sleeve on a shirt. These surgeries can be optimal in the patient's ability to retain good lung and breathing function.
Recovery Expectations: Hospital stays post-op may vary, but patients should expect the home recovery to last several weeks. The operation itself can often take longer, and there will be more time required to heal, as this procedure can involve a more invasive series of cuts and reattachment. Like the other options available for surgery, sleeve resection recovery will require a great deal of patience, as healing takes time. In-home recovery and healing efforts are paramount to regain full lung function.
Minimally Invasive (VATS) Surgery
Lobectomy and segmentectomy can often be performed via a minimally invasive approach, or video assisted thoracoscopic surgery (VATS) surgery. This type of surgery in less invasive than a traditional thoracotomy and minimizes pain, and allows for quicker recovery time and shorter hospital stay.
Each Patient Is Different
Because each individual presents with a unique health history and lung cancer characteristics, it's best to recognize that surgical treatments and recovery expectations will also vary for each person. If you find yourself facing a recommendation for one of these surgeries, don't be afraid to ask questions. You'll want to inquire about surgery time, duration, and post-surgical hospital care. Ventilators and chest tubes after surgery can cause anxiety for some individuals, but knowing what to expect ahead of time can help them prepare mentally. Also, inquire about any potential risks for post-op infections or complications and preventative measures. Having your cancer care team guide you through each step of surgical treatment and post-op care management can help reduce the anxiety and anticipation.
Post Lung Cancer Surgery Suggestions
Once the patient is back home after surgery, there are a few tips to recovering comfortably. Resting and drinking plenty of water is an essential first step. Making sure you have a good plan for post-op pain management will be helpful, as well. Because each of these procedures affects lung function, patients should avoid any activity or situations that may cause more demand on the lungs. Recovery may take weeks, and for some, even months. The care team will fully inform each patient on post-op guidance and expectations.
Don't hesitate to reach out to your cancer care team of specialists at Arizona Oncology for answers to some of your personal health questions regarding lung cancer. They can provide direction and guidance through each phase of the lung cancer management process. Having a complete understanding about your specific diagnosis, recommended surgical treatment, as well as recovery expectations, is an essential step.