Surgery for non-small cell lung cancer

Surgery| is most commonly used for non-small cell lung cancers that are small in size and haven’t spread. Before any operation you may need to have further tests to assess your ability to cope with the surgery. Radiotherapy| or chemotherapy| may be given before of after surgery.

Types of operation Back to top

There are three main types of surgery for lung cancer; lobectomy, pneumonectomy and wedge resection. The type of operation will depend upon the size and position of the tumour.

Removal of a lobe of the lung, as shown in the diagram below, is called a lobectomy. Removal of two lobes is called a bi-lobectomy.

Removal of a whole lung, as shown below, is called a pneumonectomy.

Occasionally, in people who have very early lung cancer, a very small amount of the lung is removed. This is called a wedge resection (shown below).

A segmentectomy operation removes a slightly larger part of the lung. These operations are not done very often.

People are often worried that they won't be able to breathe properly if their lung has been removed. However, it’s quite possible to breathe normally with only one lung. People who had breathing difficulties before the operation may continue to be breathless afterwards. Breathing tests, to measure how well your lungs work, will be done to help you and your doctor to decide whether an operation is right for you.

Before any operation, make sure that you have discussed it fully with your doctor so that you understand what it involves.

After your operation Back to top

It can take many weeks to recover fully from a lung operation, although some people recover more quickly than others. There are things you can do to help speed up your recovery. After your operation you will be encouraged to start moving about as soon as possible. This is an essential part of your recovery. Even if you have to stay in bed, it’s important to keep up regular leg movements to help your circulation and prevent blood clots. A physiotherapist will visit you regularly on the ward to help you with breathing exercises to prevent chest infections and other possible complications.

X-rays will be taken regularly to make sure your lung is working properly.

Drips and drains

While you are recovering in hospital, a drip (intravenous infusion) will be used to give you fluids for a couple of days, until you’re able to eat and drink normally again.

You will also have drainage tubes in your wound. These are usually taken out about 2–7 days after your operation, depending on your recovery. The wound will usually be around the side of your chest between two ribs. It will be covered by a dressing, which the nurses will check. 

Pain

It is quite normal to have some pain |or discomfort after your operation. This can usually be controlled with painkillers. Let your doctor or one of the nurses know if you have any pain, so they can treat it as soon as possible. It’s important to be as comfortable as possible so that you can breathe properly. This can reduce your risk of developing chest infections.

Mild discomfort or pain in your chest can last for several weeks, and you will be given some painkillers to take home with you. Some people find that they have pain that starts some weeks or months after their operation. This is usually because nerve endings which have been damaged during the operation have started to grow back. Talk to your specialist if you start to have pain some time after your operation.

Going home

You will probably be ready to go home about 5–10 days after your operation. If you think that you might have problems when you go home – if you live alone, for example, or have several flights of stairs to climb – it’s important to tell one of the nurses or the hospital social worker when you’re admitted to the ward.

They can arrange for help when you go home. When you go home, you will need to exercise gently to build up your strength and fitness. It’s a good idea to check with your doctor or physiotherapist which types of exercise would be suitable for you. Walking and swimming are good exercises that are suitable for most people after treatment for lung cancer.