Surgery for lung cancer

Surgery is mainly used in the treatment of non-small cell lung cancer. The surgeon will remove the cancer as well as the surrounding lymph nodes in the chest. There are three types of operations used to treat lung cancer. The surgery you’ll have depends on the stage of the caner and your general health. Doctors will run some tests to make sure you are well enough to have an operation on your lungs.

  • Lobectomy – one the lobes of the lung is removed.
  • Pneumonectomy – one of the lungs is removed.
  • Wedge resection – only a small section of the lung is removed. This type of surgery is used to treat early stage lung cancer.

During the operation, the surgeon will also remove lymph nodes in the nearby area to check if the cancer has spread.

These operations can be done as open surgery, which means opening the chest, between the ribs. Or they can sometimes be done through video-assisted thoracoscopic surgery (VATS). This is a form of keyhole surgery and is less invasive than open surgery. But it can only be carried out by specially trained surgeons.

Having surgery to treat lung cancer

Surgery for lung cancer involves removing the cancer and the nearby lymph nodes in the chest. Whether surgery is suitable depends on the type of lung cancer you have, its stage and your general health.

A lung operation is major surgery and you need to be well enough to cope with it. Before surgery you will have tests to measure how well your lungs are working. A surgeon who is an expert in lung surgery will do your operation.

Surgery can be used in early stage (stage 1 and stage 2) non-small cell lung cancers and, occasionally, in some stage 3 cancers.


Small cell lung cancer (SCLC)

Doctors rarely advise surgery for small cell lung cancer because it has usually spread outside the lung. It may sometimes be an option if the cancer is very small and your doctor is confident it has not spread. You will need chemotherapy after surgery.


Most common types of surgery

Lobectomy

This is an operation to remove one of the lobes of the lung. About a third to a half of your lung will be removed.

Lobectomy
Lobectomy

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Pneumonectomy

This is an operation to remove one of your lungs. You can still breathe normally with only one lung. If you had breathing difficulties before the operation, you may still be breathless afterwards.

Pneumonectomy
Pneumonectomy

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Wedge resection

These operations remove a very small amount of the lung. You may have this if you have a very early lung cancer. It can also be done if the lung is too damaged to safely have a lobectomy.

A segmentectomy removes a slightly larger part of the lung than a wedge resection.

Wedge resection
Wedge resection

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Open surgery

Surgery for lung cancer usually involves opening the chest between your ribs and sometimes cutting a rib. This is called a thoracotomy. You will have a 10–20cm-long scar around the side of your chest afterwards.

Video-assisted thoracoscopic surgery (VATS)

Sometimes surgeons use a different type of surgery called video-assisted thoracoscopic surgery (VATS). It’s a less invasive way of doing lung surgery and is also called keyhole surgery.

It’s not suitable for everyone and is only carried out by surgeons who have been specially trained to do it.

The surgeon makes several small 2cm cuts in the skin and puts a thoracoscope with a video camera attached into the chest. The camera sends images of inside the chest to a computer screen so the surgeon can see. They pass small instruments through the cuts to remove the cancer.

After VATS there is a much smaller scar than with open surgery and people usually have less pain afterwards and recover faster.

Removing lymph nodes

During an operation to remove the cancer, your surgeon also removes lymph nodes close to the cancer. The lymph nodes will be examined under a microscope to check for cancer cells.

If the lymph nodes contain cancer cells, they will have been removed. Knowing if the cancer has spread to the lymph nodes also helps your doctors decide if you need further treatment with chemotherapy or radiotherapy.

If you have questions or would like to know more, talk to your doctor or specialist nurse to make sure you understand what surgery involves.

Back to Surgery explained

Who might I meet?

A team of specialists will plan your surgery. This will include a surgeon who specialises in your type of cancer.