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Types of Surgery for Lung Cancer

Medically reviewed by Seunggu Han, MD on October 30, 2017Written by Valencia Higuera on October 30, 2017
types of surgery

After a lung cancer diagnosis, your doctor will determine the next steps in your treatment. Lung cancer is when abnormal cells develop and divide in the lungs. Although the disease starts in the lungs, it can spread to other parts of the body. So it’s important to detect it early and receive treatment.

Treatment for lung cancer varies. Options include chemotherapy drugs or radiation to destroy cancer cells. Another option is immunotherapy, which can boost your immune system to fight the disease. Your doctor may also recommend surgery. This depends on the size of the tumor, its location within the lungs, and whether it has spread to nearby organs and tissue.

Surgery removes cancerous tumors from the body. It’s often used to treat early stage non-small cell lung cancer (NSCLC). If your doctor believes surgery is the best approach, you may have one of the following procedures.

Lobectomy

The lungs are divided into five lobes — three on the right lung and two on the left lung. Cancer can develop in any part of the lungs. If cancer is in one or more of your lobes, your doctor may perform a lobectomy to remove the lobes containing cancerous cells. This surgery is an option when one or two lobes need removal.

Pneumonectomy

Sometimes, treating lung cancer requires removing the entire affected lung. This may be necessary if cancer affects more than two lobes, such as all three of your right lobes or both of your left lobes. This surgery eliminates cancer from your body so that it doesn't continue to grow or spread.

This procedure isn’t recommended for everyone. Because this surgery takes out one lung, you’ll have to undergo pulmonary testing beforehand. This will ensure you’ll have enough healthy lung tissue remaining after surgery. Healthy lung tissue allows for sufficient breathing.

During this procedure, your surgeon makes an incision in your side. Then they remove your lung after separating your tissue and ribs.

A pneumonectomy can treat lung cancer, but it’s a complicated procedure. Your doctor may only recommend this procedure if there’s a chance of achieving remission. If you have advanced cancer or it has already metastasized, removing the lungs may not help.

Removing a section of the lung

Another option is removing only a section of diseased tissue from the lungs. Your doctor may recommend this procedure when tumors are small and haven’t spread beyond the lungs. Options include:

  • Wedge resection. This removes a small piece of lung tissue from one or more lobes.
  • Segmentectomy. This removes a larger section of lung tissue, but doesn't remove an entire lobe.
  • Sleeve resection. This surgery is an alternative to removing the entire lung. It preserves part of the lung by removing cancerous areas, including sections of the bronchus or air passage.

Surgery can be an effective treatment for lung cancer. But your doctor may also recommend chemotherapy or radiation after surgery. This treatment is a precaution and helps kill microscopic cancer cells, which could spread to your lymph nodes.

How is lung cancer surgery performed?

Besides the different surgeries for lung cancer, there are different ways to perform these procedures.

Open surgery (thoracotomy)

The surgeon makes an incision below the nipple and around the back underneath the shoulder blade. This type of surgery is used when removing the entire lung.

Video-assisted thoracic surgery

This is a minimally invasive surgery to remove cancer without opening the chest. This is used to remove lobes or sections of the lungs. A surgeon makes a small surgical incision. Next they insert a long tube with an attached camera into the chest. They can then perform the surgery while watching an image of your lungs on a screen.

Robotic-assisted surgery

Robotic-assisted surgery is another minimally invasive procedure to remove cancerous cells. With this surgery, your doctor performs the procedure while seated at a control unit. The surgical team inserts a tiny video camera into a small incision. Surgical instruments attached to a robotic hand are used during the procedure. Your doctor guides the robotic hand from the control unit. This surgery can assist with hard-to-reach tumors.

Lung cancer surgery risks

Lung cancer surgery is a serious operation, and it can take weeks or months to recover depending on the procedure. Although effective, surgery does carry some risks, such as:

  • allergic reaction to anesthesia
  • bleeding
  • blood clots
  • infection
  • pneumonia

It’s important to discuss these risks with your doctor. Another possible long-term complication is shortness of breath with certain activities. This is especially true if you have a lung disease along with lung cancer (such as emphysema or chronic bronchitis).

Outlook

Surgery is an effective treatment for lung cancer, but it’s not recommended for everyone. This treatment can cure early stage lung cancer that hasn’t spread. But even when surgery is successful, your doctor may suggest extra therapy like chemotherapy or radiation.

The sooner you begin treatment for lung cancer, the better. Speak with your doctor to understand your surgical options.

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