Lung Cancer Surgery
Specific treatment plans for lung cancer depend on the stage of the cancer, as well as your overall health, physical condition and other factors. Our lung cancer specialists provide the personalized treatment you need. When surgery has been determined to be the best form of treatment, you can expect state-of-the-art techniques in a safe and comfortable environment.
When you have lung cancer, surgery may be the first form of treatment, or it may be used after chemotherapy, radiation or both have been administered to shrink the tumor.
Lung resection is the surgical removal of the diseased portion of a lung or the entire diseased lung. It is the preferred treatment for people with early stage lung cancer. Surgery can be performed with minimally invasive techniques, such as thoracoscopy or video-assisted thoracic surgery (VATS), robotic surgery, or open incision (thoracotomy).
We are constantly expanding our treatment options, recommending minimally invasive procedures whenever possible. Among other benefits, you will likely experience a faster recovery, less pain and reduced scarring. There are four main types of surgery used to treat lung cancer:
- Wedge or segmental resection is the removal of a small part of the lung.
- Lobectomy is the removal of an entire section (lobe) of the lung.
- Bilobectomy is the removal of more than one lobe.
- Pneumonectomy is the removal of the entire lung.
The amount of lung removed depends on several factors, including the size and location of the tumor, whether lymph nodes have cancer and how well the lungs are functioning. Not all lung cancers are amenable to surgery, and some are initially treated with chemotherapy and radiation.
To find out whether your lungs are healthy enough for surgery, your doctor may give you several tests, such as pulmonary function tests and a quantitative ventilation/perfusion scan. Surgical removal of the tumor is a common choice when the cancer has not spread to other tissues in the chest or beyond.
Generally, surgery is not used as first-line treatment if the lung cancer has:
- Spread from the lung into other parts of the chest, such as the heart or the plural fluid, which is fluid between the lung and chest wall
- Spread to lymph nodes in the neck, mediastinum (area located in the center of the chest, but outside the lungs) or to other organs, such as the liver, adrenal glands or brain
- Makes it difficult to breathe
- Developed in a part of the lung that can’t be removed
- Been diagnosed as small cell lung cancer
- Developed in a patient with other health-related problems that make surgery risky, such as heart or vascular problems, severe emphysema, diabetes, and certain other chronic conditions
Pulmonary rehabilitation programs may be recommended, both before and after surgery – especially for people who do not have a regular exercise program. Sometimes bronchodilators, like those used to treat asthma, can also help improve breathing function enough for surgery. p
For patients with poor lung function who cannot tolerate major surgery, a technique called video-assisted thoracic surgery (VATS) may be helpful.
VATS is a minimally invasive procedure that allows surgeons to make smaller incisions and avoid spreading the ribs as required in traditional open surgery. Doctors use a tiny video camera (called a thorascope) through one of the incisions to view the lung on a flat-screen monitor and precisely maneuver surgical instruments.
This procedure may reduce surgical trauma and shorten hospital stays by avoiding large incisions.
Pleurodesis is a surgical procedure that may be recommended when fluid has built-up in the membranes around the lung. This build-up of fluid is called pleural effusion. It prevents the lungs from fully expanding within the chest.
Pleurodesis is also used with patients whose lung has collapsed due to a hole in the lung. It allows surgeons to repair the lung thorascopically by stapling the hole.
Treatment typically involves placing a tube (thorascope) in the chest, then inserting a special powder that attaches to the tissues lining the lungs. The powder causes the tissues to stick together so there is no space for fluid to accumulate, allowing the lungs to move and expand again.