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Posted on in Cancer

Surgical Options for Lung Cancer

Medically Reviewed by
Gregory Jones, MD

“If the lung cancer is contained at an early stage and the patient has a good heart and lung reserve, removing a section of the lung, as well as dissecting out lymph nodes, is pretty much the standard of care,” says McLeod Cardiothoracic Surgeon Gregory Jones, MD. “Plus, surgeons are pushing ahead with less invasive procedures, including video-assisted platforms and small incisions in places that can spare muscles and nerves.”

Let’s look at some of the key points in that overview offered by Dr. Jones.

EARLY STAGE CANCER

Surgery alone may be most appropriate if the cancer is so-called “non-small cell” cancers, which have not spread to lymph nodes or outside the borders of removal. Smoking is the most common cause of this cancer as well as other cancer cell types.

“Small cell” cancer of the lung is usually caused by smoking.  But it spreads early and chemotherapy may be the selected treatment, rather than surgery.

Chemotherapy and/or radiation therapy may be used prior to surgery to stop the spread or shrink the tumors. Chemo and/or radiation therapy can also be used following surgery to ensure that all cancer cells were killed.

GOOD HEART & LUNG RESERVE

Lung cancer patients will be tested to ensure that their heart and lungs can handle the surgery. A human can survive and have a good quality of life with only one lung.  However, if a patient already suffers from a breathing problem, such as asthma or COPD, surgically removing part or all of a lung may not be a workable treatment option.

REMOVING A SECTION OF THE LUNG

There are 3 basic surgical procedures that can be undertaken for lung cancer.

  • Wedge Resection involves removing a small portion of a lung surrounding the cancer tissue.
  • Lobectomy (loab-EK-tuh-mee) is the removal of one lobe section of the lung.  The right lung has 3 lobes and the left lung has only 2 lobes.
  • Pneumonectomy (new-muh-NECK-tuh-mee) is required when removing one lobe will not eliminate all the cancer – and the entire lung must be excised (cut out).

DISSECTING OUT THE LYMPH NODES

Generally, the surgeon also removes lymph nodes, which receive drainage from the lung.  These will be examined to see if the cancer has spread beyond the lung.

LESS INVASIVE PROCEDURES

Cancer surgery for the lung has two forms.  For years the standard of care has been an incision across the side of the chest. Ribs are spread apart to allow the surgeon to reach the lung. 

As with many types of surgery, minimally invasive techniques are being introduced.  Video-Assisted Thoracic Surgery (VATS) uses a tiny video camera on the end of a thin tube.  Long instruments are passed through other small incisions.  If necessary, the incisions can be slightly enlarged to enable removal of the lung section.

With VATS surgery, patients usually have less pain and a shorter hospital stay.  But not all patients’ cancer will be suited for the VATS procedure.  

  • Talk with your cancer specialist, surgeon and, if the cancer program has a Nurse Navigator, chat with her as well.
  • Together, your team will guide you to the most effective treatment plan.

Also see, 5 Lung Cancer Myths You Need To Know and You’ve Been Diagnosed with Cancer. Now What?.

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Sources include:  McLeod Health, Society of Thoracic Surgeons, American Lung Association, Cancer Research UK, Lung Cancer Alliance, American Cancer Society, National Institutes of Health

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