Surgery for lung cancer consists of removing the cancer and the nearby lymph nodes. Whether surgery is a suitable alternative for a patient will depend on the type of lung cancer they have, its stage, and their overall state of health.
Lung surgery is a major operation and patients must be physically well enough to handle it. Before undergoing surgery, you will have tests done to check on how well your lungs are working.
Non-small cell lung cancer (NSCLC)
Surgery can be performed at an early stage (1 and 2) of non-small cell lung cancer and in some people whose cancer is in stage 3.
Small-cell lung cancer (SCLC)
Doctors rarely advise surgery for small-cell lung cancer because in these cases the cancer has usually spread beyond the lung. Surgery can sometimes be an option if the tumor is very small and your doctor is confident that it hasn't spread. You will need chemotherapy after surgery.
This is an operation to remove one of the lobes of the lung. Approximately one-third to half of your lung will be eliminated.
This is an operation to remove one of your lungs.
- Wedge resection or segmentectomy
These operations remove a small amount of the lung.
These can be performed in cases of very early-stage lung cancer. It can also be done if the lung is too damaged for a lobectomy to be performed safely.
A segmentectomy removes a slightly bigger part of the lung than wedge resection resection.
- Open surgery
Surgery for lung cancer normally consists of opening up the chest between the ribs. This is called a thoracotomy.
- Video-assisted thoracoscopic surgery (VATS)
Sometimes, surgeons use a different type of surgery called video-assisted thoracoscopic surgery (VATS). It is the least-invasive way of operating on lung cancer; these types of surgery are called minimally invasive surgery.
The surgeon makes several small incisions measuring 2 cm in the skin and inserts a thoracoscope equipped with a video camera into the chest. The camera sends image of the interior of the chest to a computer screen so that the surgeon can see the image. They then insert small instruments through the incisions in order to remove the cancer.
The scar that remains after VATS is much smaller than with open surgery, and patients usually have less pain and recover more quickly.
- Lymph node removal
During an operation to remove cancer, the surgeon also removes lymph nodes located near the cancer; these are examined under a microscope to see if there are any cancer cells in the nodes. Knowing whether the cancer has spread into the lymph nodes helps doctors decide whether you need more treatment with chemotherapy or radiotherapy.