How effective is lung surgery for lung cancer?

Dr. Laki J. Rousou, MD
Cardiothoracic Surgeon

Surgery is usually the best option for stage one or two, followed by chemotherapy sometimes. Stage three is mostly chemotherapy, radiation and possibly surgery afterwards. Stage four, or metastatic cancer, never involves surgery, except for a possible diagnosis.

Before surgery, your doctor will need to find out if you can tolerate surgery and how much affected area needs to be removed. To determine that, several different tests are done, such as a pulmonary function test, which gives a hard number in terms of how much lung can be removed safely. Your doctor may also do some blood work, and consult with other medical colleagues on the level of surgery you could tolerate.

Stage three lung cancer usually doesn’t involve surgery. However, biopsies of lymph nodes in the middle of the chest may determine if you are a candidate for surgery. If cancer cells are present in those lymph nodes, then surgery isn’t really an option.

Whether you should immediately seek surgery for lung cancer depends on your stage of lung cancer. If you have a lung cancer that has already spread to lymph nodes or other organs, you likely aren’t a candidate for surgical resection. The first step with a confirmed lung cancer diagnosis is a consultation with a medical oncologist.

Dr. Daniel A. Nader, DO
Pulmonary Disease Specialist

For early stage lung cancer, that is stages 1 or 2, surgery for lung cancer can be very effective. But there has to be a distinct staging that's done prior to surgery, and the patients must be able to tolerate having a significant portion of their lung removed. The patients not only have to be eligible for surgery based on the tumor stage, but be able to have a portion of their lung removed. For later stages of lung cancer, such as stage 3 or stage 4, there is treatment that can be incorporated, such as radiation therapy and chemotherapy.

Dr. Raja M. Flores, MD
Cardiothoracic Surgeon

Thoracic surgeons are specially trained to perform lung cancer surgery. Their goal is complete removal of the lung tumor as well as the nearby lymph nodes in the chest. The tumor must be removed with a surrounding border of normal lung tissue called the margin.

The lungs have a total of five lobes. There are three in the right lung and two in the left. Removing the lobe which has the cancer is called a "lobectomy." Depending on the size and location of the tumor, the surgeon will decide how much of the lung needs to be removed in order to most effectively treat the tumor. If the surgeon is unable to remove the entire lobe for whatever reasons, just the tumor can be removed in a procedure called a wedge resection, surrounded by a margin of normal lung. For tumors close to the center of the chest, a pneumonectomy can be done. This is a surgical procedure that removes the entire lung. Patients can continue to breathe comfortably with a single lung.

Whether a patient gets surgery for lung cancer depends on the stage of the disease. In this video, Raja Flores, MD, thoracic surgeon, discusses in which stages surgery makes sense and which stages chemotherapy to radiation may be needed.

Here are some tips to help you determine if lung cancer surgery is right for you.

  • Do not submit to any procedure until you understand what is being done and you have all the answers to your questions.
  • Be aware that if surgery is being considered for lung cancer, it is a good sign that the degree of tumor involvement or spread is probably limited.
  • Consider getting a second opinion. Your doctor should not be offended by this suggestion and might encourage it.
  • Get a lung function test before surgery. This test helps identify if you have a high surgical risk.
  • Ask about cardiopulmonary exercise testing. It may be helpful to determine whether or not you can withstand lung surgery.

After surgery for lung cancer, you may have significant pain. You should receive pain medication to manage it. Some pain, however, is persistent. Many people who have lung surgery complain of lasting pain at the surgery sites. This is especially difficult for women because the surgery line is often right at the bra line. Many women find alternatives to tight clothing to avoid this irritating and lasting pain. In some instances, nerve blocks performed by an anesthesiologist may help.

Dr. Brian D. Mott, MD
Cardiothoracic Surgeon

Surgery for lung cancer is effective when all of the known cancer can be removed with no residual tumor/cancer cells left behind. This usually means early stage 1 or 2 lung cancer but patients with stage 3 lung cancers are frequently candidates for surgery. Most early stage lung cancers can now be treated with minimally invasive surgical techniques or VATS Surgery (video assisted thoracic surgery). There are usually 4 small incisions and no rib spreading like a traditional thoracotomy. VATS lobectomy is safe, effective as a cancer operation, and associated with fewer post-operative complications and shorter hospital stays.

Continue Learning about Lung Cancer Treatment

Managing Your Life While Treating NSCLC With Infusions
Managing Your Life While Treating NSCLC With Infusions
With infusions for non-small cell lung cancer happening every few weeks it can be hard to keep track of treatment. Dr. Oz has a few helpful tips for y...
Read More
When is pneumonectomy performed to treat lung cancer?
Lyall A. Gorenstein, MDLyall A. Gorenstein, MD
If the lung cancer is quite large or very central in the lung—close to where the major bronchus sepa...
More Answers
Why is lung resection surgery performed?
Lyall A. Gorenstein, MDLyall A. Gorenstein, MD
A lung resection is a surgical procedure to remove a damaged or diseased portion of a lung, or a...
More Answers
How Does Smoking Affect My Risk of Developing Cancer?
How Does Smoking Affect My Risk of Developing Cancer?

Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.