Lung Cancer

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Lung Cancer Surgery

Dr. Farhood Farjah describes different types of surgery for lung cancer treatment

There are several surgical treatments for lung cancer, depending on the type and severity of your disease, as well as your general health and lung function. Some operations may be used to relieve symptoms of lung cancer as well. Seattle Cancer Care Alliance (SCCA) patients with lung cancer have surgery at University of Washington Medical Center (UWMC) performed by thoracic surgeons who are among the best in the country. More lung operations are done here than anywhere else in the Pacific Northwest.

Surgery to remove lung cancer may be an option for early-stage non-small cell lung cancer. When it is an option, it provides the best chance for a cure. Surgery is rarely used for patients with small cell lung cancer because by the time the disease is found it has often spread too far for surgery to be effective. If you have surgery to remove a tumor, your surgeon will most likely remove lymph nodes as well to check them for signs of cancer. 

Surgical Procedures for Lung Cancer

Here are the surgeries typically used to treat lung cancer.

Lobectomy

Lobectomy is a surgical procedure in which a whole lobe (section) of the lung is removed. This is the most common lung cancer surgery. The right lung has three lobes. The left has two.

Pneumonectomy

In a pneumonectomy, an entire lung is removed. The size or location of your cancer may mean you need this surgery rather than a lobectomy.

Wedge Resection and Segmentectomy

A wedge resection or segmentectomy may be used to treat lung cancer in people whose lungs are too weak to tolerate more radical surgeries. In a wedge resection, only the tumor and a small amount of surrounding lung tissue are removed. In a segmentectomy, or segmental resection, a larger portion of lung, but not an entire lobe, is removed.

Video-Assisted Thoracic Surgery

Video-assisted thoracic surgery (VATS) is a minimally invasive alternative to traditional surgery that may be appropriate for many patients with early-stage cancer. UWMC is one of only about 30 centers in the country where VATS lung resections are available. Patients who have surgery using this method may have less pain and a shorter recovery. Read more about VATS.

Advanced Surgical Procedures

Some patients’ cancer is in a challenging location in relation to other important anatomy in the chest. Lung cancers may involve the main air passages, major blood vessels, the rib cage, or other structures near the heart. Often patients in these situations are told that they cannot have surgery or that surgery is too risky. But SCCA thoracic surgeons have some of the most extensive experience in the world in removing these more complex lung cancers.

Some of the procedures performed at UWMC for complex lung cancers are:

  • Sleeve resection. This type of surgery is used for cancer that is located in the large airways (trachea or bronchi). The cancerous section of the airway is removed, and the remaining sections are pieced together.
  • Carinal pneumonectomy. This is a rare surgery that involves removing the lung and the lower part of the trachea, where it branches toward that lung.
  • Vascular reconstruction. This surgery is done to reconstruct the pulmonary artery when the tumor involves this blood vessel as well as the airways.
  • Chest-wall resection and reconstruction. This surgery is used to remove a tumor in the chest wall and reconstruct the chest.

Possible Complications and Risks

Surgery for lung cancer is a major operation, and like any medical procedure, it has risks and requires recovery time. Potential complications associated with surgery depend on the extent of the surgery, the experience of the surgeon, and your overall health. Complications may include bleeding, infection, pneumonia, and pain. Your surgical team will take steps to reduce the risk of complications. Be sure to discuss the details of your case with your doctor to get a better idea of what the risks may be for you and what your long-term outcome is likely to be.

If your lungs are in good health aside from the cancer, you can look forward to returning to normal activities even after a section of a lung or an entire lung is removed. However, if you have other medical problems—such as emphysema or chronic bronchitis, common among heavy smokers—these may complicate your recovery.


Video-Assisted Thoracic Surgery

Video-assisted thoracic surgery (VATS) is an approach that allows surgeons to operate inside the chest through two to four small incisions. Benefits may include a shorter hospital stay, faster recovery, and less pain.