Surgical intervention is not always a cure for lung cancer (LC). Much depends on the staging of the disease, its location, and the ability of the patient to tolerate an operation. Sometimes, surgery is performed as the sole method of treatment. Other times, it may be done as an adjunct treatment along with chemotherapy and radiation therapy.
There are a few different surgical procedures for addressing lung cancer. In this article, we’ll describe each of them as well as what to expect after the operation. Before we do so, however, we’ll explain the circumstances that determine whether surgery is warranted in the first place.
When Is Lung Cancer Surgery Indicated?
There are several criteria used by doctors to help them decide if an operation is worthwhile given the risks (e.g. infection, bleeding, clotting, etc.). For example, if the patient suffers from small cell lung cancer, surgical intervention is generally less useful since the disease spreads rapidly to areas outside the lungs. Other treatment options, such as chemotherapy, may be more appropriate.
We mentioned earlier that staging of the disease is a key factor in the decision to operate. Staging reflects the size of the tumor and the extent of its spread (known as metastasis). A tumor that is small and localized is in an early stage – for example, stage 1 or 2. The LC is contained in the lung tissue, and thus surgery is often curative. Even in stage 3A, where the tumor has spread to the lymph nodes, an operation can successfully eliminate the disease. Once non-small cell lung cancer (NSCLC) has reached stage 3B or 4, chemotherapy and radiation therapy are usually necessary.
Another factor is the location of the tumor. If the surgeon believes it is too close to the heart, an operation may be considered too risky, even if the disease is localized.
The type of procedure used to address non-small cell lung cancer is based largely on the size and location of the tumor. When the tumor is small and contained in a single lobe of the lung, a wedge resection can be performed. The section of the lobe containing the tumor, as well as the tissue surrounding it, is removed.
A wedge resection can be effective as long as the disease is still in its early stages. Once it has spread outside the lobe, more extensive procedures are necessary. It’s also worth noting that a recurrence of the tumor, though uncommon, is more likely following this operation than others discussed below.
When NSCLC has spread throughout a lobe, but remains contained within it, the entire lobe is removed. This procedure is known as a lobectomy. Depending on the circumstances, it may be performed via conventional thoracotomy, or with a minimally-invasive technique known as VATS lobectomy.
The effect of a lobectomy on the patient’s pulmonary function is partly dependent on which lung is operated upon. The left lung has two lobes while the right lung has three lobes. Hence, the impact of this procedure is less severe when it is done on the right side.
In some cases, NSCLC is detected after it has spread throughout the lung, but has not yet metastasized to other areas of the patient’s body. Here, a pneumonectomy may be performed. This procedure involves the removal of the entire lung.
Because a pneumonectomy is such an extensive operation, the patient must show signs of strong pulmonary function before the surgeon performs it. If the remaining lung is weak, the procedure is rarely done. Instead, chemotherapy and radiation therapy are administered.
What Happens After Surgery?
Postoperative recovery is based on the type of surgery performed, the patient’s overall health, and any complications that surfaced during the procedure. The patient will experience a degree of pain that is likely to last for several weeks. He or she will also be encouraged to perform breathing routines that are designed to strengthen the lungs and prevent infection.
Though lung cancer surgery is common, it poses the same risks as any major surgical procedure. If you have been diagnosed with NSCLC, speak with your doctor regarding the available treatment options.