Lung cancer surgery - Medical specialists

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Lung cancer surgery - Further information

Overview of lung cancer surgery

Lung cancer is caused by rapidly growing abnormal cancerous cells that develop in the lung tissue. Surgery designed to remove all or part of an affected lung may be performed by making an incision on one side of your thorax (chest), using a surgical procedure known as a thoracotomy. Approaching from the side is the best way to keep clear of vital organs in the chest, such as the heart and the spinal cord.

Once an incision has been created, how much of the lung is removed will depend on the kind of cancer present, as well as its location and the extent to which it has spread.

Keyhole surgery is a more modern technique that can be used for some types of lung cancers. This minimally invasive intervention, normally known as VATS surgery (video assisted thoracoscopic surgery), requires just some small incisions between the ribs.

The types of lung cancer surgery offered will also depend on whether you have non-small cell lung cancer or small cell lung cancer. Generally speaking, surgical intervention is rarely used for small cell lung cancer.

narrowing of the bronchus by a carcinoma
Narrowing of the bronchus by a carcinoma

Who offers lung cancer surgery?

Lung cancer surgery is commonly offered by specialist private health clinics, which are in some cases managed by universities, insurers, mutual societies or religious institutions. In addition, there are state-run hospitals (such as the UK’s NHS), which also employ skilled surgeons who specialise in various kinds of lung surgery.

What does lung cancer surgery help with?

According to your needs, your non-small cell lung cancer may be treated by the following surgical procedures:

  • a segmentectomy, which involves the removal of a small, wedge-shaped piece of lung that contains the lung cancer cells, together with some healthy lung tissue surrounding the cancerous region. This procedure is often performed if it seems likely that your lung function would be significantly reduced by removing a lobe of the lung (lobectomy). Using this method can increase the risk of your cancer returning later on.
  • a lobectomy is used to remove an entire lobe of whichever lung contains cancerous cells. Your right lung consists of three lobes, while your left lung has only two. Your remaining lobes should still be enough to maintain your lung functions.
  • a pneumonectomy procedure removes whichever lung is the site of your lung cancer. Because a pneumonectomy will reduce your overall lung functioning, this intervention is only carried out when it is deemed absolutely necessary.
  • a sleeve resection is a procedure in which the surgeon removes the part of the windpipe (bronchus) containing the cancerous cells, before reconnecting the healthy ends. The bronchus forms the lower section of the trachea (windpipe), below the point at which it branches left and right to enter each lung.

After lung surgery, a chest tube is used to ensure that blood and fluid drain from your chest cavity in order to help your lung function by making it easier for your lung to refill with air.

A video-assisted thoracoscopic surgery (VATS) may be performed as an alternative to a thoracotomy, or before that procedure takes place. VATS surgery uses a tiny camera in a long, thin tube (videoscope) together with some specialised micro-surgical instruments inserted through small incisions made between your rib bones.

When is lung cancer surgery used?

Lung cancer surgery is most often performed on non-small cell lung cancers. It is only rarely used to treat small cell lung cancer detected at a very early stage.

What are the risks of lung cancer surgery?

Possible lung surgery complications include:

  • excess bleeding
  • blood clotting in the lungs or legs
  • wound infections
  • pneumonia
  • an air leak in the lung
  • tissue damage to your heart or lungs, blood vessels, or chest nerves
  • pain in the wall of your chest
  • the risk of a reaction to general anaesthesia

Are there alternatives to lung cancer surgery?

In some circumstances, your doctor may not recommend surgery if the lung cancer is very close to any of these organs or structures:

  • heart
  • windpipe
  • oesophagus (gullet or food pipe)
  • major blood vessels

Depending on your particular circumstances, the following treatments may be recommended instead of surgery for a non-small cell lung cancer:

  • radiation therapy (destroying cells using powerful rays)
  • chemotherapy (using strong drug medications to destroy cancerous cells)
  • targeted therapy (attacking cancer cells with medication via your body’s immune system)
  • laser therapy (eradicating cancer cells using a strong laser beam)
  • PDT (photodynamic therapy uses drugs to make cancer cells light-sensitive in order to kill them)
  • cryosurgery (freezing cells to destroy them)
  • electrocautery (using an electrical current to burn off cancerous cells
Small cell lung cancer is not generally treated by surgical intervention but may respond to:

You may wish to ask your doctor about new, emerging treatments that are currently being tested in clinical trials.