To find out whether your lungs are healthy enough for surgery, your doctor may give you several tests (e.g., pulmonary function tests and a quantitative ventilation/perfusion scan).
Surgical removal of the tumor is a common choice when the cancer has not spread to other tissues in the chest or beyond. The following types of surgery are used to treat lung cancer:
- Wedge or segmental resection—removal of a small part of the lung
- Lobectomy—removal of an entire section (lobe) of the lung
- Bilobectomy—removal of more than one lobe
- Pneumonectomy—removal of the entire lung
Surgery may be the first type of treatment used, or it may be used after chemotherapy, radiation or both have been administered to shrink the tumor. Generally, surgery is not used as first-line treatment if the lung cancer has:
- Spread from the lung into other parts of the chest (e.g., the heart or the plural fluid, which is fluid between the lung and chest wall)
- Spread to lymph nodes in the neck, mediastinum (area located in the center of the chest, but outside the lungs) or to other organs (e.g., the liver, adrenal glands or brain)
- Makes it difficult to breathe
- Developed in a part of the lung that can’t be removed
- Been diagnosed as small cell lung cancer
- Other health-related problems make surgery risky (e.g., heart or vascular problems, severe emphysema, diabetes, and certain other chronic conditions).
Pulmonary rehabilitation programs may be recommended, both before and after surgery—especially for people who do not have a regular exercise program. Sometimes bronchodilators, like those used to treat asthma, can also help improve breathing function enough for surgery.
For patients with poor lung function who cannot tolerate major surgery, a new technique called video-assisted thoracic surgery (VATS) may be helpful. VATS:
- Uses a tiny video camera to guide the surgeon
- Makes it possible to remove a section of a lung though a small incision
- May reduce surgical trauma and shorten hospital stays by avoiding large incisions.
- Robotic-assisted VATS surgery - St. Joseph Hospital utilizes the da Vinci Robotic Surgical System. Robotic surgical technology allows for smaller incisions and shorter hospital stays. For more on the da Vinci Robotic Surgical System, click here.
Other surgical techniques being investigated include nerve-sparing surgery and computer-enhanced imaging tools.