Lung Cancer

Lung cancer - surgery

Only a small number of those diagnosed with lung cancer have tumours that are suitable for surgery. If a non-small cell lung cancer is small and has not spread it may be possible to operate and remove it. In small cell lung cancer the cancer has usually spread to other parts of the body before being diagnosed so surgery is rarely used. Here people discuss their experience of lobectomy (the removal of a lobe of the lung), pneumonectomy (removal of an entire lung), and extra-pleural pneumonectomy (removal of the lung, all the pleura, the diaphragm and the pericardium).

In some hospitals surgeons can perform a lobectomy using keyhole surgery, also known as video-assisted thoracoscopic surgery (VATS).

Before surgery the hospital will send instructions. One man of South Asian decent described the things he took into hospital for his pneumonectomy. He was a vegetarian and was given special permission to take his own food to the ward.

On arrival in the ward members of the hospital team, such as the anaesthetist, may ask questions. The doctor explains what is going to happen, and asks for written consent for the operation.

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Patients are not allowed to eat or drink for several hours before surgery. Usually a 'pre-med' (a sedative) is given. The patient is then taken to the operating theatre, where the anaesthetist may start a 'drip' (intravenous infusion).

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The operation is done under a general anaesthetic, but the patient may also have an epidural anaesthetic at the same time This may be kept in place for a while after surgery to prevent post-operative pain. One man described how an epidural combined with a self-operated pump, also known as a patient controlled analgesic device (PCA), stopped all the post-operative pain. He also remembered being given oxygen.

One woman had had an epidural, but due to low blood pressure after her lobectomy it had to be discontinued. She had severe pain in the area where she had the drainage tubes and was given morphine to relieve it.

For mesothelioma at an early stage, an extra-pleural pneumonectomy (removal of the lung, all the pleura, the diaphragm and the pericardium), can sometimes be performed. However, so far it remains uncertain whether this surgery helps. Extra pleural pneumonectomy is rarely done in the UK and is no longer considered appropriate by the majority of surgeons and chest physicians for the treatment of mesothelioma. 

One man here described his experience of the radical surgery extra-pleural pneumonectomy for mesothelioma. Like other patients, he spent some time in the High Dependency Unit after surgery. 

After a short time in the High Dependency Area, patients return to the ward with one or two chest drains in place. These are usually removed after a few days. Patients may also have a catheter inserted into the bladder, which is kept there for a day or two until urine can be passed normally. 

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Postoperative recovery in the ward includes physiotherapy. Patients are encouraged to cough up phlegm, and are taught to exercise their arms, shoulders and legs.

Patients are usually allowed home after 5-10 days. The wound heals gradually and the district nurse may remove the clips or stitches. One man, who had surgery in 2002, was happy to show the long scar on his back. 

After such major surgery people may take a while to recover, although some reported feeling much better within a week. Three months after his operation one man said that he could do an hour in his garden but then he had to rest. Some people are left with long-term side effects. One man felt that he would never really recover from his operation. (See 'Side effects of lung cancer surgery', and for information about Cryosurgery see 'Cryosurgery and other treatments for lung cancer').

For more information sources see our Resources.
  

Last reviewed May 2016.

Last updated May 2016.

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