Thoracic Surgery for Lung Cancer

Creating a team of lung cancer experts is important in your lung cancer journey. Understanding the benefits of surgery for lung cancer and the recovery process, and when it’s appropriate, is important. A thoracic surgeon may be part of the team of thoracic oncologist, nurse practitioners, radiologists, respiratory therapists, palliative care staff, physical therapists, and nurses – all key to delivering your best treatment.

Do you know the surgical options that are available for lung cancer patients?

Understand the basics of thoracic surgery for lung cancer in these videos from Hope with Answers. The intro video provides basic information for those newly diagnosed with lung cancer. Lysa Buonanno, patient advocate, discusses thoracic surgery for lung cancer with thoracic surgeon, Dr. Jessica Donington.

View the Intermediate video to learn more about thoracic surgery for stage 3 lung cancer patients with Dr. Jessica Donington and Lysa Buonanno. Hope with Answers’ in-depth video provides the next level of information for patients to understand treatment options, particularly if they’ve experienced resistance or if their lung cancer has progressed.

When is lung cancer surgery recommended?

Lung cancer treatment is changing, thanks to breakthroughs and early detection. However, surgery might be an option for early-stage non-small cell lung cancer (NSCLC). It typically provides the best chance to cure the disease at this stage. The type of operation your doctor recommends depends on the size and location of the tumor in addition to how well your lungs are functioning.

A Thoracic Surgeon will perform the surgery that involves the removal of lung tumors. Depending on the size and location of the lung tumor, the surgeon may recommend minimally invasive surgery or traditional open surgery.

Surgery is rarely used as part of the main treatment for small cell lung cancer (SCLC), as the cancer has usually already spread by the time it is found.

What are the types of lung cancer surgery?

Sleeve resection: Some cancers form in the large airways in the lungs. In a sleeve resection, the thoracic surgeon cuts across the airway above and below the tumor. Then the surgeon reconnects the clean airway sections together. This operation may be chosen instead of a pneumonectomy to preserve more lung function.

Segmentectomy or wedge resection surgery is when only part of a lobe is removed. If a person doesn’t have adequate lung function to withstand removing the whole lobe, this procedure is preferred.

A bilobectomy is the removal of two lobes of the right lung – the upper and middle lobes or the middle and lower lobes.

Lobectomy is the removal of the entire lobe containing the tumor(s). This form of surgery is often the preferred type of operation for NSCLC. The lungs are made up of 5 lobes – 3 on the right and 2 on the left.

Pneumonectomy is the removal of an entire lung. This procedure is used if the cancer cannot be fully removed with the lobectomy or if the tumor is close to the center of the chest.

How is Surgery Used as Part of Combination Therapy?

Patients who have surgery for small cell lung cancer (SCLC) typically receive chemotherapy after surgery. This treatment approach has been shown to improve cure rates compared with surgery alone.

For more advanced tumors, surgery may also be used in combination with chemotherapy and radiation therapy. However, surgery may not be preferred in all early stage lung cancers. Your oncologist will be the best person to determine your personalized treatment.

What are the advances in Surgical Procedures for lung cancer?

The most important factor in the success of any type of thoracoscopic surgery is the surgeon’s experience and skill. Surgery is usually done through a large incision between the ribs in the side of the chest or the back which is called a thoracotomy.

A surgeon may approach a thoracic surgery using one of these new procedures:

Video-assisted thoracic surgery (VATS)

VATS is a procedure being used more frequently to treat early-stage lung cancers. This procedure uses smaller incisions, the patient typically has a shorter hospital stay and fewer complications than a thoracotomy.

VATS can do many procedures that used to need traditional open surgery. Your healthcare provider might recommend VATS to biopsy part of the lung, the lymph nodes, the tissue around the lung. VATS might also be recommended to remove part or all of a lung.

This procedure will take several hours, your surgeon will start by making several cuts over your chest wall. After putting a small video camera (thoracoscope) through one of these incisions, the surgeon puts other small instruments through other small incisions as needed to do the procedure. For example, the surgeon may remove part of a lung. If you need to have part of your lung removed because of cancer, your surgeon might take out some lymph nodes as well. These can help show how advanced a cancer might be. After surgically closing the chest incisions, a bandage will be applied. Learn more about this procedure.

Robotically-assisted thoracic surgery (RATS)

Lung cancer research has rapidly advanced robotics used in surgeries. This method of surgery may allow for quicker recovery for lung cancer patients who have tumors removed.

Board certified thoracic surgeons are able to remove the cancerous tissue sitting at a control panel inside the operating room to maneuver long surgical instruments using robotic arms. This minimally invasive technique allows for far smaller incision sites and more rapid recovery for patients.

Early detection makes thoracic surgery a cure

“We have techniques for early detection of lung cancer that, frankly, didn’t exist 30 or 40 years ago. Today we have the ability to improve early detection, find tumors when they’re still surgically curable, and remove them.”

~ Dr. David Johnson, Chairman Emeritus of Lung Cancer Foundation of America’s Scientific Advisory Board
Photo of David Johnson

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