Learn: What types of lung cancer patients need surgery? What does staging mean?

Thoracic Surgery

Understand the basics of thoracic surgery for lung cancer in this Hope with Answers video. Here, Lysa Buonanno, patient advocate, discusses thoracic surgery for lung cancer with thoracic surgeon, Dr. Jessica Donington.


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.

Types of Treatment

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.

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

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.

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What to Expect

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.
  • 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.

Side Effects

Thoracic surgery is a common treatment option for lung cancer patients, especially those with early-stage disease. While this procedure can be life-saving, it is important to be aware of the potential side effects that may arise as a result. Understanding these side effects can help patients prepare for their recovery and manage any challenges that may arise. In this article, we will explore some of the common side effects associated with thoracic surgery for lung cancer.

  • Pain and Discomfort: Following thoracic surgery, patients may experience pain and discomfort in the chest area. This is a normal part of the healing process and can be managed with prescribed pain medications. It is important to follow the doctor’s instructions regarding pain management to ensure optimal comfort during recovery.
  • Breathing Difficulties: Due to the nature of thoracic surgery, patients may experience temporary breathing difficulties. This can be a result of the lung’s reduced capacity or inflammation in the surrounding tissues. Breathing exercises and respiratory therapy can help improve lung function and alleviate these difficulties.
  • Fatigue: Fatigue is a common side effect following any major surgery, including thoracic surgery. The body requires time to heal, and it is normal to feel tired and lack energy during the recovery period. Adequate rest and gradually increasing physical activity levels can help manage fatigue.
  • Infection: As with any surgical procedure, there is a risk of infection following thoracic surgery. Patients will be prescribed antibiotics to minimize this risk. It is crucial to follow proper wound care instructions and report any signs of infection, such as increased pain, redness, or drainage, to the healthcare team.
  • Scarring: Thoracic surgery involves making incisions on the chest, which can result in visible scars. The size and appearance of scars can vary depending on the specific surgical approach used. While scars are a natural part of the healing process, patients can discuss scar management options with their healthcare team.
  • Complications: Although rare, there is a possibility of complications arising from thoracic surgery. These can include bleeding, blood clots, pneumonia, or damage to surrounding organs. Close monitoring by the healthcare team and prompt reporting of any unusual symptoms can help identify and address potential complications early on.

Thoracic surgery is an important treatment option for lung cancer patients, but it is essential to understand the potential side effects associated with the procedure. By being aware of these side effects and working closely with the healthcare team, patients can better manage their recovery and improve their overall quality of life.