Lung Cancer Surgery

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Surgery is a common treatment for non-small cell lung cancer (NSCLC), particularly when the disease is detected early and the tumor is small and is only in one part of the lung. For small cell lung cancer (SCLC), physicians rarely use surgery because by the time the disease is found it has often spread to other parts of the body.

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Types of Surgery for Lung Cancer

The primary goal of lung cancer surgery is to remove the tumor while sparing as much of the surrounding healthy lung tissue and nearby lymph nodes as possible. At Fred Hutch Cancer Center, the surgeries we typically use to treat lung cancer are:

  • Lobectomy: Removing a whole lobe (section) of the lung. This is the most common lung cancer surgery.
  • Wedge resection or segmentectomy: Removing part of a lobe of the lung. This is the second most common lung cancer surgery. It may be used for several reasons, including if you have poor lung function, are too sick to undergo lobectomy or strongly prefer to keep the existing lung function you have.
  • Pneumonectomy: Removing the entire lung on the side of your body with the tumor. Your physician may recommend this surgery due to the size or location of your cancer, although most surgeons look for ways to spare the lung using advanced surgical procedures.

Minimally Invasive Video-Assisted Thoracic Surgery

Video-assisted thoracic surgery (VATS) is a minimally invasive option that may be recommended if you have early-stage lung cancer. 

With VATS, the incisions are much smaller (usually, just three to four small incisions) than in traditional open surgery. There is also less need to cut muscle and no need at all to spread the ribs as with traditional procedures. Instead, the surgeon inserts a tiny camera through one incision and tiny surgical instruments through the others to perform the procedure.

People who have VATS may have less pain and a quicker recovery than people who undergo traditional open surgery for lung cancer.

Advanced Surgical and Endoscopic Procedures

Sometimes lung cancer is difficult to remove surgically because the tumor has grown into the main airways, major blood vessels, the rib cage or other important structures in the chest. When this is the case, a surgeon may recommend an advanced surgical or endoscopic procedure.

These procedures are performed by Fred Hutch and UW Medicine lung surgeons at UW Medical Center – Montlake for complex or advanced lung cancers:

  • Sleeve resection: Used for cancer in the large airways (trachea or bronchi). The cancerous section of the airway is removed, and the remaining sections are sewn together.
  • Carinal pneumonectomy: Used to remove the lung and the lower part of the trachea, where it branches toward that lung. The remaining trachea and lung airway are sewn together.
  • Stenting: Involves putting a tube inside the airway to help open it, allowing a patient to breathe easier.
  • Tumor debulking: This procedure Involves removing a tumor piece by piece from inside the airway, allowing a patient to breathe easier.

Reconstructive Surgery

Some patients need reconstructive (reconstruction) surgery after lung cancer surgery because removing the lung or portions of it has impacted the chest wall. In addition to chest wall stability, reconstructive surgery also helps support proper breathing. 

Fred Hutch and UW Medicine surgeons also provide reconstructive surgery if needed for other issues, such as:

  • Vascular reconstruction: Used to rebuild the pulmonary artery when the tumor involves this blood vessel as well as the airways. This is done to remove the cancer entirely and save the lung, in order to avoid a pneumonectomy (having to remove part or all of a lung).
  • Chest-wall resection and reconstruction: Used to remove a tumor in the chest wall and reconstruct the chest.

Learn more about reconstructive surgery.

Farhood Farjah
Dr. Farhood Farjah, associate medical director of Surgical Outcomes Research Center at UW Medicine

Why Choose Fred Hutch for Lung Cancer Surgery

Fred Hutch patients have surgery at UW Medical Center – Montlake with thoracic (chest) surgeons who are among the best and most experienced in the country. They also help diagnose and stage lung cancer and relieve symptoms of advanced disease.

Our surgeons have some of the most extensive experience in the world taking on the most complex cases, including patients who might be told elsewhere that they cannot or should not have lung surgery.

Any surgery your Fred Hutch care team recommends will depend on the type and stage of your disease, your general health and your lung function. Your surgeon may need to remove lymph nodes, too, to test them for signs of cancer.

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Surgery for Lung Cancer FAQ

Often times before surgery, your physician will recommend that you undergo lung function tests to see if surgery is right for you.

Your care team will also discuss what you can eat or drink before the procedure, as well as what medications you should or should not be taking.

Recovering from lung cancer surgery is different for each person, and it can range from several weeks to months. If the procedure is a traditional open surgery, a long incision in the chest is needed, and your ribs need to be spread to access the tumor in your lung. Because of this, your chest will be painful for some time after surgery. If you have VATS or another minimally invasive procedure, you will likely have less pain after surgery and will recover faster.

Your physician will likely recommend that you limit your activity for at least a month or two after surgery. Regarding breathing, the answer depends on many factors, such as how much lung tissue was removed and your overall health. It’s common for most people to experience some shortness of breath after lung surgery while recovering. Discuss with your physician the possible short- and long-term effects on your activity level and breathing.