Lung Cancer (non-small cell) Overview

+ -Text Size

Treating Lung Cancer - Non-Small Cell TOPICS

Surgery for non-small cell lung cancer

Surgery to remove the cancer (often along with other treatments) may be an option for early stage non-small cell lung cancer (NSCLC). If surgery can be done, it offers the best chance of a cure.

Different operations can be used to treat NSCLC:

  • Pneumonectomy: an entire lung is removed
  • Lobectomy: a section (lobe) of the lung is removed
  • Segmentectomy or wedge resection: part of a lobe is removed

A type of operation known as a sleeve resection may be used to treat some cancers in large airways in the lungs. If you think of the large airway with a tumor like the sleeve of a shirt with a stain an inch or 2 above the wrist, the sleeve resection would be like cutting across the sleeve above and below the stain and sewing the cuff back onto the shortened sleeve. A surgeon may be able to do this operation instead of a pneumonectomy to keep more lung function.

Some doctors now treat some early stage lung cancers near the outside of the lung with a procedure called video-assisted thoracic surgery (VATS). A tube with a tiny camera on the end is placed through a small hole in the chest to let the surgeon see the tumor. One or 2 other small holes are made in the skin, and long instruments are passed though these holes to remove the tumor. Only small cuts (incisions) are needed, so there is less pain after surgery. This approach is most often used for smaller tumors in the outer part of the lung. The cure rate seems to be the same as for standard surgery. The doctor who does this surgery should have experience because it takes a great deal of skill.

With any of these operations, nearby lymph nodes are also removed to look for possible spread of the cancer.

The type of operation your doctor suggests depends on the size and place of the tumor and on how well your lungs are working. People whose lungs are healthier can withstand having more of the lung removed. In some cases, if a person’s lungs are healthy enough, doctors may want to do a bigger operation because it may offer a better chance to cure the cancer.

Surgery for lung cancer is a major operation, and recovering can take weeks to months. But people whose lungs are in good condition (other than the cancer) can often return to normal activities after some time if a lobe or even a whole lung is removed. If they also have problems such as emphysema or chronic bronchitis (common among heavy smokers), they may have long-term shortness of breath.

Surgery for lung cancers with limited spread to other organs

If the lung cancer has spread to the brain or adrenal gland and there is only one tumor, you might have the metastasis removed. This surgery would be done only if the tumor in the lung can also be completely removed. Even then, not all lung cancer experts agree with this approach, especially if the tumor is in the adrenal gland.

For tumors in the brain, the surgery is done through a hole in the skull (called a craniotomy). It should only be done if the tumor can be removed without harming vital areas of the brain.

Surgery to relieve symptoms of NSCLC

For people who can’t have the usual surgery because of lung disease or other medical problems, or because the cancer is widespread, other types of surgery may be done to relieve symptoms.

Sometimes fluid collects in the chest and makes it hard to breathe. This fluid can be taken out through a small tube placed in the chest. Then either talc or some type of drug is placed into the chest to help seal the space and prevent future fluid build-up.

Other, non-surgical techniques can also be used to relieve symptoms. For example, tumors can sometimes grow into the lung airways, blocking them and causing problems such as pneumonia or shortness of breath. Treatments such as laser therapy or photodynamic therapy can be used to relieve the blockage in the airway. In some cases, a bronchoscope may be used to place a stent (a stiff tube) in the airway after treatment to help keep it open. These procedures are described in more detail in the section “Other local treatments for non-small cell lung cancer.”

For more information about surgery, please see our document Understanding Cancer Surgery: A Guide for Patients and Families.

Last Medical Review: 09/05/2013
Last Revised: 04/30/2014