Surgery for small cell lung cancer
Surgery is rarely used as the main treatment in small cell lung cancer (SCLC). In fewer than 1 out of 20 cases, the cancer is found as only one tumor, with no spread to lymph nodes or other organs. In these cases, surgery might be helpful. If used, it is usually followed by treatment with chemo and maybe radiation.
If surgery might be an option, your doctor will order tests to make sure the lung cancer hasn’t spread and to find out if you are healthy enough for lung surgery.
Different operations can be used to treat SCLC.
- Pneumonectomy: the entire lung is removed.
- Lobectomy: an entire section (lobe) of the lung is removed.
- Segmentectomy or wedge resection: part of a lobe is removed.
- Sleeve resection: a section of a large airway is removed and the lung is reattached.
Lobectomy is often the preferred operation for SCLC if it can be done. With any of these operations, lymph nodes are also removed to look for possible spread of the cancer.
With any of these surgeries you will be in a deep sleep (under general anesthesia) and will usually have a cut (surgical incision) between the ribs in the side of the chest. You will most likely need to spend about a week in the hospital after the surgery. There will be some pain because the surgeon has to cut through the ribs to get to the lungs.
Video-assisted thoracic surgery (VATS): This is a new kind of surgery for some people with early stage lung cancer. A tiny video camera is put through a small cut (incision) in the chest to help the surgeon see the tumor. One or 2 other small cuts are made in the skin, and long instruments are passed though these to remove the tumor. Since only small cuts are needed, there is a shorter hospital stay and less pain after surgery. This approach is most often used for small tumors near the outside 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.
Possible side effects of surgery
Problems after surgery depend on how much surgery was done and a person’s health beforehand. Serious problems can include bleeding, infection, and pneumonia. While it is rare, in some cases people may not survive the surgery, so it is very important to talk with your doctors to be sure you are a good candidate for surgery.
Surgery for lung cancer is a major operation, and recovering from the operation typically takes weeks to months. The surgery site will hurt for some time after surgery, which might limit your activity. People whose lungs are in good shape (other than the cancer) can often return to normal activities after some time if a lobe or even an entire lung is removed. But if they also have problems like emphysema or chronic bronchitis, which are common in heavy smokers, they may have long-term shortness of breath.
Surgery and other methods to relieve problems
In some cases, surgery or other treatments may be used to help with the symptoms of the cancer (rather than trying to remove all of the cancer).
For instance, a bronchoscope with a laser on the end can be used to open an airway blockage that may be causing pneumonia or shortness of breath. Sometimes, a metal or plastic tube called a stent may be placed in the airway using a bronchoscope to help keep it open. Other methods like radiation may also be used.
Sometimes fluid collects in the chest and makes it hard to breathe. This fluid can be removed through a small tube placed in the chest. After the fluid is drained out, either talc or some type of drug is placed into the chest to help seal the space and prevent future fluid build-up.
Last Medical Review: 09/09/2013
Last Revised: 02/11/2014