Lung Cancer Resection

Introduction

Lung cancer treatment involves working with the patient’s doctor to choose a treatment plan based on many different factors, such as the patient’s preferences, the type and stage of their cancer, and their overall health.  Options for treatment generally include one or more treatments, including targeted cell therapy, radiation therapy, chemotherapy, and surgery.  In some cases, the patient might wish to forego treatments, opting instead to have palliative therapy.  This is done when all other treatment choices have been tried and the patient still has cancer.

If the patient has surgery, their surgeon needs to remove the cancerous tissue as well as a margin of healthy tissue around it.  The different surgeries that can be done include the following:

  • Wedge resection. This involves removing a small piece of the lung that has the tumor in it along with a margin of tissue that is healthy.
  • Segmental resection. This involves removing a segment of lung tissue but not the whole lobe of the lung.
  • Lobectomy.  This involves removing one lobe of the lung and is done when the tumor is of a large size or if there have been metastases to the lymph nodes.
  • Pneumonectomy.  This involves removing the whole lung. 

If the patient has surgery, the surgeon may also decide to take out the lymph nodes from the chest area in order to see if cancer is present. 

Lung cancer surgery has some risks, including infection and bleeding.  The patient should expect to feel short of breath after lung surgery.  If a part of the lung is removed, the remaining lung tissue will get bigger over time so that it is easier for the patient to breathe better.  The doctor may decide the patient needs a respiratory therapist who ca guide then through breathing exercises to help in the recovery process.

If the patient has chemotherapy, it involves giving them drugs to get rid of the cancer cells.  At least one chemotherapy drug can be used.  It is given intravenously or through a port in the chest.  Some chemotherapy agents are given orally.   A combination of chemotherapy drugs is usually given in a series of injections given over a period of several weeks.  It is given for a period of time before a break is introduced.  This allows the patient to recover in between chemotherapy cycles.

If the patient has radiotherapy, high-powered energy beams from X-ray sources and protons.  These are used to kill the lung cancer cells.  Radiotherapy can be given outside of the body (called external beam therapy) or by putting seeds or catheters near the tumor site in order to kill the cancer internally.  Radiation therapy can be used following surgery in order to kill any cancerous cells that may be left over. 

Some patients, who have lung cancers that aren’t very big, can have stereotactic body radiation therapy. This is a form of treatment that involves aiming several beams of radiation from different angles.  Stereotactic surgery is usually done in one or more treatments.  It can take the place of general surgery for lung cancer.

If the patient has targeted therapy, they take drugs that target certain abnormalities inside the cancer cells.  Targeted therapy is often given along with chemotherapy drugs.  There are many choices for targeted therapy for lung cancer.

Preparing for Surgery

Prior to surgery, the patient needs to have a diagnosis of lung cancer.  It starts out with a visit to the patient’s primary care physician.  If the doctor believes the patient has lung cancer, they will generally refer the patient to a doctor that specializes in lung cancer treatment.  This can include oncologists, pulmonologists, radiation oncologists, thoracic surgeons, and palliative care specialists. 

Because the appointment time can be short and because there is a lot to talk about, it is a good idea for the patient to prepare for the visit to the specialist.  They need to be aware of any restrictions they need to undertake prior to surgery.  For example, they may need to stop smoking, stop anticoagulants, and cut down on drinking. 

The patient should be aware of any symptoms they have.  This includes any symptom, even if the patient believes it is unrelated to having lung cancer.  They need to write these things down and talk about them with their oncologist.  Key personal information needs to be written down as well.  This includes recent life changes and any stressors the patient has.

The patient also needs to get all of their medication and bring it to the doctor’s office before surgery.  The doctor will help the patient decide which medications to stop right away, which ones to stop the day before the surgery, and which ones to take the morning of their surgery with a small sip of water.  A family member may need to come along to these visits because they may have more questions and may remember something the patient does not.

What to Exресt Aftеr Surgеrу

After lung cancer surgery, the patient may wake up in the intensive care unit or in the recovery room.  This is common after such a large operation. As soon as the doctors feel that the patient has stabilized, they may be able to go to the general patient ward.  This usually takes about one day.  In the ICU, the patient is checked very carefully and there is often 1:1 nursing.  The anesthesiologist and surgeon will watch the patient carefully after surgery to make sure they don’t have any complications. 

Why It Is Done

Lung cancer surgery may be done in order to remove scar tissue, fix an air leak in the lungs, remove the cancer itself, or confirm the diagnosis of lung cancer.  Surgery, chemotherapy, and radiotherapy are done to remove cancerous tissue from the patient’s lungs. 

Aftеr the Surgеrу

After surgery, the patient should be ready to return to their home about ten days after removal of their lungs and 5-7 days after having a lobectomy.  If the patient has keyhole surgery, the hospitalization may last less than this.  If the patient lives alone or has problems dealing with their disease, the patient should talk about these things with their nurse or doctor before leaving the hospital.

When the patient gets home, it is important to exercise in order to try and become healthy again. The patient should check with their doctor to see what kind of exercise they need to do.  Some patients will undergo physical therapy after surgery. This can be done on an inpatient or outpatient basis.  The patient shouldn’t drive after surgery until they are approved by their doctor.  This usually takes about 4-6 weeks. 

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