Depending on your type of cancer, the stage and your overall health, there are different treatment options for lung cancer. Surgery is one treatment pathway and is mainly an option for people with Stage 1 or Stage 2 lung cancer as it is localised and usually able to be removed via a lobectomy.
Your lung cancer multi-disciplinary team would determine whether a lobectomy would be suitable for you as cancer treatment.
It’s normal to feel worried or nervous about surgery. Knowing what to expect before, during and after a lobectomy may lessen your anxiety and improve your recovery. It can also help you to feel more empowered to make informed decisions with your treating healthcare team.
We spoke with Dr Rishendran Naidoo (Director of Cardiothoracic Surgery, The Prince Charles Hospital, QLD) about lobectomies to answer some of your most frequently asked questions. Watch the video or read more below.
What is a lobectomy?
A lobectomy is a surgery to remove one of the lobes of the lungs. The lungs have sections called lobes. The right lung has 3 lobes, and the left lung has 2 lobes. When cancer is found in one part of the lung, a lobectomy may be performed to remove the affected lobe so the remaining healthy lung tissue can continue to work.
There are different types of lobectomy procedures:
- Thoracotomy: Larger incision in the chest wall to remove the part of the lung
- Video Assisted Thoracic Surgery (VATS): Minimally invasive keyhole surgery with a few small incisions in the chest wall. A tiny video camera is passed through the incisions, and the surgeon performs the operation from outside the chest.
- Wedge resection: Piece of the lobe is removed as opposed to taking the entire lobe out.
The type of lobectomy procedure you have is dependent on various factors, including: your type of lung cancer, the size and location of the tumour and your general wellbeing and fitness.
Larger tumours are difficult to remove with a smaller incision and would therefore require a thoracotomy as opposed to keyhole surgery.
For a smaller tumour near the edge of the lung, a wedge resection may be a suitable option as it does not require removing any other parts of the lung.
Your surgeon will take all these factors into account to determine what type of lobectomy procedure will be required for your tumour.
What are the risks associated with a lobectomy?
Lung cancer surgery is a significant procedure, and it does come with risks. Usually, the immediate or early risks are quite low at around 1-3%. Some of these risks include:
- Infection
- Air in the space between the lung covering (pleural space) that causes the lung to collapse (pneumothorax)
- Bleeding
- A tube-like opening between the airway (bronchus) and pleural space that causes air or fluid to leak into the chest (bronchopleural fistula)
- An area of pus in the chest cavity (empyema)
- Fluid in the space between the lung and inner chest wall (pleural effusion)
Your treating surgeon will discuss the potential risks that apply most to you as this depends on your general health and other factors.
What are the potential side effects of surgery?
To determine potential side effects of lobectomy surgery, your surgeon will complete a thorough assessment of your health. You will also have a lung function test, also known as a spirometry test, to assess your current lung function and provide information about how the lobectomy will impact your breathing and lung function after the surgery.
Some patients may experience breathing troubles early on, but it generally gets better with time. After the surgery, you will see a physiotherapist who will teach you breathing or coughing exercises to help keep your lungs clear and reduce the risk of a chest infection.
Pain post-surgery is very hard to predict, but it is more likely to be experienced after a thoracotomy. This might include numbness or nerve pain such as tingling, burning, and pins and needles. It is common for pain to last up to 6 weeks post-surgery, but some people will experience pain for a longer period of time. If this is the case, medication may be required as well as a referral to a pain specialist for ongoing management. The risk for this is relatively low but it is impossible to predict, and it is important to be well-informed prior to the surgery.
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