Depending on the type, location, and stage of cancer that they have been diagnosed with, surgery can be a promising option for some lung cancer patients. This form of treatment is most effective when the disease has been detected in an early stage (between stage 1 and stage 3). It is capable of being curative andis considered to bethe gold standard for the treatment of lung cancer.
Surgery, when feasible, is usually the first step of treatment, and it helps doctors formulate future plans for the care of the patient in terms of adjusting dosage and choosing the most appropriate form of chemotherapy or radiation therapy.
With lung cancer, the goal of surgery is to remove the tumor as well the surrounding tissue to which the spread of cancerous cells is most likely to have occurred. There are different types of surgery possible, and a choice is made on the basis of the size and stage of the tumor, its location, and the patient’s overall health condition.
Types of lung surgery-
- Lobectomy- The lungs are made up of five lobes – two lobes on the left lung and three lobes on the right.If the cancer is confined to just one part of the lung, then this type of surgery is recommended.
- Pneumonectomy- This surgery involves the removal of one entire lung – either the left or right. Breathing tests are conducted to ensure the patient is fit to undergo this type of surgery.
- Removal of a section of the lung – This type of surgery is performed very rarely, and only in the case of very early diagnosis. Depending on the type of section removed, this type of surgery may be called:
- Wedge resection- removal of a part of one or more lobes
- Segmentectomy- removal of 1 to 4 of the five segments that make up a lung lobe.
- Sleeve resection- removal of a lobe along with a section of the bronchi and the associated veins and arteries. This type of surgery is performed when the cancer is in the central part of the lung, growing into the airway.
- Lymphadenectomy- This surgery involves the removal of the lymph nodes associated with the cancer,in case they contain cancer cells that have spread from the main tumour. This helps prevent/ slow down the spread of the disease.
How is the operation performed?
The way in which the procedure is performed depends on the type of surgery chosen, the type and location of the tumour, the facilities available at the hospital, and the surgeon’s expertise.
- Open surgery- also known as a thoracotomy. Involves the division of certain muscles of the chest wall and the gentle separation of two ribs to grant access to the lungs.
- Keyhole surgery- also known as video-assisted thoracoscopic surgery (VATS). Uses a long bendy tube, called a thoracoscope, which is connected to a camera that provides an image of the inside of the chest. 1 to 4 small cuts are made on the chest, through which a surgeon, with the help of surgical instruments, removes the tumour.
- Robotic surgery- done with the assistance of a surgical robot. Like VATS, robotic surgery is also performed through a series of small incisions. But unlike VATS, the surgeon controls the robot’s movements via a console, and the instruments in the body respond in real-time.
Both VATS and robotic surgery are called minimally invasive procedures and are considered to be better for the patient in terms of recovery time and general quality of life post-surgery.