For many people diagnosed with lung cancer or another serious lung condition, surgery may be part of treatment. Your lungs are divided into lobes – three on the right lung and two on the left. A lobectomy removes one of these lobes, while a pneumonectomy removes an entire lung. In many cancer cases, surgeons also remove nearby lymph nodes to check whether the cancer has spread.
While these surgeries are serious, they have come a long way in recent years, says Joseph Whitlark, MD, head of the lung cancer program for the Southern Region Division at RWJBarnabas Health. Most surgeons perform the procedure using minimally invasive or robotic techniques instead of large open cuts.
"Older people may especially have an assumption that these surgeries involve opening your chest widely and breaking ribs, but that's no longer the case," Whitlark says. "Now we do it robotically, and the difference in pain and recovery is dramatic."
The most common reason for lobectomy or pneumonectomy is to treat lung cancer. But there are many different conditions that doctors may treat with a lobectomy or pneumonectomy, including:
- Tuberculosis (TB)
- Lung abscess (an area of pus in your lung)
- Emphysema
- Noncancerous tumor
- Fungal infection
- Traumatic lung injury
- Bronchiectasis
- Congenital lung disease
- Bronchial blockage with a destroyed lung
Your recovery will depend on which procedure you have, the condition of your lungs before surgery, and what the procedure is treating. But Whitlark says most people return to active, fulfilling lives afterward.
"People often have concerns that things will never be the same for them, but they will," he says. "By and large, the vast majority of people get back to where they were before."
Reasons for Lung Removal: Real Stories
Hearing others' experiences with these procedures can help you prepare for your own surgery. Four people share their stories and advice about lobectomy and pneumonectomy.
Whole lung removal at 30
After weeks of feeling extremely ill, a computed tomography (CT) scan revealed a tumor and a collapsed lung for Erika Jones. Doctors eventually confirmed she had a rare carcinoid tumor. The best treatment option was pneumonectomy.
"I never even knew that you could live with one lung," Jones says. "I kept wondering how I would function. It was really scary and shocking to go from being what I thought was a relatively healthy young woman to being told I was going to have a life-altering surgery."
Removing the source of the problem
Ellie Gunshanan, 43, of Orlando, Florida, learned she had a malignant carcinoid tumor after doctors monitored a lung spot that had been discovered years earlier during an unrelated hospital visit.
"I was at stage IIB at that point, so it had not metastasized, so it was contained within the lung," she says. "I was able to just opt for the lobectomy and be done with it."
Ultimately, Gunshanan says the lobectomy itself wasn't her main concern, it was what the surgery was treating.
"I wasn't even really thinking about the procedure," she says. "I was thinking, 'OK, I have cancer in my body. I don't care if you have to take it out through my nose. Just get it out.'"
Rare cancer meets modern medicine
At first, doctors told Suellen Krahn, 57, of Racine, Wisconsin, that the blood she was coughing up was "just allergies." But additional testing showed signs of cancer in her lower lung, and doctors told her the best course was to remove that lobe.
"I asked the doctor, 'If I were your mother, what would you do?' And he said, 'You'd be in today for a lobectomy.' That convinced me," she said. "So they took the lower lobe out and immediately sent it to Mayo Clinic and NYU."
There they identified the tumor as primary pulmonary angiosarcoma, an extremely rare cancer of the lining of the blood vessels and lymph vessels.
"I was so fortunate to be in such an amazing facility that could just say, 'You need your lungs out,' and then that's what happened," she says.
Lobectomy for a noncancer diagnosis
After a bout with pneumonia, Lauren Montgomery, 35, of Terre Haute, Indiana, had repeated respiratory infections, coughing, wheezing, and shortness of breath. Doctors found a calcified lymph node embedded near an artery and a completely blocked bronchial tube, making it too risky to remove the node without surgery. The node was so deeply embedded in the lung tissue, surgeons ultimately had to remove her upper right lung lobe.
"Going into my surgery, there were a lot of different possibilities of the outcome," she says. "I was told I could partially lose my lung but that wasn't guaranteed. Looking back is a blur, but I took in all the possibilities positively due to my doctor's confidence and experience."
Preparing for Surgery
Getting ready for lung surgery starts with your doctor making sure your body can handle the procedure. Your medical team will usually run tests on your heart and lungs to see how well they're working and whether it's safe to remove part of a lung. You may also need to stop taking blood-thinning medications a few days before surgery and avoid eating for several hours beforehand.
Anything you can do to bolster your health before your surgery is also a good idea. Walking and exercise are important, because they can make you better able to get through surgery easily. And if you smoke, stop.
"Any time is a great time to stop smoking," says Whitlark. "It doesn't matter if it's two days before.
Gunshanan had just about 20 days to prepare after learning she needed a lobectomy. The compressed timeline left little time to dwell on the surgery itself. Instead, she focused on practical tasks like arranging work responsibilities and notifying family members.
Jones had a longer wait of nearly two months between diagnosis and surgery, which meant she spent more time preparing emotionally. Her advice: Don't go overboard with internet searches.
"I did all of the worst things that you could possibly do," she says. "I read everything online and I watched all the surgery videos that I could find, which is a horrible idea."
Surgery Day: What to Expect
If your surgeon will be doing your procedure robotically, they'll typically make several small cuts between your ribs to insert a camera and surgical instruments. During the operation, they'll remove the targeted portion of your lung along with nearby lymph nodes so a lab can test them for cancer.
"There are four incisions plus a fifth one for a chest tube attached to a suction device to suck air and fluid from around the rest of the lung after we operate," says Whitlark.
Your procedure may last several hours, depending on how complex it is and what your surgeon is removing.
Jones' pneumonectomy took about 6½ hours. Surgeons removed her entire lung and 20 lymph nodes.
"I did a lot of research on my surgeon beforehand and knew he was one of the best in the country," she says. "He had 30-plus years of experience, so I felt comfortable with him."
Recovery Expectations and Advice
Most people spend around two to three days in the hospital after their surgery.
Jones says the first thing she clearly remembers after her pneumonectomy was the nurses asking her to walk. Doctors often encourage walking soon after surgery to help recovery.
She also couldn't talk. The intubation tube in her throat during surgery had temporarily paralyzed her vocal cords.
"I didn't really have a voice for a couple of days, and then I didn't regain my full voice for about four or five months," she says.
Montgomery spent five nights in the hospital because of high levels of fluid draining from her lung. The pain was intense, even with round-the-clock pain medication.
"I ended up needing two drainage tubes put in because I had so much fluid, and those were so painful," she says. "It was a long process to move at all those days in the hospital because of all the things I was connected to and where my tubes and incision were."
Gunshanan also recalls that the most uncomfortable part wasn't breathing afterward but the chest tubes used to drain fluid.
"The minute they took the tubes out, everything felt normal," she says.
Adjusting to Daily Life After Surgery
After recovery, many people say they can eventually return to most normal activities, although you may have to take things at a slower pace.
Krahn says she continues to exercise daily, walking and biking regularly without issue unless she's confronted with an incline.
"I can walk for miles and miles and miles on a flat surface," she says. "But boy, when I go up the steps in my house, I nearly collapse at the top."
Montgomery also stays active, working out five times a week. Still, she sometimes has lingering nerve pain around her ribs and incision site. Whitlark says this is a common aftereffect.
"When we place instruments between the ribs, we can irritate the nerves that run under them," Whitlark says. "That can cause numbness or tingling, but the nerves usually regenerate over time."
Three months of physical therapy was a huge help.
"I could have gone longer if my insurance would have covered more, but that helped me learn how to use my right side again when I was afraid to move," says Montgomery. "They massaged the scar tissue, had me stretch and do strengthening activities, including cardio."
Jones spent the first year gradually rebuilding confidence in what her body could do. Eventually, she set a goal of completing a 5K. Six months after surgery, she walked her first race.
"I finished dead last," she says. "But I finished."
Practical Tips for Recovery
These tips may help your recovery go more smoothly.
- Prepare your home. Getting in and out of bed can be difficult. Krahn says she found sleeping in a recliner easier during the first few weeks.
- Accept help from others. You may need assistance with child care, cooking, and daily tasks while healing.
- Stay as active as possible before surgery. Walking and maintaining fitness beforehand may help your recovery afterward.
- Consider physical therapy. Targeted exercises and scar-tissue work helped Montgomery get her strength back and learn to get around better.
- Choose an experienced surgical team. Find specialists familiar with lung surgery and your specific condition.
- Be patient with recovery. Pain and fatigue can be intense at first, but many people gradually return to active lives.
