Thoracic surgeons are now able to use keyhole (thoracoscopic) surgery techniques, as well as more traditional ‘open’ surgery procedures to remove lung metastases successfully. They are also becoming increasingly skilled in using specialist new equipment that can improve the safety and precision of the surgery, minimise bleeding and post-operative complications, and speed up recovery time for patients.
Surgery may be an option for you, if the size, position and grouping of the tumours are in a part of the lung that is easily accessible, and where the surgeon can reach them safely without damaging any major blood vessels or the main airways into the lung.
For example, it may be possible to take a small section of lung tissue – called a wedge – from the affected lung to remove one or two isolated metastases without losing too much of the function of the remaining lung. If your metastases have affected a larger area of the lower parts of the lung, it may be that your surgeon recommends removing a larger part of the lung – this is known as a partial lobectomy.
If you have metastases in both lungs, it may also be possible to treat them, one lung at a time. If necessary, a combination of treatments may be used to ensure that the disease is treated as effectively as possible. Your specialist may explore chemotherapy options with you – with or without targeted therapies (also known as monoclonal antibodies) or you may be offered a combination of chemotherapy and specialist radiotherapy or heat treatment such as RFA (radio frequency ablation). The aim of these treatments is to reduce the size and/or number of active tumours in the lungs, prior to surgery, to make them easier to remove.
After surgery, you will have one or more drains in your chest to drain away any blood or fluid collecting around the lung and to help the lung to re-inflate again after the surgery. You may have a cough or some shortness of breath initially after your operation, but this should settle as your wounds heal. It is likely that you will have some pain initially, but keyhole surgery techniques help to reduce the severity of post-operative discomfort and pain, which can be managed effectively with a combination of painkillers, regular deep breathing and gentle exercise with physiotherapy.
If you are having keyhole surgery to remove the metastases in your lung, you are likely to be in hospital for two to four days. Open surgery tends to be a bigger operation and you are likely to be in hospital for up to seven days, with at least another few weeks at home to recover. You will be advised to avoid any strenuous exercise or heavy lifting for at least six weeks.