Medical Oncologist
CION Cancer Clinics
Cancer surgery when you have COPD or asthma | CION Cancer Clinics
COPD and asthma make chest problems after cancer surgery more likely, but most people with COPD or well-controlled asthma can still have their operation. The risk depends on how breathless you are, whether you smoke and where the operation is. Stopping smoking, using inhalers properly, lung function tests and breathing exercises all help. This page explains how to prepare, what happens afterwards and what to ask. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
MI
Medically reviewed by Dr. Mohammed ImaduddinConsultant Surgical Oncologist · MBBS, MS (General Surgery), MCh (Surgical Oncology) · last reviewed September 2026, next review due September 2027
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On this page
- Is cancer surgery riskier if you have COPD or asthma?
- How can you get your lungs ready for the operation?
- What protects your lungs in the days after surgery?
- How do COPD and asthma differ before surgery?
- What do families believe about breathing problems and surgery?
- What does your team weigh, and what can this page not tell you?
- Common questions about surgery with COPD or asthma
The short answer
Is cancer surgery riskier if you have COPD or asthma?
Yes, somewhat, mainly because chest problems after the operation are more likely. Most people with COPD or well-controlled asthma can still have cancer surgery, and getting your lungs as ready as possible beforehand makes a real difference.
Why the lungs are under strain after surgery
Anaesthesia relaxes the breathing muscles. After an operation on the chest or upper belly, pain makes you breathe shallowly and avoid coughing. Mucus then settles in the lungs, small airways close, and a chest infection can follow. Lungs already narrowed by COPD have less room to cope with that.
What decides how much risk there is
How breathless you are day to day, how often you have flare-ups, whether you still smoke, and whether you need oxygen at home all matter. So does where the operation is. Surgery on the lung, gullet or upper belly asks far more of your breathing than surgery on a limb or the breast.
Asthma and COPD are not the same
Well-controlled asthma usually adds little risk. Poorly controlled asthma, or asthma that has needed steroid tablets recently, needs more planning. COPD is a lasting narrowing that does not fully reverse, so the work goes into making the most of the lungs you have.
The weeks before
How can you get your lungs ready for the operation?
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Stop smoking now
Stopping at any point before surgery helps, and the earlier the better. Ask for help to quit. Bidi, hookah and chewing tobacco count too.
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Check your inhalers
Keep using them as prescribed. Ask a nurse to watch your technique, because many people are not getting the full dose.
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Have lung function tests
Blowing tests such as spirometry, and sometimes a walking test, show how well your lungs work and guide the anaesthetic plan.
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Practise breathing and coughing
A physiotherapist teaches deep breathing, supported coughing and sometimes the use of a small breathing device, so you already know them afterwards.
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Walk every day
Regular walking, at a pace your doctor agrees with, builds the stamina your lungs will need to recover.
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Treat any flare-up first
If you have a chest infection or a flare-up close to the operation date, a short delay is often safer. Tell the team straight away.
Not sure whether this applies to you?
Ask an oncologistAfter the operation
What protects your lungs in the days after surgery?
Much of the work happens after surgery, and a family member at the bedside can help with every part of it.
Good pain relief
If it hurts to breathe, you breathe shallowly. An epidural, nerve block or regular painkillers let you breathe deeply and cough. Say when pain stops you.
Sitting up and moving
Sitting upright opens the lungs. Getting out of bed and walking early, with help, is one of the strongest protections against chest infection.
Chest physiotherapy
The physiotherapist helps you clear mucus and keep up your breathing exercises several times a day.
Often includes
- Deep breaths and holds
- Coughing with a pillow over the wound
- A breathing device
Your usual inhalers
These are continued or replaced with nebulisers while you recover. Oxygen is given as needed and carefully adjusted if you have COPD.
Side by side
How do COPD and asthma differ before surgery?
COPD
Asthma
Lasting narrowing of the airways, usually after years of smoke
Airways that tighten and relax, often with triggers
The aim is to make the most of the lungs you have
The aim is to get it well controlled before surgery
Some people need oxygen at home or after surgery
Recent steroid tablets may need extra cover during surgery
Stopping smoking is the most important step
Tell the team about any reaction to painkillers
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Commonly believed
What do families believe about breathing problems and surgery?
"He has smoked for forty years, so stopping now is pointless."
Stopping before surgery still helps the lungs, the wound and the heart, even after many years of smoking. It is never too late to benefit.
"Stop the inhalers before surgery so the anaesthetic works properly."
Inhalers are usually continued, including on the morning of surgery. Bring them with you. Follow the written instructions from your anaesthetist.
"After the operation he must lie still and rest."
Lying flat and still lets mucus settle and raises the chance of a chest infection. Sitting up, breathing exercises and early walking protect the lungs.
"Coughing will burst the stitches."
Coughing is needed to clear the lungs. Pressing a pillow firmly over the wound supports it and makes coughing more comfortable.
Being straight with you
What does your team weigh, and what can this page not tell you?
Whether surgery is the right step is decided by your surgeon and anaesthetist, often with a chest physician. They weigh your lung function tests, how breathless you are, the size and site of the operation, and how urgent the cancer is.
When the plan changes
For someone with severe COPD, especially if they need oxygen at home or are breathless at rest, a large operation on the chest or upper belly may carry too much risk. A smaller operation, a different approach or another treatment such as radiotherapy may be discussed. Where lung tissue itself is being removed, the tests also estimate how well you would breathe with what remains.
Questions worth asking
What do my lung function results mean for this operation? What kind of pain relief will help me breathe? Might I need a breathing machine or intensive care afterwards?
How your family can help
Bring every inhaler and recent chest report to the pre-anaesthetic check-up, along with any discharge summaries from past flare-ups. Keep the home free of smoke in the weeks before the operation. After surgery, a relative at the bedside can remind the patient to sit up, do the breathing exercises every hour while awake, and walk a little more each day. Tell the nurse quickly if breathing becomes faster, the cough brings up discoloured mucus, or the patient seems unusually drowsy.
This page cannot tell you your own risk. That depends on test results and an examination only your team can interpret.
Did you know
Smoke from wood or cow-dung cooking fires can damage the lungs in much the same way as cigarettes. Many women who have never smoked have COPD from years in a smoky kitchen, and it is worth telling your team.
Questions we are asked
Common questions about surgery with COPD or asthma
Will I be put on a ventilator after surgery?
Most people breathe on their own once the anaesthetic wears off. A few, usually after big operations or with severe COPD, need help from a breathing machine for a short time in intensive care. Ask your anaesthetist how likely this is for you, so your family knows what to expect.
Should I bring my inhalers to hospital?
Yes. Bring every inhaler, spacer and nebuliser medicine you use, and use them as instructed on the morning of surgery unless told otherwise. The team may switch you to nebulisers for a few days after the operation, then back to your usual inhalers.
What if I get a cough or cold just before the operation?
Tell your surgical team straight away. A chest infection or flare-up makes complications more likely, so a short delay to treat it is often safer. The team weighs that against how urgent the cancer is. Do not start antibiotics or steroid tablets on your own.
I take steroid tablets for my chest. Does that matter?
Yes. Regular or recent steroid tablets can affect how your body handles the stress of surgery, and you may need extra steroid cover during the operation. Tell the anaesthetist exactly what you take. Never stop steroids suddenly on your own.
Can a spinal or epidural be used instead of general anaesthesia?
For some operations, a spinal or nerve block can be used alone or alongside general anaesthesia, and an epidural often helps pain relief afterwards. Whether it suits depends on the operation and your health. Ask your anaesthetist what options apply to you.
Will I go home needing oxygen?
Most people who did not use oxygen before surgery do not need it at home afterwards. If you already use oxygen, or your breathing is slow to recover, the team will arrange it before discharge and show your family how to use it safely.
Does air pollution or dust in the city affect recovery?
Smoke, dust and strong fumes can irritate the airways and make coughing worse while you recover. Keep the home smoke-free, avoid burning incense or mosquito coils near the patient, and keep up the breathing exercises you were taught.
Are lung tests and physiotherapy covered by schemes?
When they are part of approved cancer surgery they are often included, but rules vary. Aarogyasri, CGHS, ECHS, EHS and most cashless insurers each have their own conditions. Call the helpline with your scheme or policy details and we will check what applies.
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Dr. C. Raghavendra Reddy
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MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
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Dr. Vinay Mamidala
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Sources
- NICE — Chronic obstructive pulmonary disease in over 16s (NG115)
- NHS — Chronic obstructive pulmonary disease (COPD)
- NHS — Asthma
- NICE — Perioperative care in adults (NG180)
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
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