Medical Oncologist
CION Cancer Clinics
Lung cancer surgery: what your options are | CION Cancer Clinics
There are four main operations for lung cancer. A lobectomy removes one whole lobe and is the most common. A segmentectomy or wedge resection removes a smaller piece. A pneumonectomy removes the whole lung on one side. Each can be done by keyhole or through an open cut. This page explains what each removes, how the team chooses between them, and what to ask before you consent. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
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Medically reviewed by Dr. Muralidhar MuddusettyConsultant Surgical Oncologist · MBBS (AIIMS), MS (Surgery, AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh) · last reviewed September 2026, next review due September 2027
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On this page
- What are the surgical options for lung cancer?
- What each operation actually removes
- How does the team decide which operation you get?
- Words you will meet on the scan and surgery reports
- Four things families tell us, and what is actually true
- What this page cannot tell you
- Common questions about lung cancer surgery options
The short answer
What are the surgical options for lung cancer?
There are four main operations for lung cancer. A lobectomy removes one whole lobe of the lung and is the most common. A segmentectomy or a wedge resection removes a smaller piece. A pneumonectomy removes the whole lung on one side. Which one is offered depends on where the tumour sits, how big it is, and how much lung you can safely spare.
Two decisions, not one
The first decision is how much lung comes out. The second is how the surgeon reaches it: through a few small cuts with a camera (keyhole, also called VATS), a robot-assisted version of keyhole, or a single longer cut between the ribs (open surgery). The operation inside the chest is the same whichever route is used.
Who surgery does not suit
Surgery is usually offered when the cancer is confined to the lung, or to the lung and the nearby glands. It is not usually offered when the cancer has already spread to distant organs, or when the lungs or heart are not strong enough to cope with losing tissue. Radiotherapy or drug treatment may do the job instead.
This page describes the options. It cannot tell you which one you need. That comes from your scans, your breathing tests and your surgeon.The operations
What each operation actually removes
The right lung has three lobes and the left has two. Every operation is named by how much of that map comes out.
Lobectomy
One whole lobe is removed, along with its own artery, vein and airway, and the lymph glands that drain it. This has long been the standard operation for a cancer that has not spread beyond the lung.
Segmentectomy
Each lobe is built from smaller segments, each with its own blood supply and airway. A segmentectomy removes one or two of them, with their glands, and leaves the rest of the lobe in place.
Usually offered when
- The tumour is small and near the edge of the lung
- Lung reserve is limited, so every segment counts
Wedge resection
A wedge-shaped piece of lung around the nodule is stapled off, without following the segment boundaries. It is the smallest operation and takes the least lung.
Usually offered when
- The nodule needs to be tested and cannot be biopsied by needle
- A cancer from elsewhere has settled in the lung
Pneumonectomy
The whole lung on one side is removed. It is done far less often now, because a sleeve resection, where a short length of airway is removed and rejoined, can usually save the healthy lobes even when the tumour sits centrally.
Needs strong breathing tests beforehand, because the other lung must do all the work afterwards.Not sure whether this applies to you?
Ask an oncologistHow the choice is made
How does the team decide which operation you get?
Staging the cancer
A CT scan and usually a PET-CT show where the tumour sits and whether any glands or distant organs look involved. Sometimes a camera test through the airway samples the glands in the middle of the chest.
Testing your breathing and heart
Breathing tests measure how much air you can move and how well the lung passes oxygen into the blood. From those, the team estimates what you would be left with after each operation. A heart check is added if you have chest pain, breathlessness or a heart history.
The tumour board
A surgeon, a chest physician, a radiation oncologist and a medical oncologist look at everything together. They decide whether surgery is the right first step, and if so, how much lung should come out.
The conversation with you
Your surgeon explains what is recommended, what the alternative was, and why. Bring the family member who will be making decisions with you, and bring your questions written down.
On your report
Words you will meet on the scan and surgery reports
- Lobe
- One of the five natural divisions of the lungs. Three on the right, two on the left. Each has its own artery, vein and airway.
- Peripheral or central
- Whether the tumour sits near the outer edge of the lung or close to the large airways and vessels at its root. Central tumours usually need a larger operation.
- Hilar and mediastinal nodes
- Lymph glands at the root of the lung and in the middle of the chest. Whether cancer has reached them is a large part of the stage.
- Margin
- The rim of healthy lung around what was removed. A clear margin means no cancer cells were found at the cut edge.
- Resectable
- A cancer the surgeon believes can be fully removed. Operable means something different: that you are fit enough for the operation.
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Commonly believed
Four things families tell us, and what is actually true
"Opening the chest exposes the cancer to air and makes it spread."
Air does not spread cancer. This belief comes from an older time, when operations were done without scans and surgeons often found more disease than expected. Staging now happens before the operation, so surgery is offered only when the team believes the cancer can be fully removed.
"A smaller operation means the cancer is less serious."
Not necessarily. A wedge or segmentectomy is often chosen because of your breathing reserve, not because of the tumour. The stage comes from the pathology report after surgery, and it is the stage, not the size of the operation, that guides what happens next.
"After lung surgery you will be on oxygen for life."
Most people fit enough to be offered the operation do not need home oxygen afterwards. The breathing tests before surgery are done precisely to predict this. Some breathlessness on stairs in the first months is common and usually eases.
"Keyhole surgery is a lighter version of the real operation."
The same lobe and the same glands are removed. Keyhole changes how the surgeon reaches the lung, not what comes out. Where the tumour is large or stuck to nearby structures, an open cut can still be the safer choice.
Being straight with you
What this page cannot tell you
It cannot tell you whether you need surgery, or which operation. That needs your scans, your breathing tests and a surgeon who has examined you. Nothing on this page carries a prognosis, which is the medical word for the likely course of the illness.
Questions worth asking your surgeon
Ask how much lung will come out and why that amount. Ask whether the glands in the middle of the chest will be sampled, and what happens if cancer is found in them. Ask whether keyhole or open is planned, and what would make the surgeon change to open during the operation. Ask what your breathing tests predict for after surgery.
If you are getting a second opinion
Take the CT and PET-CT discs, the biopsy report, the breathing test printout and any letter from the tumour board. A second surgeon can only give an honest view with the same information the first one had.
If you have a report in your hand and do not understand it, call the helpline. Someone will read it with you.Questions we are asked
Common questions about lung cancer surgery options
Is lobectomy the only operation for lung cancer?
No. It is the most common, and has long been the standard for a cancer confined to the lung. Smaller operations, a segmentectomy or a wedge, are used for small tumours near the edge or when breathing reserve is limited. A sleeve resection or pneumonectomy is used when the tumour sits near the centre.
Can I choose keyhole instead of open surgery?
You can ask, and you should. Whether it is possible depends on the size and position of the tumour, on scarring from old infections such as TB, and on the surgeon's experience with the technique. Ask which approach is planned and what would make the team switch to an open cut during the operation.
Will I be able to breathe normally after losing a lobe?
Most people who pass the breathing tests before surgery manage daily life without oxygen afterwards. You may notice stairs and hills more in the early months. If the numbers are borderline the team will say so and consider a smaller operation or a different treatment.
What if the cancer has reached the lymph glands?
It depends which glands. Glands inside the lung or at its root are removed with the lobe. Glands in the middle of the chest are usually sampled before or during surgery. If several are involved, the tumour board may recommend chemotherapy or radiotherapy first, or instead of surgery.
Is surgery better than radiotherapy for early lung cancer?
For someone fit enough for an operation, surgery is usually the first recommendation because the tumour and the glands can be removed and examined. Focused radiotherapy, called SBRT, is the usual alternative when surgery is too risky. Which suits you is a tumour board decision.
Can I have surgery if I have COPD or have smoked for years?
Often yes, but the breathing tests matter more. COPD reduces the reserve you have to spare, so the team may lean towards a smaller operation or towards radiotherapy. Stopping smoking before surgery lowers the chance of a chest infection afterwards, and the team will help you with that.
Will I need chemotherapy as well as surgery?
Sometimes. It depends on the stage found in the pathology report after the operation, and on the tumour's markers. Chemotherapy or targeted tablets after surgery are called adjuvant treatment, meaning treatment added to lower the chance of the cancer returning. Sometimes it is given before surgery instead.
Is lung surgery covered by Aarogyasri or my insurance?
Usually yes, when it is part of an approved cancer treatment plan. Aarogyasri, CGHS, ECHS and EHS are accepted at CION, and most cashless insurers are empanelled. Cover for keyhole charges varies, so call the helpline with your card details and we will check before you travel.
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Medical Oncologist
Dr. C. Raghavendra Reddy
MBBS(Gold Medal), DNB(General Medicine), DM(Medical Oncology)(Gold Medal)
Medical Oncologist
Dr. Bharati Devi Gorantla
MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
Medical Oncologist
Dr. Owais Mohammed
MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)
Medical Oncologist
Medical Oncologist
Surgical Oncologist
Dr. Muralidhar Muddusetty
MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
Surgical Oncologist
Surgical Oncologist
Surgical Oncologist
Dr. Vinay Mamidala
MBBS, MS(General Surgery), M.Ch(Surgical Oncology), FMAS, FARIS(Ongoing)
Surgical Oncologist
Radiation Oncologist
Radiation Oncologist
Radiation Oncologist
Hematologist
Surgical Oncologist
Dr. Vajja Sandeep Kumar
MBBS, MS (General Surgery), DrNB (Surgical Oncology), FALS Oncology
Surgical Oncologist
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Sources
- Cancer Research UK — Surgery for lung cancer
- American Cancer Society — Surgery for Non-Small Cell Lung Cancer
- NHS — Lung cancer: treatment
- National Cancer Institute — Non-Small Cell Lung Cancer Treatment (PDQ) - Patient Version
- NICE — Lung cancer: diagnosis and management (NG122)
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
Related pages
Lobectomy: What the Operation InvolvesThe most common operation, step by stepSegmentectomy and Wedge Resection ExplainedThe two smaller operations and when each is usedVATS vs Open Lung SurgeryHow the surgeon reaches the lung, and what changesLung Function Tests Before Lung SurgeryThe tests that decide how much lung you can spareDeciding on Cancer SurgeryQuestions to ask before you consent
Talk to us
Been told you need lung surgery and not sure which operation?
Send us your CT or PET-CT report and biopsy result, or call the helpline. A surgical oncologist will explain what is being offered and why. One helpline serves every CION centre.