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Lung metastasectomy: removing cancer spots from the lung | CION Cancer Clinics
Lung metastasectomy is an operation to remove cancer that has spread to the lungs from elsewhere in the body. It is considered only when there are a few spots, every one can be removed while leaving enough healthy lung, and the original cancer is under control. It does not suit everyone. This page explains the operations used, recovery, who it is not right for and what to ask. 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 is lung metastasectomy surgery?
- What kinds of lung operation are used?
- What happens from the first scan to going home?
- What do the words on your report mean?
- What do families often believe about lung surgery for spread cancer?
- Who is lung metastasectomy usually not suited to?
- Common questions about lung metastasectomy
The short answer
What is lung metastasectomy surgery?
Lung metastasectomy is an operation to remove cancer that has spread to the lungs from somewhere else in the body. It is considered only when there are a few spots, all of them can be removed, and the original cancer is under control.
Why a spot in the lung is not lung cancer
A secondary tumour in the lung is made of the same cells as the cancer it came from. Bowel cancer that spreads to the lung is still bowel cancer, and it is treated as bowel cancer. That is why your medical oncologist for the original cancer stays closely involved, even though a chest surgeon does the operation.
Which cancers it is most often discussed for
It is most often considered for bowel cancer, sarcoma, kidney cancer and some cancers of the head and neck, testis or womb that have spread only to the lungs. For many other cancers, spread to the lungs is usually treated with drugs rather than an operation.
What the operation aims to do
The aim is to remove every visible spot while keeping as much healthy lung as possible. The surgeon usually takes a small wedge of lung around each spot rather than a whole section.
This page explains the operation. It cannot tell you whether it suits you or your parent. That is for the team who have read every scan.How it is done
What kinds of lung operation are used?
The choice depends on how many spots there are, how deep they sit, and how much lung you can safely spare.
Wedge removal
A small wedge-shaped piece of lung containing the spot is taken out. This is the most common approach, because it saves the most healthy lung.
Suits
- Small spots near the lung surface
- People who may need further surgery later
Segment or lobe removal
When a spot sits deep in the lung or near an airway, a larger section may need to come out. This takes more lung and needs good breathing reserve.
Keyhole approach
The surgeon works through a few small cuts using a camera. Recovery is often quicker. It can be harder to feel for very small spots that did not show on the scan.
Ask your centre which approach they use and why.Open approach
A longer cut between the ribs lets the surgeon see and feel the whole lung directly. It may be chosen for several spots, deep spots, or when both sides need checking.
Not sure whether this applies to you?
Ask an oncologistThe pathway
What happens from the first scan to going home?
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Scans to count the spots
A fresh CT of the chest, and often a PET-CT, checks how many spots there are and makes sure the cancer has not spread anywhere else.
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Breathing tests
You blow into a machine that measures how well your lungs work. This tells the surgeon how much lung can be removed while leaving you able to breathe comfortably.
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The tumour board
Surgeons and oncologists agree whether surgery, focused radiotherapy, drugs or a mix makes sense, and in what order.
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The operation
Done under general anaesthesia, meaning you are fully asleep. A chest drain, a tube that lets air and fluid escape, is usually left in for a short time afterwards.
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The first days
Breathing exercises and walking start early, because they help the lung re-expand and lower the chance of a chest infection. The drain comes out when the air leak settles.
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Home and follow-up
Tiredness and some chest wall soreness are common for a few weeks. The pathology report and a plan for regular scans follow.
On your report
What do the words on your report mean?
- Pulmonary metastases
- Spots of cancer in the lung that came from a cancer elsewhere in the body.
- Nodule
- A small round spot on a scan. Not every nodule is cancer; some are old scars or infection.
- Wedge resection
- Removal of a small wedge-shaped piece of lung around the spot.
- VATS
- Video-assisted thoracic surgery: the keyhole method, done through small cuts with a camera.
- Clear margin
- The pathologist found no cancer at the edge of the lung tissue removed. This is what the operation aims for.
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After going home, what cannot wait
If breathlessness suddenly gets worse, you cough up blood, you have chest pain that is new or sharp, a high fever, or the wound turns red and leaks, go to the nearest emergency department the same day. Say you have had lung surgery recently. Do not wait for your next clinic visit, and call the helpline on the way.
Commonly believed
What do families often believe about lung surgery for spread cancer?
"Spots in both lungs mean surgery is impossible."
Not always. Spots in both lungs can sometimes be removed, either in two separate operations or together. What matters is whether every spot can come out and enough lung remains.
"After lung surgery, he will never breathe normally again."
Wedge removals take very little lung, and most people return to their usual daily activity once recovered. Breathing tests before surgery exist to protect exactly this. Ask what the surgeon expects for your own breathing.
"Once the spots are removed, the cancer is gone."
New spots can appear later, because cells too small to see may remain. Regular scans continue, and sometimes a repeat operation is possible if new spots appear.
"Radiotherapy is only for people who cannot have surgery."
Focused radiotherapy is a real alternative for some small lung spots, not a second-best. The team weighs both, and the right choice depends on the spot and on you.
Being straight with you
Who is lung metastasectomy usually not suited to?
It is usually not suited to people whose cancer has also spread outside the lungs in a way that cannot be treated, whose spots keep appearing quickly, or whose original cancer is not under control. It is also not suited when removing every spot would leave too little lung to breathe comfortably.
When the lungs or heart are already weak
Long-standing smoking damage, serious heart disease or ongoing breathlessness at rest can make lung surgery unsafe. Focused radiotherapy or needle treatments may do a similar job with less strain.
When the evidence is thin
Much of what is known comes from studies of carefully chosen patients. For some cancers, it is not certain how much removing lung spots adds to drug treatment. A good team will say this openly.
What this page cannot tell you
It cannot tell you whether you qualify, how the operation would change what happens next, or how long anyone will live. Those answers belong to your own team, who know your cancer and your health.
Questions we are asked
Common questions about lung metastasectomy
How long is the hospital stay after lung metastasectomy?
It depends on the approach and how quickly the lung seals. Keyhole operations usually mean a shorter stay than open ones. The chest drain is often the deciding factor, because it stays until air stops leaking. Ask your surgeon what they expect for your operation, and plan for someone to be with you at home.
Is the operation very painful?
There is pain, especially around the ribs and the drain site, and it is managed with regular pain relief. Good pain control matters, because it lets you breathe deeply and cough, which protects the lung. Tell the team early if the pain stops you taking a full breath.
Will chemotherapy stop before surgery?
Usually it is paused so that you can heal safely, and it may restart after you recover. The timing is set by your medical oncologist and surgeon together. Do not stop or change any medicine on your own, including blood thinners. Ask them to write down the plan.
What if the scan shows spots in both lungs?
Spots on both sides can sometimes be removed, either in two operations some weeks apart or in one. It depends on how many there are, where they sit and how well your lungs work. Ask the surgeon how they would plan it, and what the alternatives would be.
Can a spot on the scan turn out not to be cancer?
Yes. Small lung spots can be old scars, past infection such as tuberculosis, or inflammation. This is especially common in India. If there is real doubt, the team may take a biopsy first or remove the spot and check it under the microscope. The pathology report gives the final answer.
Can I climb stairs and travel after going home?
Gentle walking and stairs are encouraged once you are home, taken slowly. Long journeys and flights need a word with your surgeon first, because the lung needs time to heal fully. Lifting heavy things is usually avoided for a while. Your team will tell you when each is safe.
What if new spots appear later?
This happens for some people. A repeat operation is sometimes possible, if the spots are few and your lungs can spare the tissue. Focused radiotherapy or drug treatment are other options. The team looks at the new scans the same way they looked at the first ones.
Does Aarogyasri or insurance cover lung metastasectomy?
Often, when the operation is part of an approved cancer treatment plan. Aarogyasri, CGHS, ECHS and EHS are accepted, and most cashless insurers are empanelled. Cover depends on your scheme and policy, so call the helpline with your card details before you plan.
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Dr. C. Raghavendra Reddy
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MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
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Dr. Owais Mohammed
MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)
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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
- National Cancer Institute — Metastatic cancer: when cancer spreads
- Cancer Research UK — About cancer
- Macmillan Cancer Support — Secondary cancer
- American Cancer Society — Understanding advanced and metastatic cancer
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.
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