What happens after lung cancer surgery?
What happens after lung cancer surgery?
If you have early or localized lung cancer, most likely you would have been offered surgery. During the operation, the part of the lung containing the cancer is removed along with the lymph nodes within the chest. Depending on how much the cancer has spread, you may have received chemotherapy or immunotherapy before or after your procedure.
After surgery, you will receive an invitation for regular checkup appointments. This practice (of surveillance) has several objectives. During the first months after surgery, healthcare professionals will keep an eye out for any side effects of your treatment and monitor how you have recovered. After this timeframe, the objectives are to look for evidence of cancer returning, new cancers forming as well as your general state of health.
Whilst cancer may not “return” for many, the risk increases if the removed cancer is large and/or if the lymph nodes were involved. The risk of cancer returning is highest in the first 4 years after surgery, and the risk of a new lung cancer developing is highest after two years but remains a relatively small figure at 3 to 6% per year.
The most frequent cause of ill health after lung cancer surgery (especially in smokers) are chronic obstructive lung disease, heart and blood vessel disease. If you are struggling to give up smoking, then the follow-up clinic visits are a fantastic opportunity to get additional support to help you to stop and reap the benefits of reducing the risk of further cancers, strokes, lung disease, heart attacks and diseases of the blood vessels.
The best way to conduct checkups after lung surgery is still being debated. Between separate countries and hospitals, follow-up can be organized very differently. It can be led by different doctors such as your family doctor, hospital specialist, surgeon, chest physician, oncologist, or dedicated nurses. In addition, the methods of follow-up also vary, and most often rely on clinical assessment and CT scans of your chest. Most agree on systematic follow-up (at least) every 6 months for the first 2 years and yearly after that. Follow-ups that are planned and scheduled can detect significantly more cancer returning, or new cancer developing – often neither condition is associated with any symptoms. Moreover, regular follow-up may pick up cancers at an earlier stage and increases the chance of further treatments that can lengthen your life.
Sadly, there is no high-quality published research to date that suggests systematic checkups after surgery result in an improvement in your length of life. For all these reasons, scheduled follow-up can be very different from hospital to hospital and for each individual. If you do experience new symptoms that you are worried about, you should contact your cancer care team so they can evaluate and advise you even if you are in between two appointments. Don’t wait until the next appointment so that your care team can act promptly if required.
January 2023
Professor Virginie Westeel has no disclosures to report.