Pneumonectomy is a type of lung cancer surgery. This procedure involves removing the entire lung affected by cancer, and if necessary, some surrounding tissue. Interestingly, people can live with just one lung after a pneumonectomy. For many, this surgery provides the best chance of a cure.

What Is a Pneumonectomy?

A pneumonectomy is also used to treat injury or other lung diseases. Depending on which lung is affected, either the left or right lung will be surgically removed. Pneumonectomy is a type of lung resection surgery, which may remove a lung.

A pneumonectomy is performed only in people with lung cancer when other, smaller lung surgeries (such as a lobectomy) can’t remove all the cancer. A pneumonectomy may be performed if there are multiple lung tumors or if the tumors are near the center of the lung and can’t be removed easily.

A pneumonectomy can be done to treat both non-small cell lung cancer (NSCLC) and small cell lung cancer. This surgery may be performed if the lungs are affected by other issues such as:

• Metastasis (spread) of other types of cancer to the lungs
• Tuberculosis
• Congenital disease (present at birth)
• Traumatic injury
• Fungal infection
• Bronchiectasis, a chronic condition in which the airways are permanently widened and damaged
• Irreversible damage to a lung with blocked airways

Pneumonectomy Procedure

A pneumonectomy is a very involved surgical procedure. Your doctor and health care team will want to prepare you as best as possible to ensure a positive outcome. This preparation may include various tests, lifestyle adjustments, and detailed discussions about the surgery and recovery.

Before Surgery

Before thoracic surgery — which involves the lungs or other organs inside the chest wall — your doctor will typically perform a physical examination and a series of tests to determine your pulmonary function (lung function) and if your overall health makes you a good candidate for pneumonectomy. If you smoke, you’ll be asked to quit before surgery.

You will likely have imaging tests to help your doctor look at your lungs. These and other tests before surgery can include:

• Chest X-ray
• Chest CT scan
• Electrocardiogram (ECG or EKG)
• Blood tests
• Lung function tests to check how well the other lung is working before surgery

During Surgery

You will be asleep under anesthesia during the procedure, so you won’t feel any pain. The thoracic surgeon, who specializes in chest and lung surgeries, will cut two ribs (known as a thoracotomy). This incision will run from the side of your chest, under your arm, and around to your back.

The surgeon will separate the two ribs along the cut and then deflate the lung to remove it. Some lymph nodes also may be taken out. Examining the lymph nodes can help your doctor determine if the cancer has spread further.

In some cases, your surgeon may perform an extrapleural pneumonectomy. During this procedure, the surgeon removes the entire affected lung, part of the diaphragm, part of the sac covering the heart, and the pleura (the membrane lining the chest and lungs).

After the lung is removed, the surgeon will close the cut with stitches and apply a dressing over the area. A chest tube might be left in to help drain fluid from the area where the lung had been. Once you’ve healed, the drainage tube will be removed.

Recovery From a Pneumonectomy

Immediately after surgery, you’ll be put into a recovery room to wake up from the anesthesia. You will then be given pain medication and oxygen. Once you have recovered from the anesthesia, you’ll be moved to a hospital room to be monitored for several days. During this time, you will be given breathing exercises to strengthen your remaining lung and help remove fluid that may have collected during surgery.

You’ll likely be sore because the surgeon needs to cut through major structures in the chest. This soreness is normal, and your health care team may prescribe pain medication to take home.

You will also likely be more tired than usual because your body will be recovering from an intensive procedure. You should gain back your strength over the next several weeks.

Read more about what to expect during recovery after lung surgery.

Can You Function With One Lung?

After a pneumonectomy, the remaining healthy lung will begin to perform all the functions that both lungs did before. You will still be able to breathe in enough oxygen, and the lung will help remove carbon dioxide from your body.

Eventually, the remaining lung may expand into the space where the other lung was, shifting toward the heart. However, the remaining lung will not replace the function of the removed one — your lung capacity will be about half of what it was with two healthy lungs. This capacity is enough to go about your normal, daily activities, but more intense activities may become difficult or impossible.

Some members of MyLungCancerTeam have talked about living with one lung after pneumonectomy. “My body is still adapting to one lung, but I find I’m less short of breath,” wrote one member. “I think it’s just a matter of time to feel mostly normal.”

Complications of a Pneumonectomy

As with any surgery, pneumonectomy brings certain risks. Although many people recover well after the procedure, complications can carry a high risk and include:

• Cardiac arrhythmias (irregular heartbeat), such as atrial fibrillation
• Damage to liver, spleen, diaphragm, or major blood vessel
• Shock
• Respiratory failure
• Pneumonia or other infections
• Pulmonary embolism (blood clot in the lung)
• Negative reactions to anesthesia

You may also experience shortness of breath and mild chest pain after the surgery, especially during strenuous activity. Your doctor will provide medical advice regarding exercise and other appropriate activities after your procedure.

One of the most serious complications after a pneumonectomy is cardiac herniation, which may happen within 24 hours of surgery. Cardiac herniation causes a severe drop in blood pressure and a collapse of heart function, requiring immediate surgery.

Another life-threatening complication is bronchopleural fistula, which causes a serious air leak in the lung. Pulmonary edema is also a very serious complication, which causes a dangerous build-up of fluid in the lungs.

If you have a pneumonectomy, your doctor will closely monitor you for any complications to manage them effectively.

How Effective Is a Pneumonectomy for Treating Lung Cancer?

A pneumonectomy is an effective way to remove lung cancer and the affected lung tissue. As long as the cancer has not spread to nearby lymph nodes or the other lung, a pneumonectomy can put a person into remission and improve their life expectancy.

In cases of cancer that keeps coming back, a pneumonectomy can offer the best chance of survival. A study from the Journal of Thoracic Disease found that the five-year survival rate of 28 people who had a pneumonectomy to treat recurrent NSCLC was 43.1 percent. This means after five years, 43.1 percent of study participants who underwent the procedure were still alive.

One MyLungCancerTeam member shared their experience with pneumonectomy. “In 1987, I underwent a complete pneumonectomy, and one of my lungs was totally removed,” they wrote. “I only have one lung, and for 34 years, everything was OK. But in 2021, the biopsy results showed a carcinoid and carcinoma in my lung.”

Although lung removal may offer the best chance for treating lung cancer in some cases, it’s still possible that the disease will come back. Fortunately, several other effective treatment options are available, which may improve quality of life and long-term survival.

Talk With Others Who Understand

MyLungCancerTeam is the social network for people with lung cancer and their loved ones. More than 12,600 members come together to ask questions, give advice, and share their stories with others who understand life with lung cancer.

Have you had a pneumonectomy to treat your lung cancer? Do you have tips for anyone else facing this situation? Share your experience in the comments below, or start a conversation by posting on MyLungCancerTeam.