Quality of Life After Lung Cancer Surgery

Table of ContentsView AllTable of ContentsPerceptionLevel of FunctioningType of SurgeryDisease RemissionStrategies

Table of ContentsView All

View All

Table of Contents

Perception

Level of Functioning

Type of Surgery

Disease Remission

Strategies

Having lung cancer surgery is a life-altering event, and there is no way to minimize the emotions a person can go through when undergoing a procedure like this. The aim of surgery, however, is to not only extend life but improve your overall quality of life. The benefits of treatment will almost invariably outweigh the risks.

Healthcare providers today are paying attention to more than just “life years” when monitoring how people respond to lung cancer surgery. They want to know how people feel, how readily they can return to normal life, and how they perceive their own quality of life.

Recovery is different for everyone. It depends not only on the type of surgery used but also on an individual’s general health and psychological well-being before and after surgery.

Studies have shown that a person’s general health at the time of their lung cancer diagnosis influences their perceived quality of life (QoL) and response to treatment.

According to research published in 2017, 32% of people in good health at the time of their lung cancer diagnosis report a “high” to “very high” quality of life following treatment, compared to 31% who report “very low” QoL.

This illustrates that the severity of illness does not necessarily translate to the sameperceptionsof quality of life in people with lung cancer. As this study demonstrates, it can often go either way.

Among the factors known to influence the perceived quality of life in people with lung cancer are:

Lung cancer surgery invariably influences these perceptions as well. In people who undergo surgery, the perception of quality of life drops dramatically, with 81% reporting poor QoL overall. By contrast, only 60% of those who do not undergo surgery report poor quality of life.

While this may suggest that lung cancer surgery reduces a person’s quality of lifephysically—making them unhealthier or less able to take care of themselves—research suggests that perceptions of ill health can influence a person’s quality of life just as profoundly. In some cases, it can undermine it completely, even if a person’s ability to function is restored.

What Performance Status Means In People With Cancer

While many people regard lung cancer surgery as a means to “cut out the cancer,” one of the primary aims of the surgery is to restore or improve the quality of life. And, despite what some may think, people can live normal, active lives even when part or all of a lung is removed.

Lung cancer surgery is an option for some people based on thetype,stage, and location of a tumor. It may be used for the purpose of curingearly-stagenon-small cell lung cancer (NSCLC)orcarcinoid canceror to relieve symptoms ofadvanced lung cancer. For most people, the benefits of surgery, when indicated, outweigh the risks.

Although lung cancer surgery is associated with a short-term deterioration of one’s health following the operation, most people are able to return to pre-operative levels of function within three to six months.

With that said, a “return to pre-operative levels of function” doesn’t necessarily mean an improvement in one’s quality of life. If the quality of life (both perceived and real) before surgery is poor, it will often continue to be poor after surgery.

In virtually all cases, people with poor levels of functioning and high levels of symptoms before lung cancer surgery will have a poorer quality of life after surgery. Those who are at greater risk include the elderly, who are more likely to have diminishedlung function, and people who arecurrent smokersat the time of their surgery.

Among the other contributing factors—arguably the most important ones—are the type of surgery used and the extent of lung tissue removed.

Signs and Symptoms of Lung Cancer

There are three main types of surgery used for people diagnosed with lung cancer, each with different indications and challenges:

As a general rule, a person’s quality of life decreases in tandem with the amount of lung tissue removed. People who undergo pneumonectomy, for example, tend to have poorer QoL scores at 12 months following surgery than those who undergo lobectomy. Moreover, up to 25% will report areducedQoL.

When compared to wedge resection or lobectomy, people who undergo pneumonectomy score consistently lower on physical function, vitality, energy, social function, cognitive function, and role function (the ability to retain their role as parent, spouse, employee, or community member).

Because of this, surgeons today will opt for less invasive surgeries whenever possible, considering not only a person’s health outcomes but quality of life outcomes as well.

Risks and Complications of Lobectomy

Minimally Invasive Surgeries

In place of traditionalopen surgery,thoracic surgeonsare turning to a less-invasive technique known as video-assisted thoracoscopic surgery (VATS) whenever possible. During a VATS procedure, specialized surgical equipment and a tiny camera called a thoracoscope are inserted through tiny incisions in the chest wall.

VATS is commonly used to perform both wedge resection and lobectomy. Studies have shown that people with lung cancer who undergo VATS consistently score higher in physical function, social function, role function, and vitality than those who undergo traditional open surgery.

Another less invasive procedure calledstereotactic ablative radiotherapy (SBRT)is explored when people with early-stage NSCLC are either unable to undergo surgery or have an inoperable tumor. Within this context, SBRT can not only significantly increase survival times but may improve quality of life compared to even minimally invasive forms of lung cancer surgery.

However, with SBRT, the quality of life is conversely linked to the dose of radiation used, meaning that higher doses generally lead to poorer QoL scores.

How Lung Cancer Is Treated Today

As much as lung cancer surgery can influence a person’s quality of life,remissionfrom the disease can often restore a person’s quality of life to that of the general population. This is especially true for people with complete remission, in which all signs of cancer have disappeared for five years or more.

A 2012 study published in theAnnals of Surgerytook an extensive look at the quality of life of people who had successfully undergone lung cancer surgery versus a matched set of individuals in the general population who didn’t have cancer.

According to research, people who achieve complete remission from early-stage lung cancer have no significant difference in daily functioning compared to people in the general population. Moreover, there is no difference in survival times between the types of surgery used to achieve remission.

What this suggests is that it doesn’t matter how complicated lung cancer surgery is, once a person is deemed cancer-free, the likelihood of living a normal quality of life is as good as someone who had undergone less extensive surgery.

How to Improve Your Quality of Life

Among some of the things you can do:

If you find that you are unable to cope, do not hesitate to ask for a referral to a psychiatrist who can provide one-on-one or group counseling and prescription medications if needed.

Recovery After a Lobectomy

19 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Siddiqui F, Siddiqui AH.Lung cancer. In: StatPearls.Wang B, Hao N, Zhang X.Factors influencing the psychology and quality of life in lung cancer patients.Saudi Med J. 2017;38(9):948-51. doi:10.15537/smj.2017.9.18532Win T, Sharples L, Wells FC, Ritchie AJ, Munday H, Laroche CM.Effect of lung cancer surgery on quality of life.Thorax. 2005;60(3):234-8. doi:10.1136/thx.2004.031872Granger CL.Physiotherapy management of lung cancer.J Physiother. 2016;62(2):60-7. doi:10.1016/j.jphys.2016.02.010Pompili C.Quality of life after lung resection for lung cancer.J Thorac Dis. 2015;7(Suppl 2):S138-44. doi:10.3978/j.issn.2072-1439.2015.04.40Kato H, Oizumi H, Suzuki J, et al.Thoracoscopic wedge resection and segmentectomy for small-sized pulmonary nodules.J Vis Surg.2017;3:66. doi:10.21037/jovs.2017.03.22Rea G, Rudrappa M.Lobectomy. In: StatPearls.Kim TH, Park B, Cho JH, et al.Pneumonectomy for clinical stage I non-small cell lung cancer in elderly patients over 70 years of age.Korean J Thorac Cardiovasc Surg. 2015;48(4):252-7. doi:10.5090/kjtcs.2015.48.4.252Skrzypczak PJ, Roszak M, Kasprzyk M, Kopczyńska A, Gabryel P, Dyszkiewicz W.Pneumonectomy - permanent injury or still effective method of treatment? Early and long-term results and quality of life after pneumonectomy due to non-small cell lung cancer.Kardiochir Torakochirurgia Pol.2019;16(1):7-12. doi:10.5114/kitp.2019.82966Handy JR, Jr, Asaph JW, Douville EC, et al.Does video-assisted thoracoscopic lobectomy for lung cancer provide improved functional outcomes compared with open lobectomy?Eur J Cardiothorac Surg.2010;37:451-5Pompili C, Absolom K, Franks K, Velikova G.Are quality of life outcomes comparable following stereotactic radiotherapy and minimally invasive surgery for stage I lung cancer patients?.J Thorac Dis. 2018;10(12):7055-63. doi:10.21037/jtd.2018.11.89White A, Swanson SJ.Surgery versus stereotactic ablative radiotherapy (SABR) for early-stage non-small cell lung cancer: less is not more.J Thorac Dis. 2016;8(Suppl 4):S399-405. doi:10.21037/jtd.2016.04.40Yun YH, Kim YA, Min YH, et al.Health-related quality of life in disease-free survivors of surgically treated lung cancer compared with the general population.Ann Surg. 2012;255(5):1000-7. doi:10.1097/SLA.0b013e31824f1e9ePolanski J, Jankowska-Polanska B, Rosinczuk J, Chabowski M, Szymanska-Chabowska A.Quality of life of patients with lung cancer.Onco Targets Ther. 2016;9:1023-8. doi:10.2147/OTT.S100685McDevitt J, Kelly M, Comber H, Kelleher T, Dwane F, Sharp L.A population-based study of hospital length of stay and emergency readmission following surgery for non-small-cell lung cancer.Eur J Cardiothorac Surg. 2013;44(4):e253-9. doi:10.1093/ejcts/ezt389Wang H, Liu X, Rice SJ, Belani CP.Pulmonary rehabilitation in lung cancer.PM R. 2016;8(10):990-996. doi:10.1016/j.pmrj.2016.03.010Avancini A, Sartori G, Gkountakos A, et al.Physical activity and exercise in lung cancer care: will promises be fulfilled?.Oncologist.2020;25(3):e555-69. doi:10.1634/theoncologist.2019-0463Polański J, Świątoniowska-Lonc N, Kołaczyńska S, Chabowski M.Diet as a factor supporting lung cancer treatment—a systematic review.Nutrients. 2023;15(6):1477. doi:10.3390/nu15061477Barre PV, Padmaja G, Rana S, Tiamongla.Stress and quality of life in cancer patients: Medical and psychological intervention.Indian J Psychol Med. 2018;40(3):232-8. doi:10.4103/IJPSYM.IJPSYM_512_17

19 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Siddiqui F, Siddiqui AH.Lung cancer. In: StatPearls.Wang B, Hao N, Zhang X.Factors influencing the psychology and quality of life in lung cancer patients.Saudi Med J. 2017;38(9):948-51. doi:10.15537/smj.2017.9.18532Win T, Sharples L, Wells FC, Ritchie AJ, Munday H, Laroche CM.Effect of lung cancer surgery on quality of life.Thorax. 2005;60(3):234-8. doi:10.1136/thx.2004.031872Granger CL.Physiotherapy management of lung cancer.J Physiother. 2016;62(2):60-7. doi:10.1016/j.jphys.2016.02.010Pompili C.Quality of life after lung resection for lung cancer.J Thorac Dis. 2015;7(Suppl 2):S138-44. doi:10.3978/j.issn.2072-1439.2015.04.40Kato H, Oizumi H, Suzuki J, et al.Thoracoscopic wedge resection and segmentectomy for small-sized pulmonary nodules.J Vis Surg.2017;3:66. doi:10.21037/jovs.2017.03.22Rea G, Rudrappa M.Lobectomy. In: StatPearls.Kim TH, Park B, Cho JH, et al.Pneumonectomy for clinical stage I non-small cell lung cancer in elderly patients over 70 years of age.Korean J Thorac Cardiovasc Surg. 2015;48(4):252-7. doi:10.5090/kjtcs.2015.48.4.252Skrzypczak PJ, Roszak M, Kasprzyk M, Kopczyńska A, Gabryel P, Dyszkiewicz W.Pneumonectomy - permanent injury or still effective method of treatment? Early and long-term results and quality of life after pneumonectomy due to non-small cell lung cancer.Kardiochir Torakochirurgia Pol.2019;16(1):7-12. doi:10.5114/kitp.2019.82966Handy JR, Jr, Asaph JW, Douville EC, et al.Does video-assisted thoracoscopic lobectomy for lung cancer provide improved functional outcomes compared with open lobectomy?Eur J Cardiothorac Surg.2010;37:451-5Pompili C, Absolom K, Franks K, Velikova G.Are quality of life outcomes comparable following stereotactic radiotherapy and minimally invasive surgery for stage I lung cancer patients?.J Thorac Dis. 2018;10(12):7055-63. doi:10.21037/jtd.2018.11.89White A, Swanson SJ.Surgery versus stereotactic ablative radiotherapy (SABR) for early-stage non-small cell lung cancer: less is not more.J Thorac Dis. 2016;8(Suppl 4):S399-405. doi:10.21037/jtd.2016.04.40Yun YH, Kim YA, Min YH, et al.Health-related quality of life in disease-free survivors of surgically treated lung cancer compared with the general population.Ann Surg. 2012;255(5):1000-7. doi:10.1097/SLA.0b013e31824f1e9ePolanski J, Jankowska-Polanska B, Rosinczuk J, Chabowski M, Szymanska-Chabowska A.Quality of life of patients with lung cancer.Onco Targets Ther. 2016;9:1023-8. doi:10.2147/OTT.S100685McDevitt J, Kelly M, Comber H, Kelleher T, Dwane F, Sharp L.A population-based study of hospital length of stay and emergency readmission following surgery for non-small-cell lung cancer.Eur J Cardiothorac Surg. 2013;44(4):e253-9. doi:10.1093/ejcts/ezt389Wang H, Liu X, Rice SJ, Belani CP.Pulmonary rehabilitation in lung cancer.PM R. 2016;8(10):990-996. doi:10.1016/j.pmrj.2016.03.010Avancini A, Sartori G, Gkountakos A, et al.Physical activity and exercise in lung cancer care: will promises be fulfilled?.Oncologist.2020;25(3):e555-69. doi:10.1634/theoncologist.2019-0463Polański J, Świątoniowska-Lonc N, Kołaczyńska S, Chabowski M.Diet as a factor supporting lung cancer treatment—a systematic review.Nutrients. 2023;15(6):1477. doi:10.3390/nu15061477Barre PV, Padmaja G, Rana S, Tiamongla.Stress and quality of life in cancer patients: Medical and psychological intervention.Indian J Psychol Med. 2018;40(3):232-8. doi:10.4103/IJPSYM.IJPSYM_512_17

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Siddiqui F, Siddiqui AH.Lung cancer. In: StatPearls.Wang B, Hao N, Zhang X.Factors influencing the psychology and quality of life in lung cancer patients.Saudi Med J. 2017;38(9):948-51. doi:10.15537/smj.2017.9.18532Win T, Sharples L, Wells FC, Ritchie AJ, Munday H, Laroche CM.Effect of lung cancer surgery on quality of life.Thorax. 2005;60(3):234-8. doi:10.1136/thx.2004.031872Granger CL.Physiotherapy management of lung cancer.J Physiother. 2016;62(2):60-7. doi:10.1016/j.jphys.2016.02.010Pompili C.Quality of life after lung resection for lung cancer.J Thorac Dis. 2015;7(Suppl 2):S138-44. doi:10.3978/j.issn.2072-1439.2015.04.40Kato H, Oizumi H, Suzuki J, et al.Thoracoscopic wedge resection and segmentectomy for small-sized pulmonary nodules.J Vis Surg.2017;3:66. doi:10.21037/jovs.2017.03.22Rea G, Rudrappa M.Lobectomy. In: StatPearls.Kim TH, Park B, Cho JH, et al.Pneumonectomy for clinical stage I non-small cell lung cancer in elderly patients over 70 years of age.Korean J Thorac Cardiovasc Surg. 2015;48(4):252-7. doi:10.5090/kjtcs.2015.48.4.252Skrzypczak PJ, Roszak M, Kasprzyk M, Kopczyńska A, Gabryel P, Dyszkiewicz W.Pneumonectomy - permanent injury or still effective method of treatment? Early and long-term results and quality of life after pneumonectomy due to non-small cell lung cancer.Kardiochir Torakochirurgia Pol.2019;16(1):7-12. doi:10.5114/kitp.2019.82966Handy JR, Jr, Asaph JW, Douville EC, et al.Does video-assisted thoracoscopic lobectomy for lung cancer provide improved functional outcomes compared with open lobectomy?Eur J Cardiothorac Surg.2010;37:451-5Pompili C, Absolom K, Franks K, Velikova G.Are quality of life outcomes comparable following stereotactic radiotherapy and minimally invasive surgery for stage I lung cancer patients?.J Thorac Dis. 2018;10(12):7055-63. doi:10.21037/jtd.2018.11.89White A, Swanson SJ.Surgery versus stereotactic ablative radiotherapy (SABR) for early-stage non-small cell lung cancer: less is not more.J Thorac Dis. 2016;8(Suppl 4):S399-405. doi:10.21037/jtd.2016.04.40Yun YH, Kim YA, Min YH, et al.Health-related quality of life in disease-free survivors of surgically treated lung cancer compared with the general population.Ann Surg. 2012;255(5):1000-7. doi:10.1097/SLA.0b013e31824f1e9ePolanski J, Jankowska-Polanska B, Rosinczuk J, Chabowski M, Szymanska-Chabowska A.Quality of life of patients with lung cancer.Onco Targets Ther. 2016;9:1023-8. doi:10.2147/OTT.S100685McDevitt J, Kelly M, Comber H, Kelleher T, Dwane F, Sharp L.A population-based study of hospital length of stay and emergency readmission following surgery for non-small-cell lung cancer.Eur J Cardiothorac Surg. 2013;44(4):e253-9. doi:10.1093/ejcts/ezt389Wang H, Liu X, Rice SJ, Belani CP.Pulmonary rehabilitation in lung cancer.PM R. 2016;8(10):990-996. doi:10.1016/j.pmrj.2016.03.010Avancini A, Sartori G, Gkountakos A, et al.Physical activity and exercise in lung cancer care: will promises be fulfilled?.Oncologist.2020;25(3):e555-69. doi:10.1634/theoncologist.2019-0463Polański J, Świątoniowska-Lonc N, Kołaczyńska S, Chabowski M.Diet as a factor supporting lung cancer treatment—a systematic review.Nutrients. 2023;15(6):1477. doi:10.3390/nu15061477Barre PV, Padmaja G, Rana S, Tiamongla.Stress and quality of life in cancer patients: Medical and psychological intervention.Indian J Psychol Med. 2018;40(3):232-8. doi:10.4103/IJPSYM.IJPSYM_512_17

Siddiqui F, Siddiqui AH.Lung cancer. In: StatPearls.

Wang B, Hao N, Zhang X.Factors influencing the psychology and quality of life in lung cancer patients.Saudi Med J. 2017;38(9):948-51. doi:10.15537/smj.2017.9.18532

Win T, Sharples L, Wells FC, Ritchie AJ, Munday H, Laroche CM.Effect of lung cancer surgery on quality of life.Thorax. 2005;60(3):234-8. doi:10.1136/thx.2004.031872

Granger CL.Physiotherapy management of lung cancer.J Physiother. 2016;62(2):60-7. doi:10.1016/j.jphys.2016.02.010

Pompili C.Quality of life after lung resection for lung cancer.J Thorac Dis. 2015;7(Suppl 2):S138-44. doi:10.3978/j.issn.2072-1439.2015.04.40

Kato H, Oizumi H, Suzuki J, et al.Thoracoscopic wedge resection and segmentectomy for small-sized pulmonary nodules.J Vis Surg.2017;3:66. doi:10.21037/jovs.2017.03.22

Rea G, Rudrappa M.Lobectomy. In: StatPearls.

Kim TH, Park B, Cho JH, et al.Pneumonectomy for clinical stage I non-small cell lung cancer in elderly patients over 70 years of age.Korean J Thorac Cardiovasc Surg. 2015;48(4):252-7. doi:10.5090/kjtcs.2015.48.4.252

Skrzypczak PJ, Roszak M, Kasprzyk M, Kopczyńska A, Gabryel P, Dyszkiewicz W.Pneumonectomy - permanent injury or still effective method of treatment? Early and long-term results and quality of life after pneumonectomy due to non-small cell lung cancer.Kardiochir Torakochirurgia Pol.2019;16(1):7-12. doi:10.5114/kitp.2019.82966

Handy JR, Jr, Asaph JW, Douville EC, et al.Does video-assisted thoracoscopic lobectomy for lung cancer provide improved functional outcomes compared with open lobectomy?Eur J Cardiothorac Surg.2010;37:451-5

Pompili C, Absolom K, Franks K, Velikova G.Are quality of life outcomes comparable following stereotactic radiotherapy and minimally invasive surgery for stage I lung cancer patients?.J Thorac Dis. 2018;10(12):7055-63. doi:10.21037/jtd.2018.11.89

White A, Swanson SJ.Surgery versus stereotactic ablative radiotherapy (SABR) for early-stage non-small cell lung cancer: less is not more.J Thorac Dis. 2016;8(Suppl 4):S399-405. doi:10.21037/jtd.2016.04.40

Yun YH, Kim YA, Min YH, et al.Health-related quality of life in disease-free survivors of surgically treated lung cancer compared with the general population.Ann Surg. 2012;255(5):1000-7. doi:10.1097/SLA.0b013e31824f1e9e

Polanski J, Jankowska-Polanska B, Rosinczuk J, Chabowski M, Szymanska-Chabowska A.Quality of life of patients with lung cancer.Onco Targets Ther. 2016;9:1023-8. doi:10.2147/OTT.S100685

McDevitt J, Kelly M, Comber H, Kelleher T, Dwane F, Sharp L.A population-based study of hospital length of stay and emergency readmission following surgery for non-small-cell lung cancer.Eur J Cardiothorac Surg. 2013;44(4):e253-9. doi:10.1093/ejcts/ezt389

Wang H, Liu X, Rice SJ, Belani CP.Pulmonary rehabilitation in lung cancer.PM R. 2016;8(10):990-996. doi:10.1016/j.pmrj.2016.03.010

Avancini A, Sartori G, Gkountakos A, et al.Physical activity and exercise in lung cancer care: will promises be fulfilled?.Oncologist.2020;25(3):e555-69. doi:10.1634/theoncologist.2019-0463

Polański J, Świątoniowska-Lonc N, Kołaczyńska S, Chabowski M.Diet as a factor supporting lung cancer treatment—a systematic review.Nutrients. 2023;15(6):1477. doi:10.3390/nu15061477

Barre PV, Padmaja G, Rana S, Tiamongla.Stress and quality of life in cancer patients: Medical and psychological intervention.Indian J Psychol Med. 2018;40(3):232-8. doi:10.4103/IJPSYM.IJPSYM_512_17

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