Before your operation for lung cancer
Before surgery, you have tests to check your fitness and you meet members of your treatment team. You will go into hospital either on the day of your operation or the night before.
The length of your hospital stay depends on what operation you have. You are usually in the hospital for about two days after lung cancer surgery.
Tests to check you are fit for surgery
You have tests before your operation to check:
- your fitness for an anaesthetic, if you need one
- that you’ll make a good recovery from surgery
You might have some or all of the following tests:
- blood tests to check your general health and how well your kidneys are working
- a swab test to rule out some infections
- an
ECG 
to check that your heart is healthy - breathing tests (called lung function tests)
- an
echocardiogram - a chest x-ray to check that your lungs are healthy
- a cardio pulmonary exercise test (which checks your heart and lung function when you're resting and exercising)
Pre assessment clinic
Your pre assessment appointment prepares you for your operation.
You meet members of your treatment team at this appointment and you can sign the consent form to agree to the operation.
Ask lots of questions. It helps to write down the questions beforehand to take with you. The more you know about what is going to happen, the less frightening it will seem.
You can ask more questions when you go into hospital so don't worry if you forget to ask some. At the hospital you might meet:
The surgeon
A member of the surgical team will tell you about:
- the operation you are going to have
- the benefits of having surgery
- the possible risks
- what to expect afterwards
The anaesthetist
The anaesthetist gives you the anaesthetic and looks after you during the operation. They make sure you are fit enough for surgery.
The clinical nurse specialist
The nurse checks your:
- general health
- weight
- blood pressure
- pulse
- temperature
The nurse also checks what help and support you have to see what you will need when you go home. They are your point of contact and care for you throughout your treatment.
The dietitian
The dietitian gives you help and advice about managing your diet. They:
- help you get as well as possible before your operation
- explain how the surgery affects your diet
- give useful tips on how to increase your nutrients and calories
They might give you nutritional supplement drinks to have before surgery.
Some people need a feeding tube in their stomach or small bowel. This makes sure you get the nutrition you need before surgery.
The physiotherapist
The physiotherapist assesses how well you can move around. They let the doctors know if there is anything that could affect your recovery.
The physio will also teach you leg and breathing exercises to do after your operation to help with recovery. Learning how to do the exercises beforehand makes it easier afterwards.
Preparing for your operation
Your pre assessment clinic appointment prepares you for your operation. You have it about a week or so before surgery.
You meet members of your treatment team at this appointment. You might also sign the consent form to agree to the operation.
Enhanced Recovery Programme
Your doctor or nurse might talk to you about the Enhanced Recovery Programme at your hospital. This is a programme of care that helps people recover more quickly after a big operation.
Prehabilitation
Some people might also be asked to take part in prehabilitation. Prehabilitation (prehab) means getting ready for cancer treatment in whatever time you have before it starts. It is a programme of support and advice that some NHS hospitals are using. It covers three particular parts of your health:
- what you're eating and your weight
- physical activity or exercise
- mental wellbeing
Ask lots of questions during your appointment. It helps to write down all your questions beforehand to take with you. The more you know about what is going to happen, the less frightening it will seem.
You can ask more questions when you go into hospital. So don’t worry if you forget to ask, or think of more questions when you get home.
Learning breathing and leg exercises
Breathing exercises help to stop you from getting a chest infection after surgery. If you smoke, it helps if you can stop at least a few weeks before your operation.
Leg exercises help to stop blood clots forming in your legs. You might also have medicines to stop the blood from clotting. You have them as small injections under the skin.
You start the injections after your operation. You might also wear compression stockings and pumps on your calves or feet to help the circulation.
Your nurse and physiotherapist will get you up out of bed quite quickly after your surgery. This is to help prevent chest infections and blood clots forming.
This 3-minute video shows you how to do the breathing and leg exercises.
Breathing and circulation exercises after surgery
These exercises help prevent you developing a chest infection or blood clots in your legs after surgery. These problems are more likely when you are not moving around as you would normally.
You can do these breathing exercises while sitting up in a chair or in a bed or whilst lying down.
Relax your shoulders and upper chest.
Take a slow, deep, comfortable breath in and hold for a couple of seconds, then slowly breathe out.
Repeat this 3 times.
You can start these breathing exercises as soon as you come round from your anaesthetic.
You should try to do them every hour when awake until you are fully mobile.
If you need to cough, support your wound with your arms, a pillow or a rolled up towel.
If you are struggling to clear any phlegm, try a huff. This is where you breathe out in a short, sharp manner as if you were trying to steam up a mirror.
You should move about as soon as possible after your operation. But while you are not as mobile, try to keep your legs moving to encourage better circulation.
You can do these exercises in a bed or in a chair.
One foot at a time point your toes away from you then pull your toes towards your chin.
Try to do 10 of these on both feet at least 2-3 times an hour.
The next exercise is circling your ankles. One at time circle your ankles, clockwise and then anticlockwise. Repeat this 10 times with each ankle 2-3 times an hour.
Stop smoking
If you smoke, your doctor will ask you to try to stop smoking for at least 4 weeks before surgery. It is very important to stop smoking if you can, although this can be difficult at such a stressful time.
Your doctor and nurse can tell you where you can get help and support to stop smoking. By not smoking you reduce your risk of developing complications after surgery.
Going into hospital
You will probably go into hospital on the day of your operation or the night before.
What to take with you
Take in:
- nightgowns or pyjamas
- underwear
- dressing gown
- slippers
- contact lenses, solution, glasses and a case
- wash bag with soap, a flannel or sponge, toothbrush and toothpaste etc
- sanitary wear or tampons
- towel
- small amount of money
- medicines you normally take
- magazines, books, playing cards
- headphones and music to listen to
- a tablet or smartphone for web browsing, entertainment and phone calls
- chargers for electronic devices
- a copy of your last clinic letter (if you have one)
Before you go into hospital
It’s worth sorting out a few things before you go into hospital. These might include:
- taking time off work
- care for children or other loved ones
- care for your pets
- care for your house
- cancelling your milk or newspapers
