Problems after lung cancer surgery

There is a risk of problems or complications after any operation.

Possible problems after lung cancer surgery include feeling tired, an air leak from the lung, breathing problems, or pain. Pain can sometimes last for months. Other risks include infection, blood clots in the legs or lungs, and bleeding.

Many problems are minor and rarely happen, but some can be life threatening. Treating them as soon as possible is important.

Feeling tired and weak

Most people feel weak and lack strength for some time afterwards. How long this lasts varies between people.

Tell your doctor or nurse if the weakness continues for more than a few weeks. They can suggest things to help, such as physiotherapy.

An air leak and collapsed lung

This happens when air leaks into the pleural space. A very small number of people get this.

You might need a chest drain to help the lung to expand again, or the chest drain placed at the end of surgery will remain in place for longer.

Breathlessness

Some breathlessness is normal after lung surgery.  This depends on the type of operation you have had and how fit and well you normally are. If you had breathing problems before the operation, you might still have some problems afterwards.

Once at home, you might still get breathless when you are getting dressed or going up the stairs for example. But this generally settles down when you rest.

Many people worry that they won't be able to breathe properly if they have had part of a lung removed, or a whole lung removed. But the remaining lung usually adapts and breathing should improve over time with exercise.

Long term problems

While some people find that their breathing improves as they recover, other people might have long term problems. Talk to your doctor about ways to manage this. You could ask to be referred to a breathlessness clinic.

Infections

You are at risk of getting an infection after an operation. This includes a wound, chest or urine infection. You will have antibiotics to reduce the risk of developing an infection after surgery. Tell your doctor or nurse if you have any symptoms of infection.

They include:

• a high temperature
• shivering
• feeling hot and cold
• feeling generally unwell
• cough
• feeling sick
• swelling or redness around your wound and your wound might feel hot
• a strong smell or liquid oozing from your wound
• loss of appetite

Rarely for an infection in your wound, you may need another operation.

Blood clots

Blood clots (deep vein thrombosis, DVT) are a possible complication of having surgery because you might not move about as much as usual. Clots can block the normal flow of blood through the veins. Let your doctor or nurse know if you have an area in your leg that is swollen, hot, red or sore.

There is a risk that a blood clot can become loose and travel through the bloodstream to the lungs, causing a blockage there (a pulmonary embolism). Symptoms include:

• shortness of breath

• chest pain

• coughing up blood

• feeling dizzy or lightheaded

To prevent clots it's important to do the leg exercises that your nurse or physiotherapist taught you. Your nurse might also give you an injection just under the skin to help lower the risk whilst you are in hospital. You might need to carry on having these injections for 4 weeks, even after you go home. This depends on the type of operation you had.

Your nurse might teach you to do these injections yourself before you go home. Or a district nurse might come to your home to do them.

It's important to continue wearing compression stockings if you have been told to by your doctor.

Bleeding

You may have bleeding straight after your operation. This could be because a blood vessel tie is leaking or because your blood is not clotting properly. How bleeding is treated depends on what is causing it.

Long term pain

Some people find they have pain that lasts for a long time after surgery. The pain is from damage to nerves during the operation. The pain often runs along the operation scar. For most people it gradually reduces over a couple of years as the nerves repair themselves. But for some people it may continue for longer.

Nerve pain can be difficult to get under control. It is important to let your specialist nurse or surgeon know if you are in pain. They can refer you to a pain clinic for specialist help. 

Commonly used painkillers don't always help nerve pain. But there are other medicines your doctor can prescribe. Some types of anti epileptic drugs and anti depressants work very well at controlling this type of pain. Other ways of controlling pain can also work well, such as nerve blocks.

There is a lot of support available to you if you have long term pain.

Swimming after surgery to remove your lung (pneumonectomy)

These days it’s unusual to have surgery to remove the whole of one lung (a pneumonectomy). But if you have had all or most of your lung removed you may have difficulty swimming afterwards, even if you were a strong swimmer beforehand. This is because only having one lung can affect how well you float in water (buoyancy).

Talk to your surgeon about whether you are fit enough to go swimming, once you have recovered from your operation. Be careful when you first go in the water and have someone with you in case you get into difficulty. You may need to use floats to help you.

Any other problems

Let your doctor or specialist nurse know about any problems you have after your surgery so that they can help you.