Recovery After Lobectomy for Lung Cancer

What Can You Expect After Your Lobectomy?

Doctor smiling in recovery ward
What can you expect during your recovery from a lobectomy?. Morsa Images/DigitalVision/Getty Images

After your lobectomy, you will go through a recovery period in the hospital and then at home. During this period you will be weaned from the ventilator, have your chest tube removed, and begin to resume eating and drinking. What can you expect when your surgery is over? What happens in the hospital, and in the days and weeks after you go home? 

Here, we are discussing your recovery after your lobectomy, but you may wish to learn more about the types of lobectomy, what the procedure is like, and the potential lobectomy complications and prognosis before your surgery.

After Your Lobectomy: About Recovery

Before you have your lobectomy surgery you will probably wonder what your recovery will be like. How will you feel in the days and weeks after your surgery? How long do people usually stay in the hospital? What limitations might you have? Unless you've known someone who had the procedure done, you may feel anxious about the unknowns. Let's look at some of the questions people often ask before having lung cancer surgery and ease some of your anxiety with facts.

Recovery Room

When your surgery is complete, you will be taken to the recovery room where you will be monitored closely for several hours. Your doctor will talk to your family and/or friends about your surgery, and let them know when you will be transferred to your hospital room. For the first day or so you may be monitored in the intensive care unit (ICU). The intensive care unit is designed to take care of people who are very ill, but less so to care for the needs of family and friends. Flowers are not usually allowed, and many people are limited to only a few visitors at a time. Some physicians suggest that you limit visitors during this time to close friends and family, and encourage others to visit after you've been transferred to a regular hospital ward.

Ventilator Use and Breathing After Lobectomy

The breathing tube that allowed the ventilator to breathe for you during surgery is sometimes left in place while you are in recovery. Since this can cause some anxiety, you will be given medications that keep you very drowsy until the tube is removed—usually on the same day as your surgery. Sometimes the breathing tube needs to be left in place longer, and if so, you will probably stay in the intensive care unit. This does not necessarily mean that you are having complications. Some people, especially if a larger portion of lung was removed or if they had lung disease prior to their lung cancer, simply require ventilator support for a longer period of time before resuming breathing on their own.

When the ventilator is removed and you become less sleepy, a respiratory therapist will ask you to cough and assist you in the use of an incentive spirometer. This is a device that you breathe into to exercise your lungs and helps to keep the small air sacs (the alveoli) in your lungs open.

Hospital Course and Chest Tube

When you are able, the nursing staff will help you sit, and then encourage you to get up and walk with assistance. You may not feel like being active, but increasing activity will help you regain your strength more quickly and reduce the risk of developing blood clots. It's helpful to learn about how to prevent and recognize blood clots before your surgery, since these are not uncommon after lung cancer surgery, or even with lung cancer when surgery is not done.

Your chest tube will be left in place until the surgeon feels that the drainage has stopped and no air is leaking. This usually occurs 3 days to 4 days following surgery, but can vary significantly. Again, it does not mean your recovery is going poorly if the chest tube needs to be left in place longer than the average amount of time. Instead, surgeons wish to be cautious, and it's easier all the way around to leave a tube in place a little longer than to have to reinsert a tube. Most people spend at least 5 to 7 days in the hospital following an open lobectomy and 3 to 4 days following a video-assisted thoracoscopic surgery (VATS). Many people are anxious to get out of the hospital and return to their own bed, only to realize that perhaps they shouldn't have been so anxious to leave. Trust that your surgeon will understand when it's a good time to take those steps out of the hospital.

What Is Recovery From Lobectomy Like?

Returning to your usual lifestyle can be a little frustrating following lung cancer surgery—especially if you were not having a lot of symptoms from your lung cancer prior to the procedure. Some people have found that it helps to notice progress every day—such as having tubes progressively removed. Focusing on the small steps forward rather than expecting yourself to be "back to normal" can be calming. Even if you were fit and in good health prior to your surgery, healing takes time. let yourself heal. And even when the tubes are all removed and your scars are healing, keep in mind that there is significant healing that needs to take place inside your body, healing you can't observe directly.

As you recover you may notice that the fatigue you experience is unlike fatigue you have coped with previously. Cancer fatigue can be frustrating, especially if you are someone who has a hard time slowing down and taking it easy. It can be very helpful to pace yourself when you return home and focus on the activities which take the most mental or physical energy early on in the day. It can be difficult allowing people to help, but now is not the time to be a hero or the "strong one." One of the greatest frustrations of loved ones of those with cancer is the sense of helplessness they feel. Delegating some tasks and learning to receive help may not only help you recover faster, but can give your loved one something to ease that sense of being helpless.

Return to Work

Some people return to work after six to eight weeks, but your doctor will give you special restrictions, such as avoiding any heavy lifting. It will also take time for your remaining lung tissue to take over, and some shortness of breath may persist for several months following surgery. It's a fairly new concept in lung cancer surgery recovery, but pulmonary rehabilitation before or after lung cancer surgery has been found to help many people when done at the appropriate time. You may have to ask your doctor about this option, however, since unlike therapy for heart disease and joint replacements, therapy for cancer survivors is taking longer to catch on.

Complications of a Lobectomy

Some people have few problems after their lobectomy procedure and recovery, but complications are not uncommon. Persistent pain referred to as post-thoracotomy pain syndrome can be frustrating for some people. Learning to live with less lung capacity can also take time, even if you have pulmonary rehabilitation.

When Should I Call My Doctor?

When you are released from the hospital, you will be given careful instructions on how to care for yourself at home and instructions on when to follow-up with your doctor. Between appointments, you should call your doctor if you have any symptoms or questions that concern you. Call your doctor right away if you develop a fever, have chest pain that is different from what you have been experiencing, become more short of breath, have any bleeding or redness near your incision, or if you develop any pain in your calves (possible blood clots).

A Word From Verywell

The recovery period after a lobectomy is different for everyone. After your surgery, you will be taken to the recovery room and monitored closely as your anesthesia wears off. Since you will still be connected to the ventilator, your doctor will probably keep you fairly sedated in these first hours. Once you are removed from the ventilator a respiratory therapist will likely work with you and encourage you to cough.

The next step (and tube to get rid of) is the chest tube. On average a chest tube is left in place for 3 to 4 days (and somewhat shorter with a VATS procedure) but this can vary. Some people will have a persistent air leak requiring it to be left in place longer.

During these first days (and up to a few weeks) you will likely need pain medications to control your pain, and you will probably notice the pain a bit more as you begin moving around more. Studies have shown that those who stay on top of their pain (rather than waiting too long to use medications and playing catch up) experience a more comfortable recovery, but also end up needing fewer pain medications overall. The news is full of information warning on the dangers of opioids, but in the setting of acute surgical pain, these medications are usually needed both for comfort, and to make it possible to do the best thing you can to heal and avoid blood clots: get up and move around.

At this point, you will begin to see what your breathing is like. It can be frightening at first if you feel short of breath, but times and pulmonary rehabilitation if needed can be very helpful.

When you return home expect to be very tired. Some people expect to get back to their routine fairly quickly and are surprised by the degree of fatigue. View this fatigue as a sign from your body telling you that you need to take it easy. Your fatigue will improve with time.

Some people have persistent pain after lung cancer surgery and this can be frustrating. There has been a significant amount of research in recent years on methods to cope with and reduce post-thoracotomy pain. Talk to your doctor if this is bothering you

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