Pneumonectomy overview

Overview

A pneumonectomy is a major surgery to remove an entire lung. It is usually done to treat serious lung problems, such as lung cancer, severe infections, or large abscesses that cannot be helped by other treatments.

No, pneumonectomy is not common. It is reserved for serious lung conditions that cannot be treated with less invasive methods.

It mainly affects adults who have lung cancer, severe tuberculosis, bronchiectasis (widened and scarred airways), or other advanced lung diseases. Smokers and people with a family history of lung cancer are at higher risk.

Symptoms

Common symptoms

• Persistent cough that does not go away
• Coughing up blood or red-tinged phlegm
• Shortness of breath that gets worse over time
• Chest pain that is dull or sharp and does not improve
• Unexplained weight loss or loss of appetite
• Frequent lung infections like pneumonia or bronchitis

Symptoms in children

• Pneumonectomy is very rare in children, but if needed, the most common symptoms leading to it are severe lung infections that do not respond to antibiotics, or lung damage from a birth defect.

Symptoms in older adults

• In older adults, symptoms of underlying lung disease may be mistaken as normal aging. Look for increasing breathlessness, fatigue, or a nagging cough. Falls or confusion can sometimes be signs of low oxygen levels.

Causes

Main causes

• Lung cancer that has spread to the main airways or is too large to remove with a smaller surgery
• Severe, long-term infections like tuberculosis or fungal infections that have destroyed part of the lung
• Bronchiectasis – a condition where the airways become permanently widened and prone to infection
• Trauma or injury that severely damages one lung beyond repair

Risk factors

• Smoking cigarettes, cigars, or pipes – the biggest risk factor for lung cancer and many lung diseases
• Exposure to secondhand smoke, asbestos, radon gas, or other lung irritants at work or home
• A family history of lung cancer or chronic lung disease
• Weakened immune system from illness or medication

When to see a doctor

See a doctor urgently if:

• If you cough up blood or have sudden chest pain with shortness of breath, seek emergency care immediately.

Book a routine appointment if:

• If you have a cough that lasts more than a few weeks, unexplained weight loss, or ongoing shortness of breath, make an appointment with your GP.
• If you have a known lung condition that is not improving with treatment, ask your specialist if pneumonectomy might be an option.

Diagnosis

Pneumonectomy is not diagnosed – it is a treatment. But to decide if you need one, doctors will thoroughly diagnose the underlying lung condition using scans, tests, and biopsies.

Tests that may be done

• Chest X-ray – a quick image to see large abnormalities in the lungs
• CT scan – a detailed 3D scan to look at the size and location of the problem
• PET scan – helps see if cancer has spread beyond the lung
• Bronchoscopy – a thin tube with a camera is passed through the mouth into the airways to take samples
• Lung function tests – to measure how well your lungs work and estimate if you can safely have surgery
• Blood tests – to check overall health and oxygen levels

What to expect at your appointment

If your doctor thinks you might need a pneumonectomy, they will refer you to a specialist surgeon and a lung team. You will have several appointments to discuss the risks and benefits. You may also be asked to stop smoking and to do breathing exercises before surgery.

Treatment

Pneumonectomy is the main surgical treatment when one lung is too damaged to heal. After surgery, you will have a hospital stay of about one to two weeks. Recovery takes several months, and you will need regular follow-up care. Other treatments (like chemotherapy or radiation) may be used before or after surgery, depending on the condition.

Self-care at home

• Stop smoking completely – this is the most important step to help you recover and protect your remaining lung.
• Practice deep breathing and coughing exercises as taught by your nurse or physiotherapist.
• Get plenty of rest and slowly increase your activity as advised by your healthcare team.
• Keep all follow-up appointments and tell your doctor about any new symptoms.

Medical treatments

Before surgery, you may receive treatments such as chemotherapy or radiation therapy to shrink a tumour. After pneumonectomy, you will need pain relief and may be given antibiotics or treatments to prevent blood clots. Your doctor will create a personalised plan based on your condition. Do not take any new medicines without asking your doctor or pharmacist.

When is surgery considered?

Surgery is considered when the lung problem is confined to one lung and cannot be treated with less invasive options, and when you are healthy enough to survive the operation and recover with one lung.

Living with this condition

After pneumonectomy, you will have only one lung. Most people adjust well, but you may notice being out of breath more easily. You can still do many daily activities, but heavy lifting or vigorous exercise may be harder. It helps to pace yourself and take breaks.

Lifestyle tips

• Avoid smoking and secondhand smoke completely.
• Avoid air pollution, dust, and strong fumes as much as possible.
• Get vaccinated against flu and pneumonia – ask your doctor which shots are right for you.
• Wash your hands often to prevent infections.
• Protect your remaining lung – avoid contact with people who have colds or flu.

Diet and exercise

Eat a balanced diet rich in fruits, vegetables, lean protein, and whole grains to support healing. Gentle exercise, like walking or light stretching, can help your stamina. Your doctor or physiotherapist can design a safe exercise plan for you. Do not push yourself too hard – listen to your body.

Mental health and emotional wellbeing

Having a major surgery like pneumonectomy can be emotionally challenging. It is normal to feel anxious, sad, or worried about your health. Some people also feel a sense of loss. Talk to your healthcare team about these feelings – they can connect you with support services. If you feel hopeless or are thinking about harming yourself, call a crisis helpline or go to your local emergency room immediately.

Prevention

Many conditions that lead to pneumonectomy can be prevented by not smoking, avoiding lung irritants, and treating lung infections early. However, not all cases are preventable, especially if you have a genetic condition or exposure you could not avoid.

Vaccines

Vaccines for flu and pneumonia can reduce your risk of serious lung infections that might damage your remaining lung after surgery. Ask your doctor about whether you need a pneumococcal vaccine or annual flu shot.

Screening programmes

Screening for lung cancer with low-dose CT scans may be recommended for people who are at high risk due to age, smoking history, or family history. Early detection can sometimes avoid the need for a full pneumonectomy. Check with your doctor if you think you might benefit from screening.

Complications

If left untreated

• The underlying lung condition (for example, lung cancer or severe infection) can worsen and spread to other parts of the body.
• Severe shortness of breath and low oxygen levels that make daily life very difficult.
• Life-threatening infections like pneumonia or sepsis (a body-wide infection).
• Weight loss, weakness, and eventual organ failure.

Long-term outlook

For many people, pneumonectomy can be a life-saving procedure. Though recovery takes time and your breathing will never be the same as before, most people adjust well to life with one lung. The long-term outlook depends on the condition that required the surgery. For example, if lung cancer is caught early and completely removed, many people go on to live full lives. Your healthcare team will explain what you can expect based on your specific situation.

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