What happens when you are preparing for your lobectomy? If you and your doctor decide upon a lobectomy as a treatment for your lung cancer, preparing ahead of time can ease some of the anxiety and may improve your outcome as well. What should you know as you prepare for your lobectomy and what questions should you ask?
What Tests/Visits Will I HaveBefore your lobectomy, your doctor will run several tests. Since surgery is not the usual treatment for lung cancer that has spread beyond the lungs, she will recommend tests to rule out any spread (metastasis) of the cancer. These may include a bone scan to look for spread of the cancer to bone, a brain scan to rule out brain metastases, and an abdominal scan to evaluate your liver and other organs.
Tests will then be done to make sure you will be able to tolerate living without a lobe of your lungs. Pulmonary function tests will evaluate your lung function and determine whether your remaining lobes will be able to deliver adequate oxygen to your body. Your doctor may also recommend tests to make sure your heart is functioning well, since surgery can add stress to the heart. A careful history and physical exam and lab work will be done to make sure you are as healthy as possible.
After your doctor has studied the results of your tests, she will carefully discuss the benefits and risks of surgery. It is very helpful to bring a list of questions with you to make sure any concerns you have are not overlooked (see below for some sample questions).
If you are on any medications that can increase bleeding, such as Coumadin (warfarin), aspirin, or anti-inflammatory medications such as ibuprofen (Advil etc.), your doctor will recommend discontinuing these for a period of time before your surgery. Make sure to let your doctor know if you are using any herbal remedies or nutritional supplements, since some of these can thin your blood as well.
If you smoke, she will strongly recommend that you quit as soon as possible prior to your surgery. Studies have shown that lung cancer surgery is more successful and has fewer complications if people stop smoking beforehand.
A Few Things to Consider Before Surgery
- A Second Opinion - Don't be afraid to ask to see another oncologist or surgeon to ask for a second opinion.
- Donating Blood - If there is enough time before surgery, some people choose to donate their own blood in case they need a transfusion during or after surgery.
- Advance Directives - Most of the time surgery goes smoothly, but in the event that you have complications and are unable to express your medical wishes, filling out advance directive forms ahead of time will help your family honor your wishes with regard to medical care. Expressing your desires in this way can also help to alleviate tension if family members should disagree on care options.
The Night Before and Day of Surgery
The night before surgery, your doctor will recommend that you “fast” – that is, not eat or drink anything (even water) for at least 8 hours. Ask your doctor about any medications you ordinarily take in the morning and if you should take these or not. It is recommended that you avoid wearing any make-up or nail polish, and contact lenses and dentures should be removed prior to surgery.
On the morning of your surgery, a nurse will ask you several questions and place an IV (intravenous) line in your arm. She will also fit you with monitors so that your blood pressure, heart rate, and oxygen levels can be monitored throughout surgery. Your surgeon will visit to again discuss the procedure and ask you to sign a consent form. The anesthesiologist will also visit to talk about the anesthesia you will be given, and ask about any problems you or any family members have experienced with anesthesia in the past. The operating room staff will guide your family to a family waiting area, where the surgical staff can keep them updated on your progress and speak with them when your surgery is done.
Questions to Ask
- How many of these procedures have you done?
- How long do you expect I will be hospitalized after surgery?
- What activities will I be able to do when I return home? How much help will I need at home? If I am unable to manage at home, what options are available for transitional care, and are these covered by insurance?
- What will my scar look like?
- What medications will I be given to control pain, both while in the hospital, and after my return home? What should I do if my pain is not adequately controlled?
- When can I return to work?
- Who should I call if I experience problems after returning home?
- Lobectomy Overview - Procedures and Indications
- During Your Surgery - The Procedure
- Recovery After Lobectomy
- Complications and Prognosis
American Cancer Society. Detailed Guide: Lung Cancer – Non-Small Cell. Surgery. Updated 02/17/12. http://www.cancer.org/cancer/lungcancer-non-smallcell/detailedguide/non-small-cell-lung-cancer-treating-surgery
Erhunmwunsee, L. and M. Onaitis. Smoking cessation and the success of lung cancer surgery. Current Oncology Reports. 2009. 11(4):269-74.