Can You Live With One Lung After Lung Cancer or Mesothelioma Surgery?

Update: This post was originally published July 8, 2022 but was updated January 6, 2023 with more information.

One of the most common topics related to mesothelioma cancer or lung cancer is about whether you need both of your lungs. “Can you live with one lung?” is often asked by patients and caregivers to medical experts and online sources.

The answer is “yes.” However, some people are better equipped than others to live with one lung.

People with mesothelioma or asbestos lung cancer often ask about having a lung removed because living with one lung might be their best path to getting rid of their cancer. These two cancers form on or near the lungs, and one lung is usually overrun with tumors quickly. Taking out the lung can remove tumors along with the organ and help the patient beat the cancer.

 

What Is a Pneumonectomy?

Pneumonectomy is a surgery to remove one of your lungs. The surgery takes out the entire lung. Some lung cancer surgeries remove just part of the lung. This surgery is a major part of lung cancer treatment.

Pneumonectomy is a surgery option for both lung cancer and mesothelioma. It’s suggested by doctors when the tumors have overrun tissue on the lungs. If the cancer is in stage 2 or 3, then pneumonectomy might be the only option to get rid of the cancer.

Patients must be healthy enough to live after a pneumonectomy, though. Living with just one lung can be challenging. It requires more work from the remaining lung to keep the respiratory system functioning at a high level.

Other Types of Lung-Removal Surgeries

There are other lung-removal surgeries but they don’t remove the whole lung. These surgeries are used for lung cancer. Mesothelioma doctors usually want to either leave the whole lung alone or take the entire lung out because they want to make sure they’ve gotten all tumors.

The other lung-removal surgeries include:

• Lobectomy — Removing up to two lobes of the lung (the right lung has three lobes and the left lung has two lobes)
• Segmentectomy — Removing up to four segments of a lobe (each lobe of the lung has 2-5 segments)
• Wedge resection — Removing a small, wedge-shaped part of lung tissue around the tumor

 

What Is an Extrapleural Pneumonectomy for Mesothelioma?

Mesothelioma lung-removal surgery is called an extrapleural pneumonectomy. In addition to removing the lung, doctors remove the thin lining around the lung cavity. This small lining of tissue and fluid is called the pleura. It’s where pleural mesothelioma forms.

After getting your lung removed, you’ll likely need physical therapy. This usually occurs in the hospital or an outpatient facility in the days, weeks and months after pneumonectomy surgery.

Physical therapy for living with one lung includes breathing exercises and physical activity, such as walking regularly. This builds endurance, strengthens breathing, and gets rid of fluid that builds up after surgery in the extra space in your lung cavity.

Extrapleural pneumonectomy surgery was used in nearly half of mesothelioma surgery cases from 1995-2012. The surgery was used less often after 2012 because mesothelioma specialists preferred a surgery that didn’t remove any lungs: pleurectomy/decortication.

The benefits of EPP surgery are:

• Higher chance of removing all cancer cells
• Less chance of cancer returning months or years after the surgery

 

Steps of Removing a Lung During Surgery

There are different steps to each lung-removal surgery. For instance, some surgeries for lung cancer only remove part of the lung. Any surgery removing the whole lung is called a pneumonectomy.

According to the MedStar Washington Hospital Center website, the steps of an extrapleural pneumonectomy for mesothelioma are:

 

Success of Surgery to Remove a Lung

In a study of 1,358 cases of mesothelioma, surgery that removed a lung was used around half of the time. The surgery’s mortality rate was around 7% and the average survival was around 13.5 months. Other studies looking at lung-removal surgery for mesothelioma saw:

• Average survival times of 14-18 months
• 2-year survival rate of 32%-41%

 

Recovery From Having a Lung Removed

Recovery after surgery to remove a lung can be challenging. The recovery time is usually longer after a lung is taken out due to respiratory recovery.

According to the University of California San Francisco Department of Surgery website, inpatient recovery after extrapleural pneumonectomy surgery usually lasts two weeks. Inpatient recovery is how long the patient remains at the hospital following surgery.

Inpatient recovery involves breathing and walking exercises. You’ll ideally come off of a breathing tube and breathe on your own before inpatient recovery can end after an extrapleural pnuemonectomy.

Other requirements to transition from inpatient to outpatient after having a lung removed are:

Outpatient recovery, which usually happens at your home, takes 6-8 weeks. Outpatient recovery involves more daily activities as you gain strength and continue breathing and walking exercises. However, you do not need constant monitoring from medical experts, like nurses and doctors.

The recovery process from lung-removal surgery lasts 8-10 weeks, although respiratory function may not return to full capacity until months after the surgery

 

Your Lifestyle With One Lung

You’ll likely be able to live your life mostly the same way. The main impact of having just one lung is exercise and physical activities.

Lungs are part of your respiratory system. The purpose of the respiratory system is to move fresh air into your body while removing waste, such as carbon dioxide. The lungs deliver life-sustaining oxygen into your blood. This is important to keeping your blood healthy as it supports other organs.

One lung can provide adequate oxygen to your blood while removing enough waste to keep you healthy. However, your remaining lung is working extra. This means you’ll probably be out of breath much faster than before. You’re also more prone to fatigue throughout the day.

The impact on breathing and respiratory function is why many mesothelioma specialists prefer pleurectomy/decortication surgery to extrapleural pneumonectomy surgery. Pleurectomy/decortication surgery is a lung-sparing operation and has a higher quality of life for most patients afterwards.

However, extrapleural pneumonectomy is an option if tumors have spread to the lung and it must be removed. Patient health is an important consideration to determine if removing the lung is valuable.

The other major effect of having one lung occurs if you get a respiratory illness. COVID-19, for instance, attacks the lungs. If it causes significant distress to your only remaining lung, you may experience severe symptoms. Another example is pneumonia, which is lung inflammation due to a virus. You’re more likely to have a longer fight with the virus and experience tougher symptoms.

In summary, yes, you can live with one lung. If you have lung cancer or mesothelioma, this might be one of the few options to beat your cancer and live comfortably and happily. Talk with your doctors about having a pneumonectomy and ways to prepare your body. Then prepare for some small lifestyle changes and hopefully many cancer-free years with family and friends.