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Newly Published European Research Reveals that Gaps in Communication and Continuity of Care Are Impacting Patient Recovery from Lung Cancer Surgery¹

01 November 2025

New research published in the journal Interdisciplinary Cardiovascular and Thoracic Surgery found 13% of patients felt their lung cancer surgery went worse than expected – a view not shared by surgeons, revealing an urgent need for greater communication to support patient recovery

What happens when lung cancer surgery is clinically successful, but the patient walks away feeling it went wrong?

That question sits at the heart of new research supported by Johnson & Johnson MedTech, in partnership with Lung Cancer Europe (LuCE), and published in the journal Interdisciplinary Cardiovascular and Thoracic Surgery. The findings uncover a persistent disconnect between how surgical teams and patients perceive lung cancer surgery success - a gap that could play a critical role in shaping empowered recovery, trust, and long-term engagement with care.

In a pan-European survey of 214 surgeons and 230 thoracic surgery patients recruited through LuCE, the data show that 13% of patients said their surgery went worse than expected. In contrast, none of the surgeons surveyed believed the procedures they had completed went worse than anticipated, exposing a striking misalignment between clinical success and personal patient perceptions.

But the perception gap doesn’t end there as broader findings from the research reveal.

Risk discussions fall short and consent suffers

While mortality is a risk for lung surgery, in advance of surgery only 61% of surgeons reported discussing this fully with their patients. Fewer still said they discussed major post-operative complications in advance such as pulmonary embolism or respiratory failure. From the patient perspective, 22% responded that they did not agree that they had ‘understood’ surgery information and complication, with 21% stating they had not ‘received’ all the expected surgical procedure information and complications.

Why it matters

Beyond just ethical considerations, the informed and empowered patient has a critical role to play in supporting their own recovery post-operatively to reduce the likelihood of costly complications that could have been avoided. Therefore, it should not be underestimated how a patient’s willingness to embrace this role can be impacted where a breakdown in communication and/or trust with their care team has unfortunately taken place.

Impacted factors might include reporting pain which, without effective management, has been linked to post traumatic stress disorder (PTSD). Reduced patient confidence may also impact early mobilization and effective completion of breathing exercises post-operatively, which – if not completed effectively – could increase the risk of postoperative complications or exacerbation of other comorbidities.

“It can be a whirlwind for patients, with many fortunate to have their lung cancer discovered early without experiencing many symptoms at all prior to this. And yet, they will be facing the challenging reality of recovery from surgery perhaps just a few short weeks later”, said Debra Montague, President of LuCE and Chair of ALK Positive UK. “It can be extremely disorientating for patients, who are often trying to grab hold of what they can control when their life has been turned upside down. Enabling their shared decision making through structured support and education, helps patients take a more active role in their care.”

Success must reflect more than margins and metrics

The research challenges traditional definitions of surgical “success,” which focus largely on clinical outcomes in the operating room. Yet for patients, from diagnosis through to recovery, success also means being informed, supported, and involved as part of shared decision making. Without alignment between these perspectives, reduced satisfaction and even disengagement can impact recovery and long-term outcomes.

Tools exist — but they’re not yet standard

Many of the solutions to these issues already exist. Enhanced Recovery After Surgery (ERAS) protocols are proven to reduce complications and opioid use, and nurse navigators are shown to improve patient understanding and satisfaction. Yet adoption remains patchy:

(80%) of surgeons stated they have been successful in adopting ERAS into their department, yet less than one third of patients recalled support from a pulmonary nurse.
Just a third of surgeons said they use remote follow-up tools despite most patients stating, if given the option for remote follow up via app on a phone, they would be comfortable to very comfortable

What’s Next

Johnson & Johnson MedTech plans to channel the findings into publication of Delphi consensus recommendations developed through expert consultation, forming practical guidelines for lung cancer care teams’ implementation. The recommendations will be designed to shape work across Europe, advocating for:

More structured, shared decision-making frameworks
Standardized communication of risks and expectations
Greater integration of digital follow-up and nurse navigation
Widespread use of patient-reported outcomes in surgical quality assessments

As surgical care continues to evolve, this research highlights a clear truth: technical excellence must be matched by human-centered care. The future of thoracic surgery must be shaped not just by what happens in the operating room, but by how well that experience is communicated, understood, and supported.

Pineda J, Atiyani O, Moreno N, et al. Patient-Surgeon Communication in Thoracic Surgery: Insights from a European Multi-Country Survey on the Perioperative Experience. Interdiscip Cardiovasc Thorac Surg. Published online September 25, 2025. doi:10.1093/icvts/ivaf228