Can You Live with One Lung?

25 November 2024

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Living with one lung may seem like an impossible challenge – the lungs are a key organ that work 24 hours a day to keep us alive – but the human body has an uncanny ability to adapt. Much like living without a pancreas, gallbladder, appendix or spleen, missing out on the functionality of these organs isn’t ideal but it can be done. Learn more about what causes people to have a single lung and how you can still live a healthy life.

Why do some people have one lung?

Each day, the human body is hard at work providing oxygen to cells so they can function properly. With each breath, the lungs fill up like a balloon with air from the outside. When exhaling, oxygen spreads to the body and carbon dioxide exits through the mouth or nose.

This job is so tedious that humans have two lungs to perform at a high level. In fact, you breathe in about 2,000 gallons of air per day. A second lung provides greater surface area that facilitates efficient gas exchange within the body. From an anatomical standpoint, the left lung is smaller than the right lung because it shares space with the heart.

But for some reasons, such as medical conditions or due to congenital anomalies, people may be forced to live with one lung. Here are some examples:

Cancer: Surgery is sometimes needed to remove the entire lung in patients with non-small cell lung cancer, pleural mesothelioma (cancer that forms in lung tissue) or due to the presence of lung carcinoid tumors.

Infection: Severe pulmonary tuberculosis and other types of fungal infections can be so damaging that lung removal becomes necessary. Pulmonary tuberculosis is a bacterial infection that destroys lung tissue. Severe aspergillosis, a group of infections caused by the Aspergillus fungi, can also result in lung removal.

Trauma: Any type of trauma or injury to the chest, such as from a car accident, gunshot wound or a stabbing, can cause irreparable damage to one lung.

Birth defects: Lungs begin to develop in the first three to five weeks of a pregnancy. During this time, anomalies can occur. Pulmonary agenesis is a rare congenital condition characterized by the absence or underdevelopment of one or both lungs. Abnormal blood flow during the fourth week of gestation is one suggested cause of pulmonary agenesis.

Lung disease: Pulmonary fibrosis or chronic obstructive pulmonary disease (COPD) can lead to severe damage to one lung. People with bronchiectasis, a long-term condition where the airways become abnormally widened and accrue excess mucus, may also require the removal of one lung.

What is a pneumonectomy?

With the exception of people who are only born with one lung, people living with one lung have undergone a type of surgery called a pneumonectomy to remove the unhealthy or damaged lung. Lung cancer is the most common reason for this type of surgery.

A pneumonectomy is different from a lobectomy because the entire lung is removed compared to just a lobe (the right lung has three lobes and the left lung has two lobes). Therefore, surgeons typically only perform a pneumonectomy to treat severe infection, irreversible lung damage or cancer.

Not everyone is a candidate for a pneumonectomy since the remaining lung has to work harder to receive oxygen and remove carbon dioxide. Before the surgery can even be performed, various tests must determine if you’re a candidate for living with one lung.

A pulmonary function tests measure lung volume, capacity, how oxygen flows and the exchange of gas.

Doctors can also use a ventilation perfusion scan to measure both airflow (how air flows in and out of the lungs) and circulation (how blood flows in the lungs). For the ventilation part of this scan, you breathe in gas that contains a radioactive tracer that is then measured by X-ray. For the perfusion scan, a radioactive tracer is administered into the blood via an IV. An X-ray then captures the images of how blood moves.

To remove the lung, a thoracic surgeon who specializes in operating on organs in the chest performs either a thoracotomy or video-assisted thoracoscopic surgery (VATS). A thoracotomy requires a large incision (usually about 6 inches) on the side so the surgeon can spread the ribs and access the lungs. By comparison, VATS is a minimally invasive procedure that uses several smaller incisions to insert a tiny camera into the chest. Once visualized, tiny instruments are inserted through the incisions to remove the lung. Alternatively, surgeons can also perform the same procedure using robotic instruments that are controlled away from the operating room table.

People who have a left-sided pneumonectomy have a better prognosis than people who have a right-sided pneumonectomy. Right-sided pneumonectomy may carry higher risks due to the anatomical location and complex structure of the right lung.

Living with one lung

Yes, living with a single lung may come with certain challenges, but the human body can compensate by expanding and working harder. As long as the remaining lung is healthy enough, one lung is enough to provide the necessary oxygen – along with carbon dioxide removal – to function.

That said, Mark Rolfe, M.D., a pulmonologist with INTEGRIS Health Baptist Medical Center, says some people with one lung may need to alter their daily routines and require health monitoring to ensure lung function remains optimal.

“I would not recommend scuba diving for sure, but if the other lung is ‘normal’ - people can ski, hike, fly in planes and do about everything short of professional sports,” explains Rolfe. “The patient needs to protect their residual lung function by not smoking, avoiding fumes or vaping. They also need to receive immunizations for the flu, RSV, Pneumococcus. And of course, try to stay away from people with known respiratory tract infections.”

Ultimately, you will need to meet with your doctor to determine a personalized plan that works best for you.

Rolfe authored this article in The New England Journal of Medicine about a patient who had a pneumonectomy due to lung cancer.

Lung function: The average lungs can hold about 6 liters of air. Living with one lung reduces this capacity by about 30 percent. That said, 70 percent functionality is still enough to oxygenate the body properly.

Reduced exercise capacity: While many people can still exercise with one lung, some people may notice they become winded more easily when participating in strenuous activity. This doesn’t mean you can’t exercise, rather you may need to find other means of activity.

Health monitoring: People living with one lung are regularly monitored by a pulmonologist, a doctor who specializes in the respiratory system. Closely following your lungs’ health ensures your doctor can monitor function and make any changes necessary.

Lifestyle adjustments: Since the healthy remaining lung has to work harder, lifestyle changes may be necessary to help protect it from losing functionality. For example, your doctor may recommend losing weight through dietary changes or avoid exposures to chemicals or pollutants.

Lung rehabilitation: Following surgery, some patients benefit from pulmonary rehabilitation, which helps teach breathing exercises and techniques to manage your lung function.

How long can you live with one lung?

Ultimately, life expectancy with one lung depends on why you needed the lung removed in the first place. In other words, the underlying disease or illness will determine how long you survive. Someone who loses a lung during a car accident has a better chance of living a long life compared to someone with an aggressive form of lung cancer or a severe lung disease.

Signs one of your lungs isn't working

Living a healthy life with only one lung is entirely possible. However, it remains crucial to prioritize your respiratory well-being and take proactive measures to prevent potential issues from escalating. One effective approach is to familiarize yourself with the warning signs that indicate suboptimal lung function. By being vigilant and proactive, you can ensure the continued health and functionality of your respiratory system.

Here are some warning signs to be aware of:

Chronic cough
Shortness of breath
Unexplained fatigue
Respiratory difficulties (trouble breathing, increased mucus production, tightness while breathing)
Limited stamina
Persistent symptoms that don’t subside

If you or a loved one is living with one lung or has a health condition that increases the risk of needing surgery to remove a lung, contact a pulmonologist or a thoracic surgeon to learn more about how to stay on top of your respiratory health.