What Singer-Songwriter Barry Manilow, 82, Recovery After Lung Cancer Surgery Looks Like? As Our Experts Explain What Patients Can Expect, the ‘Mandy’ Singer Is Pausing Touring But Vows to Keep Making Music

Thoracic surgery nurse Melissa Culligan, RN, MS, notes that the toughest part of recovery often begins once patients return home.

“Managing pain after surgery is difficult once you get home,” she says, emphasizing the importance of staying in close contact with the care team when something feels off or unexpected.

Manilow revealed late last year that after battling weeks of bronchitis and a relapse, doctors ordered an MRI that uncovered a small cancerous spot on his left lung.

“It’s pure luck (and a great doctor) that it was found so early,” he said.

Manilow said that his surgeons did not believe the cancer had spread, and he expects to avoid chemotherapy and radiation.

Lung cancer is notoriously hard to detect early because symptoms like fatigue, shortness of breath, and persistent coughing can easily be mistaken for common illnesses. Treatment options vary widely depending on stage and tumor location, and surgery—as the one Manilow underwent—often comes with a demanding recovery period.

“Having a few extra weeks to rest and prepare is what the doctor ordered,” Manilow told fans as he continues focusing on healing.

Getting Through Lung Cancer Surgery and the Recovery Afterward

Before getting serious about lung cancer, oncologists take a closer look at the heart health of the patient.

“We’ll look at the carotid arteries, which are the blood vessels that supply blood to your brain,” Dr. Joseph Friedberg, thoracic surgeon-in-chief at the Temple University Health System, explained to SurvivorNet.

“In addition to smoking, which is the most common cause of lung cancer causing cancers, it also causes heart disease and other arterial diseases,” Dr. Friedberg added.

WATCH: Preparing for lung cancer surgery

“We want to get the things to make sure that if surgery is appropriate, we, as best as we can humanly tell, have eliminated the possibilities or the likelihood that you’re going to have a heart attack or a stroke if we subject you to the surgery,” Dr. Friedberg said.

There are several types of surgery that can remove lung cancer, which include:

• Segmentectomy (removal of a small segment of the lung)
• Lobectomy (removal of a lobe of the lung)
• Pneumonectomy (removal of the entire lung)

The decision is largely based on the size of the tumor and where in your lung it is located.

“If the tumor is on the outer part of the lung and it’s small, you can get something called a wedge resection, which is a pizza pie-shaped resection of that lung,” Dr. Raja Flores, Chairman of the Department of Thoracic Surgery and the Steven and Ann Ames Professor in Thoracic Surgery for the Mount Sinai Health System, said.

WATCH: Surgical Options for Lung Cancer

“It removes the lung, and it spares a lot of the lung parenchyma, which is the functional part of the lung,” Dr. Flores added.

Although pneumonectomy removes the entire lung, Dr. Flores says not all patients can tolerate the procedure.

“It depends on how good their lung function really is, and many of the patients are smokers, so they have damaged their lungs, so you have to get these breathing tests before you go ahead and do any big lung operation on anybody,” Dr. Flores explained.

WATCH: Pain Management After Lung Cancer Surgery

As effective as lung cancer surgery can be, the recovery often feels like its own challenge. Melissa Culligan, RN, MS, says the hardest part usually begins once patients return home and have to manage pain on their own.

“I continue to learn that honesty to your patients and their family members while maintaining a healthy dose of hope is probably the most important thing for patients and their families as they’re going through cancer treatment,” Culligan explains.

That honesty helps people prepare for what recovery really looks like.

Culligan encourages patients to stay closely connected to their care team, especially when something feels off. As healing progresses, pain often shifts in both location and intensity, and she stresses that these changes are usually expected. Reaching out allows the team to either adjust pain management or reassure patients that their experience is normal.

As patients become more active, discomfort often increases. Culligan notes that this doesn’t mean anything is wrong; it’s simply part of the body’s recovery and rebuilding strength. She urges patients to continue taking their pain medication as prescribed while they heal.

“It’s critical after surgery and after any treatment that you do keep active and keep your body in the best possible condition along the way,” Culligan said.

RELATED: What is VATS Surgery for Lung Cancer?

Manilow’s Lung Cancer Risk Factor

Manilow previously admitted to being a long-time cigarette smoker and, more recently, someone who uses vape pens to satisfy his smoking fix.

However, “Just stopping smoking even for a couple of weeks before surgery will increase your safety,” says Dr. Friedberg.

WATCH: Lung Cancer in Smokers vs. Non-Smokers

Dr. Friedberg urges people concerned about their lung cancer risk to quit.

“There’s no gray zone. Smoking causes lung cancer. That’s it. If you’re smoking, stop,” Dr. Friedberg said.

“[Quitting smoking] decreases your chance of getting lung cancer. You never return down all the way to the person who never smoked, as far as your risk of lung cancer, but it goes down,” Dr. Friedberg continued.

Smoking can complicate lung cancer surgery. Tiny, hair-like cells called cilia line our windpipes, and their main job is to sweep mucus out of the lungs. Smoking paralyzes these cells, and the inability to clear this mucus effectively is why smokers often develop that telltale hacking cough. During lung cancer surgery, these secretions can get caught in your lung and increase your risk for developing pneumonia, a potentially fatal complication.

A seven-year study published in Annals of Internal Medicine observed the benefits of lung cancer patients who stopped smoking.

“We found quitting smoking after diagnosis to be an important predictor of overall and progression-free survival in patients with early-stage NSCLC. Compared with patients who continued smoking in the follow-up period, those who quit smoking had 33% decreased risk for overall mortality and 25% decreased risk for cancer-specific mortality,” notes lead author Dr. Madhi Sheikh, a member of the Genetic Epidemiology Group at IARC.

“Furthermore, the median survival time was 21.6 months longer among those who quit smoking than those who continued smoking.”

All Lung Cancer Patients

• Median Survival Time: 5.2 years
• Probability of Survival at Five Years: 50.9%

Lung Cancer Patients Who Continued Smoking

• Median Survival Time: 4.8 years
• Median Progression-Free Survival: 3.9 years
• Median Time to Lung-Cancer Specific Mortality: 6.0 years
• Probability of Survival at Three Years: 66.2%
• Probability of Survival at Five Years: 48.6%

Lung Cancer Patients Who Quit Smoking After Diagnosis

• Median Survival Time: 6.6 years
• Median Progression-Free Survival: 5.7 years
• Median Time to Lung-Cancer Specific Mortality: 7.9 years
• Probability of Survival at Three Years: 74.5%
• Probability of Survival at Five Years: 60.6%

These numbers show that patients who quit smoking had longer median survival time  (6.6 years v. 4.8 years), longer median progression-free survival  (5.7 years v. 3.9 years), and longer median time to death from lung cancer (7.9 years vs. 6 years).

Manilow previously detailed with the London Evening Standard in a 2012 interview his long history of smoking.

“Well, I smoked for 30 years. I started when I was nine years old. I grew up in Brooklyn,’ he said.

After revealing his cancer diagnosis, Manilow received an outpouring of support from fans and fellow musicians alike. Former “Guns N’ Roses” drummer Matt Sorum said, “Sending love from The Sorums …we just saw one of your Christmas shows, and you were unbelievable, take care of yourself, Barry, and we’ll be here when you’re ready.”

According to Manilow’s biography on his website, in 1972, he signed with Bell Records for his debut solo album. Two years later, he produced a popular U.K. hit, “Brandy” Manilow renamed “Mandy,” which became a number one hit in 1975, putting him on the map as a key music act from then on.

“Get well soon, Barry! You’re in my prayers. This will pass, and you’ll be as healthy as an apple real soon! But please! Throw the E-cigarette away, please! Much love and warm hugs,” Instagram user Anna Beckwith said.

Understanding Lung Cancer and Why It’s Hard to Catch Early

Lung cancer forms when cancer cells develop in the tissues of the lung. It is the second most common form of cancer and the leading cause of cancer deaths in both men and women in the U.S., SurvivorNet experts say. It’s “completely asymptomatic,” says Dr. Friedberg.

“It causes no issues until it has spread somewhere. So, if it spreads to the bones, it may cause pain. If it spreads to the brain, it may cause something not subtle, like a seizure,” Dr. Friedberg adds.

WATCH: Detecting lung cancer in the absence of symptoms.

Scans such as X-rays can help doctors determine if a shadow appears, which can prompt further testing for lung cancer.

Lung cancer often doesn’t cause symptoms until it has already spread outside the lungs, according to SurvivorNet’s experts.

There are two main types of lung cancer, which doctors group together based on how they act and how they’re treated:

Non-small cell lung cancer (NSCLC) is the most common type and makes up about 85% of cases.
Small cell lung cancer (SCLC) is less common, but it tends to grow faster than NSCLC and is treated very differently.

Some people with lung cancer may experience symptoms such as:

• A cough that doesn’t go away, that gets worse, or that brings up bloody phlegm
• Shortness of breath
• Fatigue
• Chest pain
• Hoarse voice
• Appetite loss
• Weight loss

If you are experiencing these kinds of symptoms consistently, contact your doctor for further tests.

Advancements In Lung Cancer Treatment

Lung cancer treatment is still evolving, offering the promise of hope for people living with this type of cancer. Research presented at the 2024 American Society of Clinical Oncology (ASCO) showed that (generic name: durvalumab) (brand name: Imfinzi), a type of immunotherapy drug, could reduce the risk of death for patients with limited-stage small cell lung cancer (LS-SCLC) by 27 percent.

The study demonstrated that the use of Imfinzi improved overall survival and progression-free survival (the time a patient lives without their disease getting worse) in patients.

“SCLC is one of the most aggressive types of lung cancer. The ADRIATIC trial is a landmark study and provides a new standard of care with the addition of immunotherapy for patients with early-stage SCLC who are being treated with the goal of curing their cancer,” said Dr. Lauren Byers, thoracic section chief in the Department of Thoracic-Head & Neck Medical Oncology at the University of Texas MD Anderson Cancer Center in Houston.

Dr. Byers pointed out that Imfinzi helped patients live for years compared to many other treatment approaches, where the benefits were measured in months.

WATCH: Understanding Immunotherapy in Lung Cancer.

Another treatment option that has shown great promise is the drug Rybrevant, which is approved by the U.S. Food and Drug Administration for non-small lung cancer (NSCLC) and has a specific genetic mutation your doctor can identify through testing.

“When a patient comes in, we immediately sequence the tumor. We are doing panels that might include three, four, or 500 genes, the ones that are most likely. Some sort of next-generation approach is the best standard of care these days – it has to be done,” Dr. Herbst explains.

The active ingredient in Rybrevant is amivantamab-vmjw. It belongs to a class of drugs known as biologics, which are made from living cells.

The drug works like a guided missile, finding and sticking to the bad cancer cells. It targets and attaches to two specific proteins in cancer cells, disrupting their growth signals and activating the immune system to fight the cancer.

Once it finds its target, it blocks the signals the cells need to grow and spread. This stops the cancer from worsening and helps patients feel better for longer.

Rybrevant is different from older cancer treatments because it is a targeted drug therapy. It doesn’t just attack all rapidly dividing cells as traditional chemotherapy does. Instead, it goes after the cancer cells with the mutation it was designed to treat while avoiding the healthy surrounding cells. This means it can be more effective and might have fewer side effects than other treatments.

WATCH: Imfinzi offering hope to patients.

Lorlatinib and crizotinib are other lung cancer treatments known as tyrosine kinase inhibitors. These drugs target ALK, a signaling protein inappropriately present in the tumors of about five percent of patients with NCSLC.

“It is encouraging that the upfront benefits of lorlatinib over crizotinib continue for several years in more than half the patients. It is also encouraging that patients receiving lorlatinib had much fewer incidences of brain metastasis, which can be devastating,” Dr. Leslie Busby, an oncologist at Rocky Mountain Cancer Centers, told SurvivorNet.

Five-year PFS, or the percentage of patients who lived five years without any evidence of cancer growth or death, was 60% among patients who received lorlatinib compared to only 8% among patients who received crizotinib—an absolute difference greater than 50%.

How Molecular Testing Helps Lung Cancer Patients

Lung cancer treatment has seen notable progress, partly because of molecular testing and profiling. This type of testing helps better understand specific genetic alterations and mutations that drive the growth, development, and progression of cancer cells. Some of these molecular characteristics can be targeted using precise and effective new therapies to improve patient outcomes. Ultimately, understanding the molecular profile of each person’s cancer allows oncologists to use customized and personalized treatments.

RELATED Next-Generation Sequencing in Lung Cancer

There are several next-generation sequencing (NGS) tests you may encounter, depending on where you are getting treatment and what you are getting treatment for. Here are some of the common ones currently on the market:

• FoundationOne®CDx looks at 324 genes in solid tumors and says results can take up to 12 days. Test results include microsatellite instability (MSI) and tumor mutational burden (TMB) to help inform immunotherapy decisions.
• OmniSeq Insight provides comprehensive genomic and immune profiling for all solid tumors. It looks for 523 different genes. Test results include microsatellite instability (MSI) and tumor mutational burden (TMB), as well as PD-L1 by immunohistochemistry (IHC).
• Cobas EGFR Mutation Test v2 identifies 42 mutations in exons 18, 19, 20, and 21 of the epidermal growth factor receptor (EGFR) gene. It is designed to test tissue and plasma specimens with a single kit, allowing labs to run tissue and plasma simultaneously on the same plate.

Questions for Your Doctor

If you find yourself diagnosed with lung cancer and are concerned about the long-term impacts, here are some questions you can ask your doctor.

• Has my cancer spread to other parts of the body?
• Based on my cancer stage, what are my treatment options?
• What are the side effects of my recommended treatment?
• Are there ways to help minimize the effects of treatment?
• How long will I be unable to work or carry out my daily activities?
• What financial resources are available to get the treatments I need?

Learn more about SurvivorNet's rigorous medical review process.

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