What is Cancer Surgery?

Cancer surgery involves removing the tumor and nearby tissues during an operation. A doctor who treats cancer through surgery is called a surgical oncologist. Surgery is the oldest type of cancer treatment and remains effective for many types of cancer today.

There are many reasons to use surgery:

• To diagnose cancer;
• To remove all or part of a cancer;
• To determine the location of the cancer;
• To determine if the cancer has spread or affects the functions of other organs in the body;
• To restore the appearance or function of the body;
• To relieve side effects;

You can undergo surgery in a doctor's office, clinic, surgical center, or hospital. The location of the procedure depends on the type of surgery and the time needed for recovery. If you are hospitalized, you will need to spend a night or more in the hospital to recover from the operation. Outpatient surgery means you do not need to spend the night in the hospital before or after the operation.

Types of Cancer Surgery

Diagnostic

For most types of cancer, a biopsy is the main way to diagnose cancer. During a surgical biopsy, the surgeon makes an incision in the skin and removes some or all of the suspicious tissue.

After a biopsy, a pathologist examines the removed tissue under a microscope. A pathologist is a doctor who interprets laboratory tests and examines cells, tissues, and organs for disease. The pathologist then gives a pathology report to the oncologist, who reviews the report and diagnoses the tumor.

Tumorectomy

Tumor removal, also called curative surgery or tumorectomy, is most often used to remove the tumor and some of the surrounding healthy tissue (the margin).

Tumor removal may sometimes be the only treatment for the tumor. It can also be combined with other treatments, such as chemotherapy or radiation therapy.

For this type of procedure, the surgeon makes large incisions through the skin, muscles, and sometimes bone. Sometimes, less invasive surgical techniques can be used, speeding up recovery and reducing post-surgical pain.

Debulking

Sometimes, the surgeon cannot remove all of the tumor, or removing it could cause too much damage to the body. In these cases, surgery is used to remove as much of the tumor as possible. Other treatments, such as radiation therapy or chemotherapy, may be used after surgery to continue treating the cancer. These treatments may also be given before surgery to help shrink the tumor so it can be removed by surgery.

Palliative Surgery

Palliative surgery relieves side effects caused by a tumor, greatly improving the quality of life for people with advanced cancer or widespread disease. For example, surgery can be used to:

• Relieve pain or restore physical function when a tumor causes the following problems:
• Pressure on a nerve or the spinal cord;
• Blockage of the bowel or intestines;
• Pressure or blockage elsewhere in the body;
  • Stop bleeding: Some cancers are more likely to cause bleeding:
  • Cancers located in areas with a large amount of blood vessels, such as the uterus;
  • Cancers located in delicate organs can easily bleed during the passage of food and waste, such as the esophagus, stomach, and intestine;

Bleeding can also be a side effect of some medications used to treat cancer. When surgery is needed to stop bleeding, a common technique is suture ligation, which ties off blood vessels using surgical thread.

Reconstructive Surgery

After the main operation to remove a tumor, another operation may be chosen to restore the appearance or function of the body. This is called reconstructive or plastic surgery. Reconstructive surgery can be done at the same time as tumor removal surgery or after the person has healed or after additional treatment. Examples include breast reconstruction after a mastectomy and surgery to restore appearance and function after head and neck surgery.

Preventive Surgery

Surgery is also performed to reduce the risk of getting cancer. For example, doctors often suggest removing precancerous polyps in the colon to prevent colon cancer. Also, women with a strong family history of breast or ovarian cancers or known mutations in the BRCA1 and BRCA2 genes may choose to have a mastectomy (breast removal) or oophorectomy (ovary removal) to reduce their risk of developing these cancers.

Making Decisions About Cancer Treatment

After a cancer diagnosis, individuals and their families must make several treatment decisions. These decisions are complicated by anxiety, unfamiliar terminology, statistics, and a sense of urgency. However, unless the situation is extremely urgent, take time to explore your options, ask questions, and talk to family or a trusted friend.

Decisions about cancer treatment are personal, and you should feel comfortable with your choices. Many people, however, don't know where to start.

Individual treatment plans depend on the type and stage of cancer. Learn as much as possible about your specific diagnosis and ask your healthcare team questions. Be cautious when researching online, as many sites can be frightening, inaccurate, or misleading. Your healthcare team can suggest reliable websites.