Surgery
Innovative new techniques are constantly transforming this ancient medical art.
Surgery is one of the oldest, most
effective, and most widely practiced
medical techniques. Surgeons
remove appendixes, restore vision,
and mend broken bones every
day. And while surgery has been
performed since the beginning
of human civilization, new
innovations and techniques
continue to make surgery one
of the most effective and versatile
cancer treatments today.
Most people with cancer
will undergo one or more
surgical procedures during
their treatment, and
in many cases surgery
offers the best chance
for a cure.
Here are some of
the ways that surgery
is used to help
prevent, diagnose,
and treat cancer:
- Preventive surgery
removes precancerous,
abnormal, and sometimes
normal tissue that could
become cancerous.
- Diagnostic surgery is used to
detect whether a disease is present.
In a biopsy, a small portion of
tissue is removed to find out if it
is cancerous.
- Staging surgery removes tissue to
see how widespread a cancer is.
- Curative surgery removes a tumor
that has not spread beyond its original
site. Your doctor may prescribe
chemotherapy or radiation after
surgery to treat any cancerous cells
that may have been left behind.
- Cytoreductive or debulking surgery
removes most, but not all, of a
tumor. Usually it’s followed with
chemotherapy or radiation to
destroy the rest of the cancer.
- Palliative surgery is performed to
relieve cancer symptoms.
- Reconstructive surgery rebuilds
tissue to restore the function or
appearance of a part of the body
that may have been affected by
cancer or during treatment.
Check the margins
During surgery to remove a tumor,
your surgeon will also remove some
of the tissue that borders the tumor,
known as the margin. After the operation,
a pathologist will examine this
tissue under a microscope for signs of
cancer cells. A clean margin shows no
cancerous cells, and means it’s likely
that all the cancer was removed from
the body. A positive margin contains
cancer cells, and your doctor will recommend
additional surgery or other
conventional treatment. Even people
with clean margins might benefit from
an adjuvant or additional therapy to
enhance the effectiveness of the primary
therapy. That’s because there’s
always a chance that undetected cancer
cells remain after surgery.
Most people feel anxiety about
surgery, from fears about the operation
itself to concerns about managing
pain or dealing with physical limitations
or changes after treatment. But
there are steps you can take to help
things go smoothly and get back to
your routine as quickly as possible:
Before
Ask questions. Find out exactly what
to expect before, during, and after
the procedure.
Take care of yourself. A healthy diet,
plenty of rest, and appropriate
physical activity prepare your body
for the challenges ahead. Smoking
can prolong recovery and may lead to
post-operative lung complications.
After
Be prepared. Ask your
care team how to look
after incisions and follow
instructions carefully
for taking your
medications. Find
out which side effects
are normal and
which might indicate
a complication. Make
sure you know whom
to contact if you
need help.
Know your limits. Ask
about any restrictions
with regard to working,
driving, and physical
activity, and follow
your doctor’s guidelines
carefully.
Follow next steps. Find out
when and how to start
rehabilitation and when to schedule
follow-up appointments.
An informed decision
Before your surgery, you’ll be asked
to sign a consent form. This is a
legal document confirming that
your doctor has fully explained the
operation, its risks, and your other
options. Before you agree, you’ll want
to make sure that surgery is the most
appropriate treatment. In some cases,
there may be less invasive treatment
options that may be as effective
for you.
Also, it’s a good idea to gather as
much information as you can about
the surgeons in the hospital where
you plan to have your operation.
Studies show that experienced
surgeons who regularly perform
complicated procedures have much
higher rates of success than doctors
who may be similarly qualified to
operate but do so less often.