Cancer Treatment
Surgical Oncology
Certain types of cancer are treated most effectively by simply removing the tumor surgically. Surgery is the oldest form of cancer treatment and can also have an important role in diagnosing and staging cancer. Advances in surgical techniques have allowed surgeons to successfully operate on a growing number of cancer patients. Today, more limited (less invasive) operations are often done to remove tumors and to try to preserve as much normal function as possible.
Surgery is done for many reasons, often to accomplish one or more of these goals:
Preventive (or prophylactic) surgery is done to remove body tissue that is not malignant (cancerous) but is likely to become malignant. For example, this type of surgery may be used if you have a precancerous condition such as polyps in the colon. Preventive surgery is sometimes used to remove an entire organ when a person has an inherited condition that makes development of a cancer likely.
Diagnostic surgery is used to get a tissue sample to identify your specific cancer and make a diagnosis. The diagnosis of cancer often can be confirmed only by looking at the cells under a microscope. Several surgical techniques can be used to obtain a sample. These techniques are described in the next section.
Staging surgery helps determine the extent and the amount of cancer. While your physical exam and the results of lab and imaging tests can help determine the clinical stage of your cancer, surgical staging is usually a more accurate assessment of how far the cancer has spread.
Curative surgery is the removal of a tumor when it appears to be confined to one area. It is done when there is hope of taking out all of the cancerous tissue. Curative surgery is thought of as primary treatment of the cancer. Curative surgery may be used along with chemotherapy or radiation therapy, which can be given before or after the operation.
Debulking (or cytoreductive) surgery is done in some cases when removing a tumor entirely would cause too much damage to an organ or surrounding areas. In these cases, the doctor may remove as much of the tumor as possible and then try to treat what’s left with radiation therapy or chemotherapy.
Palliative surgery is used to treat complications of advanced disease. It is not intended to cure the cancer. It can also be used to correct a problem that is causing discomfort or disability. For example, some cancers in the abdomen may grow large enough to obstruct (block off) the intestine. This may require surgery for effective relief. Palliative surgery may also be used to treat pain when it is hard to control by other means.
Supportive surgery is used to help with other types of treatment. For example, a vascular access device such as a catheter port can be placed into a vein to help deliver chemotherapy treatments reducing the number of needle sticks needed.
Restorative (or reconstructive) surgery is used to restore a person’s appearance or the function of an organ or body part after primary surgery. Examples include breast reconstruction after mastectomy or the use of tissue flaps, bone grafts, or prosthetic (metal or plastic) materials after surgery for oral cavity cancers.
