Definition & Overview

Oncology surgery is a branch of medicine that refers to a method of treating cancerous tumours. Its main goal is to surgically remove the abnormal cancerous growths that infect the body. Although physically removing the cancer does not always completely cure the disease, it is considered as an important component of cancer treatment. It is, in fact, considered as the foundation of cancer management, and is often supplemented with chemotherapy, radiation therapy, and biologic treatments. This branch is becoming more distinct from general surgery as more and more specialized cancer treatment centres are established in response to the growing rate of the disease. It is also continually growing as traditional surgical techniques are improved by modern, less invasive ones.

Who Should Undergo & Expected Results

Oncology surgery refers to a medical treatment that is required to treat people suffering from the disease due to the presence of a cancerous growth. The surgery can either remove the malignant growth or repair the part of the body that has been affected by the disease. Thus, cancer surgery, as it is referred to, is categorized based on the procedure’s specific purpose, which include the following:

  • Preventative surgery – Those who have a high risk of developing cancer due to family history or a pre-existing genetic condition can undergo cancer prevention even without the presence of a malignant tumour. This is to prevent the cancer from developing in the first place. This form of oncology surgery removes the tissues or organs that are susceptible to the type of cancer that the person is at risk of developing. For example, a woman with a family history of breast cancer may choose to have a [mastectomy(https://www.docdoc.com/info/procedure/breast-cancer-screening) even without a cancer diagnosis.

  • Diagnostic surgery – Oncology surgery is also sometimes performed to confirm a suspected cancer, usually by taking a small sample of the tumour so that it can be studied under a microscope. This procedure, called a biopsy, can be done using minimally invasive techniques, and is the most effective way of determining whether a tumour is malignant or benign (non-cancerous).

  • Determination of cancer stage – Cancer staging may also require some surgery; this is done to determine the extent of the disease, which is an important factor in creating a treatment plan for the patient. This form of surgery evaluates the size of the tumour and checks whether the body’s lymph nodes have already been affected.

  • Initial treatment - In many cases of cancer, surgery is the primary course of treatment with the highest chances of success since the procedure will remove the malignant tumour from the body. If the infection is localized and has not spread to other parts of the body, the surgery may be enough to treat the disease. Otherwise, the patient will require other therapies.

  • Relieving symptoms – Cancer surgery is also used to relieve the symptoms that a patient experiences due to the disease, such as pain caused by a tumour that’s pressing on a nerve or a tumour that’s constricting the intestines.

How Does the Procedure Work?

Cancer surgery is performed in many possible ways using either traditional or modern surgical techniques. Traditional cancer surgery removes a malignant tumour completely from the body; to do so, the surgeon has to make an incision to remove not just the infected tumour but also some of the healthy tissue that surrounds it; this ensures that the cancer will be fully removed. In some cases, affected lymph nodes are also surgically removed.

Aside from traditional open surgery, cancer can also be surgically treated using specific technologies, such as:

  • Cryosurgery – This type of surgery works by freezing the tumour to destroy the cancer cells. This also works for preventative oncology surgery.

  • Electrosurgery –This type of surgery uses high-frequency electrical currents to destroy the cancer cells. This is most effective for skin or mouth cancers.

  • Laser surgery. Laser technology is another effective tool for treating cancer, as the high-intensity laser beams are capable of shrinking and vaporizing the cancerous cells in the body. This is a widely preferred surgery because laser technology allows the surgeon to target only specific cancer-infected cells, thus minimizing the collateral cell damage.

  • Laparoscopic surgery – Laparoscopic surgery is a breakthrough surgical technique that is in use nowadays not only in oncology surgery but also in other surgical branches. The concept of laparoscopic surgery is to use a scope-like tool to see and perform operations inside the body without having to make large cuts. What used to be one large incision is replaced by several smaller ones through which a tiny camera and other surgical tools are passed. Several patients opt for laparoscopic surgery because it causes less pain and allows them to recover faster.

  • Robotic-assisted surgery - Robotic-assisted cancer surgery allows the surgeon to perform the surgery while guided by a 3D image of the affected area. Surgical tools are then connected to hand controls that allow the surgeon to perform the surgery simply by maneuvering the controls. This is often reserved for operating in areas that are difficult to access.

  • Mohs surgery – Most effective for removing cancer cells affecting sensitive skin areas, Mohs surgery is a procedure that removes the cancer growth layer by layer until all the affected cells are removed.

  • Orifice surgery – Currently still being developed, this cancer surgery technology aims to remove affected cells in the abdominal organs without making an incision. The surgical tools take advantage of the body’s natural orifice openings, i.e. the mouth, vagina, or rectum.

Specific types of cancers may also require specialized surgeries, categorized either by the type of cancer they treat or the technology used in the surgery. Lung cancers often require the surgical removal of one or both lungs, procedures that are respectively known as lobectomy and pneumonectomy. In the case of breast cancer, the patient may require a mastectomy, which refers to the removal of the entire breast, or a lumpectomy, in which only a portion of the affected breast is removed.

Possible Complications and Risks

All surgical procedures have risks. Cancer surgery poses the risk of:

  • Pain –It is normal to experience pain following a surgical operation to remove a cancer. Some procedures, however, may cause more pain due to the location of the cancer, its extent, and the technique used.

  • Infection – As with any surgery, the site where the surgery was conducted becomes susceptible to infection especially in the time immediately after the surgery. A patient’s attending physician or oncologist will provide proper post-operative care instructions to keep infection at bay. If an infection sets in, the patient will require antibiotics.

  • Altered or compromised organ function – There is no guarantee that the affected organ or body part will function normally following a cancer treatment surgery. In fact, some surgeries may require the removal of an entire organ. Following the surgery, the patient will be taught how to live with compromised or altered organ function.

  • Blood clot – Although the risk of developing a blood clot is very small, it is one risk that almost all types of surgeries carry. This serious complication occurs usually during the recovery stage and can cause a lot of pain and swelling.

  • Bleeding - Like with any surgery, cancer surgery carries a certain risk of bleeding.

Your oncology surgeon will take all necessary precautions to prevent these complications and risks from developing. If you have any concerns prior to the surgery, be sure to discuss them with your surgeon and oncologist.

References:

  • National Cancer Institute. Chemotherapy and you: support for people who have cancer. Available at: http://www.cancer.gov/cancertopics/coping/chemotherapy-and-you. Accessed January 8, 2015.

  • Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloff's Clinical Oncology. 5th ed. Philadelphia, PA: Elsevier Churchill Livingstone; 2014.

  • Perry MC. Approach to the patient with cancer. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 182.

  • Siegel RL, Miller KD, Jemal A. Cancer statistics, 2015. CA Cancer J Clin. 2015;65:5-29.

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