Ambulatory Surgical Procedures
About Cancer Surgery
Surgery has been used to treat cancer for many, many years. Surgery also plays a key role in diagnosing cancer and finding out how far it may have spread (a process is called staging). Ongoing advances in surgical techniques allow surgeons to operate on a growing number of patients and have good outcomes. When a surgeon has to cut into the body to operate, it’s called invasive surgery.
Today, operations that involve less cutting (less invasive surgery) often can be done to remove tumors while saving as much normal tissue and function as possible.
How is surgery used for cancer?
Surgery is done for many reasons. Some types of surgery are minor and may be called procedures, while others are much bigger operations. The more common types of cancer surgeries are reviewed here.
Preventive (prophylactic) surgery
Preventive or prophylactic surgery is done to remove body tissue that’s likely to become cancer – even though there are no signs of cancer at the time of the surgery. For example, pre-cancerous polyps may be removed from the colon during a colonoscopy. Sometimes preventive surgery is used to remove an entire organ when a person has an inherited condition that puts them at a much higher risk for having cancer someday. (An inherited condition is passed on from parent to child.) For example, some women with a strong family history of breast cancer are found to have an inherited change (mutation) in a breast cancer gene (called BRCA1 or BRCA2). Because their risk of getting breast cancer is high, these women may want to consider prophylactic mastectomy. This means the breasts are removed before cancer is found. Diagnostic surgery Surgery is often used to help diagnose cancer. In most cases, the only way to know if a person has cancer and what kind of cancer it is, is by taking out a piece of tissue (called a sample) and testing it. This is often called a biopsy. The diagnosis is made by looking at the cells of the sample under a microscope or by doing other lab tests on it. There are many ways to get a sample of cells from an area that looks like it might be cancer.
Staging surgery is done to find out how much cancer there is and how far it has spread. The physical exam and the results of lab and imaging tests are used to figure out the clinical stage of the cancer. But the surgical stage (also called the pathologic stage) is usually a more exact measure of how far the cancer has spread.
Curative surgery is usually done when cancer is found in only one part of the body, and it’s likely that all of the cancer can be removed. In this case, curative surgery can be the main treatment. It may be used alone or along with other treatments like chemotherapy or radiation therapy, which can be given before or after the operation. Sometimes radiation therapy is actually used during an operation. (This is called intraoperative radiation therapy.)
Debulking surgery is used to remove some, but not all, of the cancer. It’s sometimes done when taking out all of the tumor would cause too much damage to nearby organs or tissues. For example, it may be used for advanced cancer of the ovary and some lymphomas. In these cases, the doctor may take out as much of the tumor as possible and then treat what’s left with radiation, chemotherapy, or other treatments.
This type of surgery is used to treat problems caused by advanced cancer. Palliative surgery can be used to correct a problem that’s causing discomfort or disability. For example, some cancers in the belly (abdomen) may grow large enough to block off (obstruct) the intestine. If this happens, surgery can be used to remove the blockage. Palliative surgery may also be used to treat pain when the pain is hard to control by other means. Palliative surgery helps ease problems caused by cancer and helps people feel better, but it’s not done to treat or cure the cancer itself. Supportive surgery Supportive surgery is done to help make it easier for people to get other types of treatment.