The process of removing tumor and/or surrounding tissues with the help of an operation is known as Surgery. Surgical oncologists perform surgery for various different purposes such as:
- For diagnosing the cancer
- To find out the exact location of cancer
- To identify whether the cancer is spreading or damaging any other organs of body.
- For removing cancer fully or partially
- Surgery can be performed to reinstate appearance or a bodily function or to mitigate the side effects of cancer
There’s a term called ‘Outpatient Surgery’ meaning that the patient isn’t required to stay at the hospital overnight while an ‘Inpatient Surgery’ requires the patient to stay at the hospital for longer duration in order to monitor the success of surgery.
Types of Surgeries
The Surgical Biopsies are one of the most effective ways of diagnosing cancer. An incision is made in the skin to take out the suspicious tissues. Biopsies can be of two types depending on the procedure which is carried out for surgery – Incisional biopsies only remove a small part of suspicious tissue for further inspection while in Excisional biopsies the entire affected area is removed. Pathologists then observe the tissues which are removed through biopsy to provide a report after performing different lab tests in order to help the oncologist identify the disease
As you might already know, cancer has different stages which refer to the size of the tumor. The purpose of Staging surgery is to identify the size and the location of the tumor. Staging is an effective way for the prediction of Prognosis – the chances of recovery from cancer. The procedure involves eradication of Lymph nodes (small bean shaped organs which usually resist contagion) surrounding the cancer affected area to understand if it is spreading. The removed lymph nodes are then examined to recognize the possible treatments and recovery options.
3. Primary Surgery
Primary surgery is also referred to as Curative surgery as the procedure involves removing the tumor and margins (the healthy tissues around the tumor). Sometimes, Primary Surgery is merged with Chemotherapy or Radiation therapy to obtain optimum results.
With conventional surgery, the surgeon makes large incisions through skin, muscle, and sometimes bone. In some situations, surgeons can use surgical techniques that are less invasive. These less-invasive techniques may speed recovery and reduce pain afterwards. Learn more about types of minimally invasive surgery below.
Biopsies, Staging & Primary Surgery are conventional types of surgery while Debulking is a less invasive procedure. Debulking is usually performed when removal of whole tumor might cause a lot of damage to patient’s body. Therefore, the focus is to take out the tumor only as much as it won’t be harmful to the body. The treatments like chemotherapy or radiation therapy can be used to shrink the cancer in this case, before or after debulking.
The purpose of Palliation or Palliative surgery is to alleviate the side effects of tumor on a patient’s body. This helps them relieve various complications due to cancer such as strain on a nerve, strain on the spinal cord, minimize the pain, stop bleeding in case of uterus or stomach or bowel, blocked intestines or other blockages in body.
Some drugs for cancer have their side effects and can cause bleeding, in that case a surgery is performed to tie blood vessels with surgical thread, known as Suture Litigation.
Palliation also includes inserting a single or multiple tubes into patient’s stomach or vein to feed and medicate them if the cancer has disabled them to eat. Insert a feeding tube or tubes that deliver medications if the cancer or treatment has made it difficult to eat. A feeding tube is inserted directly into the stomach or intestine through the abdominal wall.
Cancer causes weakening of bones which can be easily broken and the recovery is too slow. Therefore, doctors insert metal rods to prevent any such damage.
The reconstruction or plastic surgery is carried out at the time of or after the primary surgery to reform the appearance or in some cases to regain the bodily functions. Commonly, the reconstructive surgery is done after mastectomy for breast reconstruction and after the primary surgery for head or neck.
As the name suggests, Preventive surgery is done to avoid cancer. Precancerous Polyps which is called Adenoma is removed because the larger the adenoma, the greater is the risk of cancer. The risk of cancer means there are chances of pre-cancerous cells present in Polyps. Therefore, the cancer specialists advise removing the precancerous polyps in the colon which diminishes the chances of colon cancer.
Women with breast or ovarian cancer in family history are more prone to cancer. In cases of breast cancer Mastectomy and in case of ovarian cancer Oophorectomy is performed to remove the breast and ovary.
8. Laparoscopic surgery
This is another less-invasive cancer treatment in which the surgery is performed by oncologists through small incisions but far from the exact location of cancer. Generally, the incisions are made 0.5 to 1.5 cm away from where the cancer is located. Due the procedure followed in this kind of surgery it is also known as Band-Aid Surgery or Keyhole Surgery. Laparoscopic surgery refers to the abdominal surgery which is less-invasive in nature. Given to the advancements of medical sciences, robotic surgeries can also be provided in case of Laparoscopic surgery.
While Mediastinoscopy is a surgery which is usually performed for Biopsy in order to diagnose the stage of lung cancer, sarcoidosis or lymphoma in the mediastinum. Thoracoscopy is the term which is used for the procedure of inserting thoracoscope, a thin tube with the help of an incision to view and inspect mediastinum, pleura and lungs.
9. Laser surgery
As clear from its name, a Laser Surgery uses an optical fiber which is then inserted into the tumour and by using high intensity laser light at the end of the optical fiber, the cancerous cells are destroyed. Laser Surgery is the most successful in cases of cancer that occur on the surface of body and at an early stage. For e.g. vaginal cancer, vulvar cancer, penile cancer and cervical cancer.
The Cryosurgery is used by Cancer Cross to destroy the cancerous cells just like in Laser surgery but instead of lasers, this kind of surgery uses liquid nitrogen or argon gas due to their extreme cold temperature. They help in freezing the harmful cells and kill them. Cryosurgery is also referred to as Cryotherapy by some oncologists. It works best for treating external cancers such as skin tumors.
11. Mohs Surgery or Chemosurgery
Named after Frederic E. Mohs, this kind of surgery is now performed with some refinements. It is the only surgery that can successfully remove BCCs (Basal Cell Carcinomas) and SCCs (Squamous Cell Carcinomas) which are the most common occurring skin cancers. Mohs Surgery includes removal of a skin layer to remove the cancer while monitoring the next skin layer under a microscope to have all normal skin cells and keep doing so until a skin layer is free of all cancerous cells.
Endoscopy uses an endoscope which is inserted into the mouth, rectum or vagina for examination and identification of any abnormal or cancerous cells. The expert surgeons then use forceps and scissors on endoscope for removing the potential tissues for the purpose of diagnosis. This procedure only involves making small incision which is to insert the endoscope.