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Cancer Surgery

Surgery is the oldest form of cancer treatment and is still used extensively today.  An estimated 60% of cancer patients will undergo surgery during their cancer journey.  In many cancers, including rare ones, surgical removal of the tumor (with clean margins) is still the primary treatment.  Cancer surgeries are done by general surgeons or surgeons who specialize in only cancer related surgeries.  Surgical oncology has become a medical field of it's own, although it does not currently have a separate board certification.  Surgery, as a cancer treatment, may be used for many purposes, including:

Curative - removal of the complete tumor including clean margins.

Cytoreductive (debulk) - removal of the majority of the tumor, leaving necessary organs in place.  

Diagnostic - removal of tissue samples for testing and evaluation.

Palliative - to relieve discomfort and improve the patient's quality of life.

Preventive (prophylactic)- removal of tissue that does not yet contain cancer cells, but has a high risk of turning cancerous.

Restorative (reconstructive surgery) - repair or replace damaged or destroyed areas of the body.

Supportive - surgical placement of a device that will aid in the delivery of medications.

Surgery is sometimes used as the only treatment for a cancer.  Some treatments are used as adjuvant treatments to surgery; such as radiation and chemotherapy.  If an adjunct treatment is to be used, surgery is usually done first.  But there are situations where other treatments are done prior to surgery.  For example, the tumor may be irradiated to bring it down to a manageable size for the surgeon.  Surgical procedures for cancer often include:

Biopsy - removal of sample of tissue via a hollow needle or scalpel.  May include colposcopic, core, endoscopic, excisional, fine needle aspiration (fna), incisional, and stereotactic procedures.  

Cryosurgery (cryotherapy)- use of extreme cold (liquid nitrogen) to kill cancer cells. 

Electrocauterization - process of destroying tissue by using chemical corrosion, electricity, or heat.

Electrosurgery - use of high-frequency electrical currents to destroy cancer cells.

Endoscopy - use of a flexible tube with a camera, allowing the surgeon a view inside the hollow area of the body.  Biopsies can be taken through the tube by inserting the required instruments.

Excisional - cutting away the tumor with a scalpel or other instruments to completely remove it.

Laparoscopy - insertion of a viewing tube with a camera attached through a small incision in the abdomen to examine it's contents and biopsy tissue, if necessary.

Laser surgery - uses a powerful, precise beam of light, in place of a scalpel.  This procedure is often used with fiber optic technology to reduce the invasiveness of cancer surgeries.

Photodynamic - utilizes lasers to activate light sensitive pharmaceuticals used to destroy cancer cells.

You can read more about surgical oncology at:

CancerHelp UK - about cancer surgery as a treatment.

Cancer Index - offers links for specific oncological surgery topics and journals.