Cancer Surgery

Cancer surgery is a procedure to remove part or all of a cancerous tumor or cancerous tissue. Surgery has been part of cancer treatment for a very long time. In the beginning, healthcare providers only used surgery to remove tumors. Now, a surgical oncologist may use cancer surgery to:

• Diagnose cancer: They may do a biopsy to get small pieces of tissue to look at under a microscope. They use biopsy and other test results to set a cancer stage.
• Remove a tumor: Sometimes, it may be the only cancer treatment you’ll receive. For example, eliminating a single tumor that hasn’t spread may cure cancer.
• Ease symptoms: You may have debulking surgery for pain if a tumor presses on nerves or organs.
• Restore or rebuild: You may have reconstructive surgery to repair changes in your body after cancer surgery.
• Prevent cancer: People with high cancer risk may have surgery to keep cancer from developing in a specific organ. A prophylactic mastectomy is an example.

Types of cancer surgery

The different types of cancer surgery are:

• Open surgery: Your surgeon makes a large cut through your skin to reach and remove a cancerous tumor.
• Minimally invasive surgery: This procedure involves making small cuts and using other techniques.
• Electrosurgery: Electricity kills cancer cells. A dermatologist may use it to treat skin cancer.
• Cryoablation: Cryoablation uses very cold gas to freeze and kill cancer cells. It’s a treatment for many cancer types.

Your surgeon and cancer care team will recommend a specific surgery based on the type of cancer you have, cancer stage, your health and your preferences.

What conditions does this procedure treat?

Cancer surgery treats many kinds of cancer, including the most common ones:

• Breast cancer in women: A mastectomy is an example of open cancer surgery. It involves removing all or part of your breast. A lumpectomy to remove a single tumor is a form of minimally invasive breast cancer surgery. Cryoablation may be another option.
• Colon cancer: Your surgeon may take out parts of your colon or just cancerous or precancerous polyps.
• Lung cancer: Surgeons may remove all or part of your lungs. They may do open surgery or video-assisted thoracic surgery (VATS). They may also use cryoablation.
• Prostate cancer: This may be an open or minimally invasive prostatectomy or cryoablation.
• Skin cancer: Mohs surgery and electrosurgery are common treatments for skin cancer.

How should I prepare for cancer surgery?

Your surgery preparation will depend on your situation. Your cancer care team will explain what you need to do to get ready. Some procedures don’t involve incisions (cuts) and regional or general anesthesia. You may not need to do anything before surgery.

The case is different if you’re having open or minimally invasive cancer surgery. For example, you may have:

• Prehabilitation: This is cancer rehabilitation treatment so you’re in the best physical shape for surgery.
• Neoadjuvant therapy: This treatment shrinks a tumor before surgery. Shrinking it makes it easier to remove. You may have chemotherapy, hormone therapy, monoclonal antibody therapy or radiation therapy before your surgery.

Closer to your surgery date, your cancer care team may tell you to:

• Stop taking certain medications
• Avoid alcohol and tobacco
• Plan to be in the hospital for a day or several days after surgery
• Plan for someone to take you home
• Stop eating and drinking at a certain time

What happens during cancer surgery?

That depends on the specific procedure. For example, Mohs surgery for skin cancer is an outpatient procedure. You have local anesthesia before your surgeon takes thin slices of the tumor. You can go back to work or straight home afterward.

Your experience will be very different if you have open surgery for lung cancer. In that case, you’ll have general anesthesia so you’re asleep during surgery.

Your surgeon will make a large cut through your skin. They’ll spread your ribs to get to the cancerous tumor and tissue. They’ll insert a drain tube in your chest to drain fluid. The surgery may take up to six hours to complete. You’ll need to stay in the hospital for two to three days.

While surgery is common cancer treatment, the specific process is different depending on cancer type, stage and your overall health. Your surgeon will explain what you can expect. That may be a lot of information to take in .Don’t hesitate to ask questions or ask them to repeat information.

What are the potential benefits and risks of cancer surgery?

Surgery is an essential part of your treatment. It may be a cure if you have a single small tumor that hasn’t spread from where it started.

Like all surgeries, there are risks involved, including:

• Anesthesia complications
• Damage to nearby tissue and organs
• Excessive bleeding
• Infection
• Pain

Your cancer care team will explain potential risks. This is important information. Don’t be shy about asking questions, like what the cancer care team does to reduce risk.

What happens after this procedure?

Your cancer care team will explain what you can expect after your surgery. For example, they may give you information about:

• Caring for surgical wounds if you have open or minimally invasive surgery
• Avoiding certain activities as you recover
• Managing pain
• Eating well

You may have other treatments after surgery, including chemotherapy or radiation therapy to kill any remaining cancer cells.

When should I call my healthcare provider?

After you go home after surgery, contact your cancer care team right away if you have:

• Bleeding that you can’t control
• Infection symptoms like chills and fever, or pus draining from the surgery site
• Pain that doesn’t ease even after you take recommended or prescribed pain medication

Is cancer surgery always an option?

Surgery is often the first choice if the tumor is small and hasn’t spread from where it started. But factors like tumor location, size and your health can affect your ability to have cancer surgery:

• Tumor location: Your surgeon may not recommend surgery if a tumor is very close to major blood vessels or certain organs that may be damaged during surgery. But there are nonsurgical treatments that may work well against the tumor.
• Tumor size: Very large tumors may be hard to remove safely. In some cases, debulking surgery or other cancer treatments to shrink the tumor can make it small enough for surgery.
• Your health: Some cancer surgery can be tough on your body. You’ll have tests to confirm you’re strong enough to manage surgery and recovery. Your surgeon may suggest you work with a nutritionist before surgery.

Can cancer surgery make cancer spread?

No, surgery doesn’t cause the cancer to spread. Very rarely, a biopsy to get tissue samples of certain cancerous tumors may cause cells to spread. If that’s a possibility, your surgeon may remove the tumor without doing a biopsy.

Does surgery always get rid of cancer?

Often, removing a cancerous tumor cures the disease. But sometimes, surgery and follow-up treatment may miss tiny cancer cells that tests don’t detect. In that case, cancer may come back or form in another area of your body.