Cancer Treatment Options

Surgery

Surgery is the oldest form of cancer treatment. It also plays a key role in the process of diagnosing cancer and finding out how far it has spread (a process is called staging). Advances in surgical techniques have allowed 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 is called invasive surgery. Today, operations that involve less cutting and damage to nearby organs and tissues (less invasive surgery) often can be done to remove tumors while saving as much normal tissue and function as possible.

Surgery offers the greatest chance for cure for many types of cancer, especially those that have not spread to other parts of the body. Most people with cancer will have some type of surgery.

How is surgery used for cancer?

Surgery can be done for many reasons. Some types of surgery are very minor and may be called procedures, while others are much bigger operations. The more common types of cancer surgeries are listed here.

Preventive (prophylactic) surgery

Preventive surgery is done to remove body tissue that is likely to become cancer (malignant), 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.

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 some day. For example, some women with a strong family history of breast cancer are found to have a change (mutation) in the DNA of a breast cancer gene (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

This type of surgery is used to sample tissues to find out if cancer is present or what type of cancer it is. The diagnosis of cancer is made by looking at the cells under a microscope. There are many ways to get a sample of cells from an area that looks like it may be cancer. These are described in the section, "Surgery to diagnose and stage cancer."

Staging surgery

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. To learn more about this, please see our information on Staging.

Examples of surgical procedures commonly used to stage cancers, like laparotomy and laparoscopy, are described in the section, "Surgery to diagnose and stage cancer."

Curative surgery

Curative surgery is done when a tumor is found in only one area, and it is likely that all of the tumor can be removed. Curative surgery can be the main treatment for the cancer. It may be used alone or along with 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 (cytoreductive) surgery

Debulking surgery is done to remove some, but not all, of the tumor. It is done when removing all of the tumor would cause too much damage to an organ or nearby tissues. In these cases, the doctor may take out as much of the tumor as possible and then try to treat what's left with radiation or chemotherapy. Debulking surgery is commonly used for advanced cancer of the ovary and some lymphomas.

Palliative surgery

This type of surgery is used to treat problems caused by advanced cancer. It is not done to cure the cancer. Palliative surgery can also be used to correct a problem that is 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.

Supportive surgery

Supportive surgery is done to help with other types of treatment. For example, a vascular access device such as a Port-A-Cath® or Infusaport® can be surgically placed into a large vein. The port can then be used to give treatments or draw blood, instead of putting needles in the arms.

Restorative (reconstructive) surgery

This type of surgery is used to improve the way a person looks after major cancer surgery, or to restore the function of an organ or body part after surgery. Examples include breast reconstruction after mastectomy or the use of tissue flaps, bone grafts, or prosthetic (metal or plastic) materials after surgery for head and neck cancers.

Source: American Cancer Society @ www.cancer.org