Cancer Surgery

Cancer surgery can have many purposes, including curing cancer, reducing cancer cells, reconstruction and relief.

Curative Surgery

This procedure aims to remove your cancer completely. (4) It's a curative approach to cancer care and can be done with or without chemotherapy.

Debulking Surgery

Debulking surgery involves physically reducing the size of your tumour. It is done when the cancer cannot completely be removed because of its location or the effect a complete removal would have on you. (5)

Palliative Surgery

This is done to relieve your symptoms. (6) Your care team decides on palliative surgery when your cancer cannot be cured surgically but surgery may help relieve your distress. For example, if a cancer is compressing your vital organs or causing you a lot of pain, surgery can be done to relieve those symptoms.

Reconstructive Surgery

These surgeries are done to restore the appearance or function of a part of your body. (7) For example, you can receive reconstructive breast surgery after a mastectomy or after removing a tumour from your face.

Preventive (Prophylactic) Surgeries

Prophylactic (risk-reducing) surgeries remove tissue or organs that are at high risk of developing cancer, for example in people with certain inherited gene changes (such as BRCA 1/2 or the FAP gene changes). (8) 

Different surgical techniques can be applied in the treatment of cancer. The choice of surgical procedures depends on the cancer involved, your individual circumstances, the skills of your care team and the expected response to that surgery. 

Open Surgery

This is the “traditional” kind of surgery. Here your surgeon makes an open cut on your body and removes the cancer from that open cut. (9)

Minimally Invasive Surgery

This involves much smaller incisions than those from open surgery. Because the incisions are small, wound healing happens faster and you recover faster. (10)

Minimally invasive approaches (including laparoscopic and robotic-assisted surgery) often lead to less pain, shorter hospital stays and faster recovery compared with traditional open surgery, while aiming for the same cancer control outcomes.

Laparoscopic Surgery

During laparoscopic surgery, the surgeon makes several small incisions and uses a small camera and specialised surgical instruments to perform the operation. (9)

Robotic Surgery

These high-precision surgeries use robotic systems controlled in real time by a surgeon to remove tumours. (11)

Laser Surgery

Laser surgery involves using a laser, which is a beam of focused light, to remove cancers. (12)

Mohs Surgery

This is done on an outpatient basis and is used to treat skin cancers. (13) Your surgeon removes layers of your skin and sends them for analysis.

Thoracic and VATS Surgery

These are types of surgery used for lung cancers. They are video-assisted surgeries (VATS) where the surgeon uses a video camera to look for cancer and take it out. (14)

Cryosurgery

Cryosurgery, also called cryotherapy or cryoablation in some settings, uses extreme cold to destroy abnormal or cancerous tissue. (15) Cryosurgery is commonly used for skin cancer, prostate cancer, liver cancer and cervical cancer. 

Cancer surgery is performed with a team of surgeons, anaesthesiologists, nurses, and other assistants in sterile environments.

Before Surgery

Before surgery, you will receive preoperative care, which involves making sure you are fit for surgery. You'll go for several tests, such as a full blood count and viral screening, among others. An anaesthesiologist will plan the best kind of anaesthesia for you. Some people receive general anaesthesia, while others receive local anaesthesia just for the area that will be operated upon. Your surgical team will brief you, providing all the information you should have. Optimising nutrition, fitness and other measures such as smoking cessation before surgery can improve outcomes.

During Surgery

Before the procedure begins, you will receive the type of anaesthesia planned for your operation. During surgery, the surgical team will remove all or part of the tumour according to your treatment plan. Depending on the operation, some surrounding tissue and/or nearby lymph nodes may also be removed.

Immediately After the Surgery

You will be transferred to a recovery room where you'll be monitored immediately after your surgery for complications or other possibilities. You'll be given pain medication to help manage your pain, and your recovery will begin. Neoadjuvant (before) and adjuvant (after) combination treatments with chemotherapy/radiotherapy are common after surgery.

The risk and limitations of cancer surgery depend on the kind of procedure you've received and your overall state of health. Successful surgeries depend on the type and stage of cancer, whether clear margins can be achieved, the presence of lymph nodes involvement, your overall fitness for surgery and any additional treatments given before or after the operation. Early stage and localised cancers have the best chance of cure with surgery.

Common Surgical Risks 

These are generally more expected than other risks, and include:

• Infection: where bacteria get into the wound and cause inflammation. 
• Bleeding: can happen during the surgery or after the surgery. Bleeding can be due to faulty sutures, sloughing off of skin, or moving too early. 
• Pain
• Anaesthesia complications: such as unexpected loss of consciousness and others. 

Cancer-Specific Risk

These include:

• Damage to nearby organs.
• Changes in how your organs function: for example, your digestive tract may shrink in size if too much of it is taken out. 

Limitations of Surgery

Not all cancers can be surgically removed, like liquid cancers. And even when cancers are removed surgically, they can also recur. 

Success Rate of Cancer Surgery

The success of cancer surgery depends on:

• The type of cancer: Cancers in areas that are accessible by surgery also have better success rates, because your doctor will find it easier to remove the tumour when he can reach it. Skin cancer, early-stage breast cancer and uterine cancer are easy to reach because of their location, whereas pancreatic cancer, brain cancer, and lung cancer are harder to reach. 
• The stage at which you receive surgery: receiving surgery in early stages increases the likelihood that it will work and you will be cancer-free. In later stages, cancers tend to spread and are harder to remove completely. (16)
• Your overall state of health.