Surgery

What is Cancer Surgery?

Cancer surgery is an operation or procedure to take out a tumor and possibly some nearby tissue. It is the oldest kind of cancer treatment, and it still works well to treat many types of cancer today. A doctor who specializes in cancer surgery is called a “surgical oncologist.”

You might have surgery to remove a tumor, help your body work the way it used to, or relieve side effects. You might also need surgery to find out:

  • If you have cancer
  • Where the cancer is located
  • If it has spread or is affecting other organs in the body

Surgery can be performed in a doctor’s office, clinic, surgery center, or hospital. Where you go depends on the type of surgery and how much time you need to heal. Your surgery may require medication to block the awareness of pain, called anesthesia. There are different types of anesthesia depending on the type and extent of the surgery.

If you need to stay in the hospital overnight or for several days after surgery, it is called inpatient surgery. Or you might not need to stay in the hospital at all. If you can go home the same day, it is called outpatient surgery or ambulatory surgery.

What are the different types of cancer surgery?

Surgery can be done for many different reasons in a person’s cancer care.

Diagnosis. A biopsy is the main way to diagnose many types of cancer. There are different kinds of biopsies. For some types, your doctor will make a small cut in the skin to remove some tissue. They may take a small sample or the entire tumor. Other types of biopsies, including fine needle aspiration and image-guided biopsies, use needles for less invasive procedures. Learn more about the different types of biopsies used for diagnosis.

After a biopsy, a pathologist looks at the tissue under a microscope. A pathologist is a doctor who looks at cancer cells, tissues, and organs to find disease. They tell your oncologist what the pathology report shows.

Staging. Staging surgery is done to learn how large the tumor is, if it has spread, and if so, where. Your doctor may remove the entire tumor or take a sample. They may also take some lymph nodes near the cancer to learn if it has spread. Surgical removal of lymph nodes is also called a lymphadenectomy. Your lymph nodes are small, bean-shaped organs that help fight infection. They are often the first place a cancer spreads. As imaging scans get more advanced, more and more staging is done using imaging studies like ultrasounds, CT scans, MRIs, and X-rays.

A pathologist will look at the tissue and talk with your oncologist about what they find. The results of staging surgery and other tests help you and your doctor decide on treatment. The results can also help predict your chance of recovery.

Tumor removal. Removing a tumor is a common type of cancer surgery. This may also be called a “resection” or “excision.” Your doctor usually takes out the tumor and some of the healthy tissue near it. The tissue around the tumor is called the margin.

Tumor removal generally requires a larger incision, or cut, than a biopsy. Sometimes, there are less invasive surgical options for tumor removal, like laparoscopic surgery or robotic surgery. These use small instruments and incisions. With a less invasive surgery, you usually have less pain and recover faster.

Surgery may be the only cancer treatment needed. Or, you might also have additional treatments, like chemotherapy or radiation therapy.

Debulking. Debulking is a surgery that removes part, but not all, of a tumor. Your doctor may not always be able to remove the entire tumor. It might damage other parts of your body or it might be too large. Debulking removes as much of the tumor as possible.

Chemotherapy, radiation therapy, or other treatments might be given before or after this type of surgery. This can help shrink the tumor and treat the cancer.

Palliative surgery. The goal of palliative surgery is to relieve side effects caused by a tumor. It can improve your quality of life if you have advanced cancer. Examples are operations that can:

  • Relieve nerve pain or pressure
  • Remove a block in the digestive system or other area
  • Stop bleeding
  • Put in a feeding tube or port for medication
  • Prevent broken bones

Reconstructive surgery. Treating cancer can change the way you look or how your body works. Reconstructive surgery can help with the effects of cancer treatment. Sometimes, reconstructive surgery is done at the same time the tumor is removed. Or you might wait until you have healed or had other treatments.

Examples of reconstructive surgery include breast reconstruction after a mastectomy and surgery to restore appearance and function after head and neck surgery.

Learn more about reconstructive surgery.

Prevention. You might have surgery to lower the risk of getting cancer. For example, if a small growth called a polyp is found during a colonoscopy, surgery is usually recommended to remove it. This is because polyps can turn into colon cancer.

Another example is when some people with a high risk of breast or ovarian cancer have their breasts or ovaries removed. This might be because they have a strong family history of these types of cancer or mutations to the BRCA1 or BRCA2 gene. People with these mutations are more likely to get breast and ovarian cancers. Having these preventive surgeries lowers their risk.

The type of surgery you have will depend on the type of cancer or cancer risk you have. You can learn more about common types of surgery for specific types of cancer in another section of this website.

Are there differences in surgical techniques?

Cancer surgery is often a major surgery. That’s why researchers continue to work on ways to reduce surgery’s overall effects on the body.

In an “open surgery,” 1 large cut (incision) is often needed. Recovery from an open surgery can take a while. Be sure to talk about the expected recovery time period with your health care team before having your operation. This conversation should include whether you may need help at home, called caregiving, during your recovery.

Sometimes, the surgeon may have an option to use a less invasive surgical technique for your surgery. “Minimally invasive surgery” uses smaller incisions compared to an open surgery. This approach also uses a camera, small instruments, and other equipment. The benefit of minimally invasive surgery is a faster recovery time with less pain. At-home caregiving may still be needed (see above). Some of the common types of minimally invasive surgery are listed below.

Laparoscopic surgery. During laparoscopic surgery, the doctor makes several small cuts in the skin. They insert a thin, lighted tube with a camera through one of the incisions. They place small instruments through the other cuts to do the operation. There are different types of laparoscopic surgery, depending on the area where it is done. Your doctor may also use a robot to do this type of surgery. They control the instruments that are on robotic arms.

Laser surgery. A narrow beam of high-intensity light is used to destroy tissue.

Cryosurgery. Liquid nitrogen is used to freeze and kill abnormal cells.

Mohs surgery. This type of surgery is done to treat skin cancer. It is also called microscopically controlled surgery. One thin layer of the cancer is removed at a time. They look at each layer under a microscope, and keep taking layers until every cell in the layer looks normal.

Endoscopy. This type of surgery takes samples of tissues for your doctor or a pathologist to look at. Endoscopies are used to look at tissue within organs, like your colon, bladder, or elsewhere in the body. It uses a thin, flexible tube with a light and camera on the tip. Your doctor puts the tube into your body through your mouth, nose, or other opening. They can also use a tiny instrument to take samples of tissue. Learn more about the different types of endoscopy.

New surgery techniques are being developed on a regular basis. Ask your doctor what all your surgical options are and how they compare to each other in terms of treatment effectiveness, side effects, recovery time, and cost.