Surgical Services

Overview

Surgery is one of the most effective ways of curing many types of cancer, especially those that have not spread to other parts of the body. Advances in surgical techniques have allowed surgeons to successfully remove tumors with less invasive operations. A minimally invasive approach--making several very small incisions and inserting robotic surgical tools to remove tissue--is used to diagnose the spread of a disease. This approach is now being used to sugical treat a number of cancers, including liver, lung, pancreatic, stomach, adrenal, cervical, ovarian, colon, endometrial, and esophageal.

About 70 percent of cancer patients will have surgery by itself or in conjunction with other therapies.

There are at least eight types of surgery:

• Preventive Removes noncancerous tissue that could become malignant, such as suspicious lesions on the skin, precancerous conditions (e.g., polyps in the colon), or organs that could be susceptible to cancer.
  
• Diagnostic This type of surgery, known as a biopsy, is used to get a tissue sample of a tumor to see if it is cancerous. A biopsy can be performed in a number of ways: with a fine-needle aspiration inserted into the tumor to draw out tissue, or an incisional or excisional biopsy, a surgeon can remove a piece of the tumor, or the entire mass.
  
• Staging This procedure, which can also take tissue samples, uses small cameras or scopes to get a better assessment of the disease and to determine its extent. For example, an endoscope uses a flexible tube with a viewing lens or a video camera to allow the doctor to see any masses in the area, such as in the esophagus (esophagoscopy), stomach (gastroscopy), small intestine (duodenoscopy), colon (colonoscopy), bladder (cystocopy), or respiratory tract (bronchoscopy). A laparoscopy is similar to an endoscopy, but it requires a small incision to be made in the abdomen. When the incision is made in the chest it is called a thoracoscopy.
  
• Curative Removes a tumor that has not spread to other parts of the body. It is often followed by radiation and chemotherapy.
  
• Debulking Reduces the tumor as much as possible before it is treated by other therapies, such as radiation and chemotherapy. This procedure, commonly used for advanced cancers of the ovary, is performed when removal of a tumor would cause too much damage to another organ.
  
• Palliative Treats advanced stages of cancer as a means of pain relief; it is not intended as a cure. For example, it can be used to correct a problem that causes a patient discomfort, such as a tumor that has blocked an abdomen.
  
• Supportive Facilitates other types of cancer treatment. For example, some patients can place a catheter port under their skin to deliver chemotherapy drugs.
  
• Restorative Returns the body to a normal, or near normal appearance. The most common type of restorative surgery is breast reconstruction.

October 2006