Surgical Oncology

Surgical Oncology

Surgery is one of the oldest treatments for cancer that not only helps in staging and diagnosing but also helps in curing many types of cancer. Surgical Oncology is oncology that specializes in treating cancer by the means of surgery or by removing cancerous tissue or tumors. Surgery is also effective in treating those cancers that have not spread to any other body organ.

Today, cancer surgery is a treatment of choice for many types of cancers. It may not be the only treatment, but it is often the most effective. Surgeons remove all or part of a tumor and some normal tissue around it to cure cancer. Surgical oncology involves the use of surgical techniques to treat all forms of cancer. An oncologist would have to consider surgery along with other treatments like chemotherapy and radiotherapy as appropriate for a particular type or stage of cancer.

Functions Of Surgical Oncology

Surgical oncology is the surgical discipline responsible for the operative treatment of malignant tumors. Its functions include:

  • Remove the part of the tumor with surgery.
  • Surgically removing the tumor along with other affected body parts.
  • Reconstructing the parts that are affected due to the surgical treatment.
  • Diagnosis of cancer and determining its stage by taking a biopsy or other methods.

Many factors affect the decision to provide cancer surgery to patients. The type of cancer and status of the tumor has to be considered along with the location and general health of the patient such as type of cancer, size, stage of the tumor, and location. Surgery is often used in combination with other treatment methods like radiation therapy and chemotherapy or hormone therapy. This approach is more effective than single-line therapy in managing cancer and preventing recurrence.

Treatment Done Using Surgical Oncology

There are various conditions that can be treated using surgical oncology, for instance:

  • Liver
  • Stomach
  • Thyroid
  • Pancreas
  • Melanoma
  • Esophagus
  • Parathyroid
  • Breast cancer
  • Adrenal Gland
  • Rectum and Colon
  • Endocrine Cancer
  • Soft tissue sarcomas
  • Head and neck cancers
  • Gastrointestinal cancer
  • Multiple Endocrine Neoplasia Types 1 and 2
  • Neuroendocrine Tumors of the Gastrointestinal Tract

Procedure Of Surgical Oncology

In addition to being full-time surgeons, the job of a surgical oncologist is unique in that they are trained to manage both simple and complex cases of primary and secondary cancers. Surgical oncologists have immense knowledge of cancer biology, imaging technologies, radiation therapy, and chemical and biological therapy.

Various procedures used for the treatment include:

Thyroidectomy: This procedure is used to make sure that thyroid cancer is completely removed. Most of the time, the half or whole thyroid is removed and a small graft made from part of your healthy thyroid is placed after the surgery. This helps you regain normal body processes once again.

Pancreatic duodenectomy or Whipplen: A Whipple procedure is a complex surgery that involves a large part of the digestive system. It's used to treat pancreatic cancer, severe pancreatitis, and some other conditions. Before the surgery, your doctor might recommend biopsies to check for cancer, or test results may show you need another type of surgery first.

Breast Surgery: A mastectomy is a surgical procedure used to remove all or part of the breast. A biopsy is done to remove or obtain small amounts of tissue that are examined under a microscope to confirm the diagnosis, while a segmental or lumpectomy removes only the tumor.

Melanoma Excision: Melanoma is the most dangerous type of skin cancer, especially if it spreads to other parts of the body. When melanoma is diagnosed, healthcare providers may recommend surgery to remove all or part of the affected area. The goal of this procedure is to remove malignant cells and prevent them from spreading.

Rectal or Colon Resection: A rectal or colon cancer is the most common form of the disease and it can occur anywhere along the large intestine. The rectum or colon is the last part of an organ called the "bowel" which connects to the anus. In some cases, a section of this bowel may be removed so part of the rectum or colon can be re-connected to avoid an ostomy or stoma.

Distal Pancreatectomy: A distal pancreatectomy is a surgical method to remove the end of your pancreas. This procedure can treat an injury, pancreatic cancer, and chronic pancreatitis.

Distal Pancreatectomy: A distal pancreatectomy is a surgical method to remove the end of your pancreas. This procedure can treat an injury, pancreatic cancer, and chronic pancreatitis.

Liver Resection: Liver resection is a surgical operation that removes parts of the liver that includes tumors, cancer, and masses. It is been performed to cure liver cancer and metastatic liver cancer. The surgical procedure is usually done under general anesthesia or regional anesthesia as an outpatient procedure.

Lymph Node Dissection: There are two types of lymph node dissection. The first one is known as completion lymph node dissection and this involves the removal of all the lymph nodes from an area of the body that includes the groin or armpit. On the other hand, a sentinel lymph node involves the removal of the initial few lymph nodes that drain a malignancy in a particular area.

Esophagectomy: Esophagectomy is a surgery to remove part or all of the esophagus. This procedure is performed to treat cancer of the esophagus.

Surgical Oncology Techniques: The Endoscopic Ultrasound (EUS) is a minimally invasive surgical oncology technique that allows obtaining samples by passing a needle inside the tumor that provides for a quick and precise diagnosis. It also helps in determining the location and size of the tumor in the pancreas by providing a clear visualization of the pancreas and the digestive tract.

Minimally Invasive Surgery: It has become very popular these days. It refers to a surgical procedure that is performed with the aid of tools that have been designed in such a way to allow access to the patient's body through very small incisions. The procedure is performed by using high-definition monitors, miniature cameras with microscopes, and tiny fiber-optic flashlights. Only an incision or a stitch is required for performing this procedure. The major benefit of this procedure is that it results in less blood loss and quick recovery.

Stereotactic Breast Biopsy: Breast biopsy is a minimally invasive procedure to examine breast abnormalities. The technique is used for taking small samples of the objective mass from the breast and examining them. Breast biopsy helps in confirming whether an abnormality is cancerous or non-cancerous.

Radiofrequency Ablation: Radiofrequency ablation is a minimally invasive procedure that uses electrotherapy to destroy a tumor. A thin needle guided by an ultrasound or computed tomography (CT) is inserted through the skin into the tumor. The tumor is heated and destroyed by delivering electrical energy by the needle. In the majority of cases, a tumor can be effectively treated with the help of radiofrequency ablation in just one treatment session.

Reconstructive Surgery: Reconstructive surgery is a surgery that is performed after the removal or excision of cancer from an area. Reconstructive surgery aims to reconstruct the affected area with the skin, muscle, and other tissue structures.

Sentinel Lymph Node (SLN) Biopsy: It is a surgical procedure that involves the removal of part or whole of the stomach. The procedure is conducted to treat cancer of the stomach or gastric cancer. Gastrectomy involves removing the tumor along with normal tissue surrounding it.

Mohs' Surgery: The surgery removes the cancer layer from the sensitive areas of the skin with the help of a scalpel and then examines it under a microscope. The surgeon carefully checks for any possible leftover cancer cells before closing up the wound with stitches.

Electrosurgery: Electrosurgery is a way to kill cancer cells by applying high-frequency electrical currents.

Cryosurgery: Cryosurgery is a procedure that uses extreme cold to freeze and destroy cancer cells. A doctor inserts a probe or liquid nitrogen into the patient's body through a catheter (thin, flexible tube). The cold can destroy tumors without damaging nearby healthy tissues.

Robotic Surgery: Robotic surgery is a precise, minimally invasive surgery that uses robotic technology to operate. It can be easily operated by a surgeon who sits away from the operating table and views the 3-D image on the screen of the area being treated. A surgeon controls the movement of a robot and also tells him how to use surgical tools for operating. Robotic surgery is considered very beneficial for treating various types of cancer.

Fluorescence Guided Surgery (FGS): Fluorescence-guided surgery is the newest technique to remove tumors in the brain which are difficult to access. The patient ingests a fluorescent dye, and it spreads throughout their body, but high activity cells like tumors absorb more dye than normal cells. Surgeons can use easily visible colors and patterns to guide them during surgery.

Types Of Surgeries

There are different surgical procedures in the treatment of cancer. The types of procedures depended on the objectives of treatment. They include:

Best Hospital And Cities For Surgical Oncology In India

There are many options when it comes to hospitals. One must know that the best treatment is what one deserves. One must choose the best hospital with the best equipment. Some of these hospitals are:

  • Aster Medcity, Kochi
  • HCG Manavata, Nashik
  • Kokilaben Ambani Hospital
  • Fortis BG Road, Bengaluru
  • Fortis Hospital, Vadapalani
  • Fortis C-DOC, Chirag Enclave
  • Manipal Hospital, Whitefield
  • Fortis La Femme, Greater Kailash
  • Manipal Hospital, Old Airport Road
  • BKL Superspeciality Hospital, New Delhi
  • Fortis Escorts Heart Institute, Okhla Road

FAQs

The surgical oncologist is trained in surgical procedures and techniques when it comes to cancer. The general surgeon does not handle specialized cases involving cancer, therefore it is best to seek an opinion from a specialist in this field.

Cancer has a way of spreading to other parts of the body. When detected early, surgery ensures that cancer cells and all affected tissues are removed. This can ensure cancer is completely treated. In advanced stages, cancer would have spread to other parts making treatment all the more difficult

Yes, anesthesia is used in surgeries to make the patient unconscious and protect him or her from the pain. The type of surgery and the patient's health are considered when deciding on the use of anesthesia. A surgical oncologist would work along with an anesthetist during the surgery.

Surgery is always a scary thing. But you've probably never thought of it as a walk in the park. Let's be honest, surgeries come with some form of risks, which can be the following: Pain, bleeding, and infection.

A second opinion should be sought as soon as you are diagnosed with cancer. A delay in seeking an opinion may reduce your chances of successful clinical management and possibly lead to disease progression.

Doctors recommend breast-conserving surgery as the primary treatment option for patients suffering from ductal carcinoma in situ (DCIS). The said surgery has been proven to be extremely safe and effective since the 10-year survival rate is more than 80%. To ensure optimal results, lumpectomy often goes hand-in-hand with radiation therapy or chemotherapy. This guarantees that a recurrence or relapse is highly unlikely to occur. Before any recommendation, doctors take into account the prognostic factors and patient-specific risk factors of a recurrence.

It is essential to follow what your doctor has recommended. In most cases, the treatment approaches are multimodal for better results after the treatment. So, if your doctor advises you to receive chemotherapy or radiation therapy before or after surgery, you must follow as advised.

The doctor will ask you to not eat or drink anything 6-8 hours before the procedure. After the procedure, you can start eating anything you want as soon as you feel comfortable.

Robotic surgery is a minimally invasive surgery done in a clinic or hospital. Smaller incisions are made and only the required body parts are removed through these small incisions. Less pain is experienced by patients as it is done in a controlled environment. Robotic surgeries have fewer infections, faster healing time, less scarring, and provide almost immediate results.

Surgery is needed to diagnose and stage cancer, remove cancer or tumor and remove parts of the tumor without harming other parts of the body. Surgery helps to ease symptoms caused by cancer and change the condition of the body after surgery.

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