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Surgery

Surgery is the oldest form of cancer treatment. About 60% of cancer patients will undergo surgery, either by itself or in combination with other therapies.

There are several types of cancer surgery:

Curative surgery simply involves removal of a cancerous tumor. It works best on localized cancers that haven't yet spread to other parts of the body, and is often followed by radiation therapy or chemotherapy to make sure all cancerous cells have been removed.

Curative surgery types include: 

Preventive surgery is used to keep cancer from occurring. Many colon cancers can be prevented by removing precancerous polyps before they become malignant. A woman at very high risk for breast cancer may decide to have her breasts removed rather than worry about getting breast cancer later in life.

Reconstructive surgery returns the body to normal or near-normal appearance or function following cancer treatment. The most common restorative surgery is breast reconstruction after a mastectomy. Facial reconstruction and testicular implants are also examples of reconstructive surgery.

Diagnostic surgery (biopsy): In this procedure, the surgeon removes some or all of a tumor for examination to determine if the growth is cancerous. A biopsy can be done in several ways:

Fine Needle Aspiration (FNA): a needle is inserted into the tumor and material is drawn out for inspection under a microscope.

Incisional or excisional biopsy: the patient is put under local or regional anesthesia, which numbs the area, and a small incision is made in the skin. The surgeon either removes a piece of a large tumor (incisional), or the entire mass (excisional), for further examination. If the tumor is in the chest or abdomen, general anesthesia is used.

Staging surgery is used to determine the extent of a cancer. This procedure can sometimes be done without an incision by using tiny cameras (scopes) attached to a flexible tube, which are inserted into natural body openings. An endoscope is used in hollow body cavities and organs such as the lungs, intestinal tract and urinary tract. Besides allowing surgeons to view the suspicious area, these devices can take a tissue sample. A laparascope is used to view the abdominal cavity. Laparotomy involves a small incision in the abdominal cavity, done under general anesthesia. Laparotomies are used when the suspicious area cannot be examined by less invasive procedures.

Supportive surgery is used to help with other cancer treatments. For example, some chemotherapy devices require a port (connecting device) to be inserted under the skin.

Palliative surgery is only used to ease pain, disability or other complications that come with advanced cancer. Palliative surgery may improve quality of life, but is not a cure or anti-cancer treatment.

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© 2014 The University of Texas MD Anderson Cancer Center