Surgery
Introduction
Surgical cancer treatment involves the physical removal of the tumor and often nearby lymph nodes or surrounding tissue that may be affected by the cancer cells.
This type of treatment is the main approach for many types of cancer, especially in the early stages, such as breast, skin, stomach, testicular and ovarian cancer, where the goal is to completely remove the cancerous tissues.
Surgery may be performed alone or in combination with chemotherapy, radiation therapy, or other therapies to achieve a better outcome.
- Lumpectomy
- Mastectomy
- Prostatectomy
- Colectomy
- Nephrectomy
- Hysterectomy
- Salpingo-oophorectomy
- Lymphadenectomy
- LLETZ
Breast Cancer Surgery
Surgery is the removal of the tumor and some surrounding healthy tissue during surgery. Surgery is also used to examine the nearby axillary lymph nodes, which are under the arm. A surgical oncologist is the doctor who specializes in this.
The choice of surgery does not affect whether you will need drug therapy, such as chemotherapy, hormone therapy, and/or targeted therapy. Drug therapies are given based on the characteristics of the tumor, not the type of the operation you are having.
In general, the smaller the tumor, the more surgical options a patient has. Types of breast cancer surgery include the following:
- Lumpectomy: This is removal of the tumor and a small, cancer-free margin of healthy tissue around the tumor. Most of the breast remains. For invasive cancer, radiation therapy to the remaining breast tissue is often recommended after surgery, especially in younger patients, patients with hormone receptor-negative tumors, and patients with larger tumors. For early stages, radiation therapy is usually given. Lumpectomy may also be called breast-conserving surgery, partial mastectomy, or segmental mastectomy. mastectomy.
- Mastectomy: This is the surgical removal of the entire breast. There are several types of mastectomies. Talk to your doctor about whether the skin can be preserved. Your doctor will also consider how large the tumor is compared to the size of the breast you to determine the best type of surgery for you. Radiation therapy may be recommended after a mastectomy.
Lymph Node Removal
Cancer cells can be found in the axillary lymph nodes in some types of cancer. Knowing whether any of the lymph nodes near the breast contain cancer can provide useful information for determining treatment and prognosis.
Sentinel lymph node biopsy. In a sentinel lymph node biopsy, the surgeon finds and removes 1 to 3 or more lymph nodes under the arm that receive lymphatic drainage from the breast. This procedure is usually not an option when the doctor already knows based on clinical assessment that the lymph nodes have cancer. Rather, it may be an option for patients without obvious clinical evidence of lymph node involvement. This procedure helps to avoid removing a larger number of lymph nodes with axillary lymph node dissection for patients, whose sentinel lymph nodes are almost cancer-free.The smaller lymph node procedure helps reduce the risk of several possible side effects.These side effects include swelling of the arm called lymphedema, and problems with arm movement and range of motion. shoulder. These can be long-term problems that can seriously affect a person's quality of life. Importantly, the risk of lymphedema increases with the number of lymph nodes and lymph vessels that are removed or damaged during treatment. crab.Axillary lymph node dissection. In an axillary lymph node dissection, the surgeon removes many lymph nodes under the arm. They are then examined for cancer cells by a pathologist. The actual number of lymph nodes removed varies from person to person. People who undergo lumpectomy and radiation therapy, who have a smaller tumor and 2 or less sentinel lymph nodes with cancer, can avoid a complete axillary lymph node dissection. This helps reduce the risk of side effects and does not reduce survival. After the results of the lymph analysis nodes is passed to:
- No chemotherapy before surgery and no cancer in the sentinel lymph nodes. For most people in this situation, axillary lymph node dissection is not recommended. A small group of patients with tumors located in certain locations or with high-risk characteristics, radiation therapy to the lymph nodes may be offered.
- No chemotherapy before surgery, but with cancer in the sentinel lymph nodes. If there is cancer in 1 to 2 sentinel lymph nodes, then additional nodal surgery can usually be avoided if the patient plans to undergo a lumpectomy and receive radiation. If there is cancer in 3 or more sentinel lymph nodes, then additional nodal surgery is recommended.
- Chemotherapy is given before surgery. Treatment for people who have received chemotherapy before surgery depends on whether the chemotherapy has killed the cancer in the lymph nodes. Therefore, after chemotherapy, patients are often re-diagnosed by a biopsy of sentinel lymph node. However, this is not always the case. If imaging scans or physical examinations suggest the presence of abnormal lymph nodes, the patient should undergo an axillary lymph node dissection instead.
Reconstructive Surgery
Patients who have had a mastectomy or lumpectomy may consider plastic surgery. This is surgery to recreate the breast using either tissue taken from another part of the body or synthetic implants. Reconstruction is usually performed by a plastic surgeon. Reconstruction performed at the same time as the mastectomy is called immediate reconstruction. You may also have this surgery at some point in the future, called delayed reconstruction.
Cervical Cancer Surgery
Surgery is the main treatment for stage 1 cervical cancer. It is also sometimes used to treat small stage 2A cancers.
There are different types of surgery to remove cervical cancer.
These are:
- Loop electrosurgical excision -LLETZ-
- Cone Biopsy
- Hysterectomy
- Trachelectomy
The type of operation will depend on several factors, including:
- Cancer Stage
- Tumor size
- Have you gone through menopause
- Do you want to get pregnant in the future
Whatever type of surgery you have, the goal is to remove all the cancer. The surgeon will remove the cancer and some healthy tissue around it. Depending on the type of surgery you have, they may also remove other tissue. After surgery, the surgeon will send all the tissue to a laboratory to be examined under a microscope.
You may need additional treatment to reduce the risk of the cancer coming back if cancer cells are found in:
- small blood or lymph vessels inside the tumor
- lymph nodes
- cervical tissue.
LLETZ Loop Electrosurgical Excision
Loop electrosurgical excision, or LLETZ, is a common way to remove abnormal cells from the cervix. It is sometimes called a loop electrosurgical excision procedure. LLETZ usually takes about 5 to 10 minutes and is usually performed under local anesthesia.
LLETZ can be done:
- to remove an area of abnormal cells from the cervix after cervical screening
- to help diagnose cervical cancer
- for the treatment of cervical cancer
Cone Biopsy
A cone biopsy is a small operation to remove an area of the cervix. This operation can be used to treat stage 1 cervical cancer.
Hysterectomy
A hysterectomy is surgery to remove the uterus. This is the standard treatment for early-stage cervical cancer. If you have gone through menopause, the surgeon will usually remove both the fallopian tubes and the ovaries. Sometimes the surgeon must remove ovaries if you haven't had menopause. This means your period will stop immediately and you will enter menopause.
After a hysterectomy you will not be able to get pregnant, so it is extremely important that you think about your fertility before the operation and discuss the matter with your doctor.
There are two types of hysterectomy. The type you have depends on the stage of the cancer
- Simple hysterectomy or total hysterectomy: The surgeon removes the uterus and cervix. He may also remove pelvic lymph nodes. This surgery may be done for very early stage cancer that cannot be seen without microscope.
- Radical hysterectomy: The surgeon removes the upper part of the vagina, cervix, uterus, pelvic lymph nodes, and tissue around the uterus and cervix.
Trachelectomy
This operation is a type of fertility preservation operation. It may be suitable if you want to become pregnant in the future and have early stage cervical cancer.
The surgeon removes the cervix and the upper part of the vagina. He usually also removes the supporting tissues around the cervix. This is called a radical trachelectomy.
Pelvic lymph nodes are also removed. The surgeon usually does this through small incisions in the abdomen. This is called laparoscopic surgery. It can be done a few days before or at the same time as the trachelectomy.
The uterus is left in place to make it possible for you to become pregnant in the future. The surgeon usually stitches the bottom of the uterus after removing the cervix. A trachelectomy is a very specialized operation and is not performed in all cancer hospitals .
How is cervical cancer surgery performed?
Abdominal Surgery
The surgeon makes one large incision in the abdomen. A scar is then left that runs across the abdomen just above the thighs or up the abdomen just above the thighs.
Vaginal Surgery
The surgeon operates through an incision in the upper part of the vagina. The surgeon may combine this with laparoscopic or robotic surgery.
Laparoscopic Surgery
The surgeon makes small incisions in the abdomen. They use small surgical instruments and a thin telescope with a video camera on the end called a laparoscope. The laparoscope allows the surgeon to look inside the body.
Robotic Surgery
It's like laparoscopic surgery, but the laparoscope and instruments are attached to robotic arms. The surgeon controls the robotic arms, which can move very delicately, stably and precisely.
Surgery for lung cancer
Your doctor will explain whether surgery is a possible treatment for you by evaluating several factors:
- Type of cancer
- Stage
- General Health
Lung cancer surgery is a serious operation and you need to be healthy enough to cope with it. Before you have surgery, your doctor will order tests to check how well your whites are working lungs and heart You may have surgery if you have:
- Non-small cell lung cancer NSCLC stage 1 or 2, or sometimes stage 3
- SCLC is a small cell lung cancer that is very small and has not spread outside the lung. Surgery is not usually done for SCLC because it often has spread outside the lung when it is diagnosed.
Other treatments may be given before or after surgery. Some people have chemotherapy or radiotherapy after surgery. But if the cancer is larger -stage 3a-, you may have chemotherapy and radiotherapy together -chemotherapy- before the operation.
Types of operations for lung cancer
There are three main types of surgery to remove lung cancer. The type of surgery depends on the size and position of the cancer. These are:
- Removal of a lobe of the lung - lobectomy
- Removal of two lobes of the lung - bilobectomy
- Removal of whole lung - pneumonectomy
How is lung cancer surgery performed?
There are different ways to perform lung cancer surgery. Your surgeon will explain which is best for you.
Open Operation
Surgery for lung cancer usually involves opening the chest between the ribs and sometimes cutting out a rib. This is called a thoracotomy. You will then have a scar on the side of your chest.
Video-Assisted Thoracic Surgery VATS
Surgeons sometimes use a type of surgery called video-assisted thoracic surgery. It is only performed by specially trained surgeons. This type of surgery may be better for people with early-stage lung cancer.
The surgeon makes one or more small incisions in the skin and inserts a thoracoscope with a video camera attached to the chest. The camera sends images of the inside of the chest to a computer screen, and then the surgeon passes small instruments through the incisions to remove cancer.
Ovarian Cancer Surgery
Surgery is an important treatment for these types of cancer. A gynecologic oncologist is a doctor who specializes in the treatment of gynecologic cancers, including surgery and drugs such as chemotherapy.
Practice shows that surgery is often necessary to establish the full extent of the disease. The goal is to provide accurate information necessary for staging. Minimally invasive surgery is often used to confirm a diagnosis and determine whether a debulking procedure should be performed at the time of diagnosis or after chemotherapy. This is important because imaging tests may not always reveal the full extent of the disease.
There are several surgical options for ovarian/fallopian tube cancer. The stage of the tumor determines the types of surgery recommended. Sometimes doctors perform two or more procedures during the same surgery:
- Salpingo-oophorectomy. This operation involves removing the ovaries and fallopian tubes. If both ovaries and both fallopian tubes are removed, this is called a bilateral salpingo-oophorectomy. If the patient wants to become pregnant in the future and has early stage cancer , it may be possible to remove only 1 ovary and 1 fallopian tube if the cancer is located in only 1 ovary. This operation is called a unilateral salpingo-oophorectomy. In people with a germ cell tumor, only the ovary with the tumor must be removed , while maintaining the ability to conceive.
- Hysterectomy. This operation focuses on removing the uterus and, if necessary, the surrounding tissue. If only the uterus is removed, it is called a partial hysterectomy. A total hysterectomy is when both the uterus and and the cervix.
- Lymphadenectomy/Lymph Node Dissection. During this procedure, the surgeon may remove lymph nodes in the pelvic and para-aortic areas.
- Omentectomy. This is an operation to remove the thin tissue that covers the stomach and intestines.
Colon Cancer Surgery
Surgery for early-stage colon cancer
Treatment of very small colon cancer can be a minimally invasive surgical approach such as:
Removing polyps during a colonoscopy, called a polypectomy. If the cancer is contained within a polyp, removing the polyp may remove the entire cancer.
Endoscopic mucosal resection. This procedure can remove larger polyps during a colonoscopy. Special tools help remove the polyp and a small amount of the lining of the colon. A minimally invasive surgery called laparoscopic surgery. This type of surgery can removes polyps that cannot be removed during a colonoscopy.In this procedure, the surgeon performs the operation through several small incisions in the abdominal wall.Instruments with attached cameras pass through the incisions and show the colon on a video monitor lymph nodes in the area around the cancer.
Surgery for advanced colon cancer
If the cancer has grown into or through the colon, the surgeon may recommend:
Partial colectomy. The operation to remove part of the colon is called a partial colectomy. During this procedure, the surgeon removes the part of the colon that has cancer. The surgeon also removes some of the tissue on either side of the cancer. Often it is possible to restore healthy parts of the colon or rectum. This procedure can often be done through a minimally invasive approach called a laparoscopy.
Surgery to create a way for waste to leave the body. Sometimes it is not possible to reconnect healthy parts of the colon or rectum after a colectomy. The surgeon creates an opening in the abdominal wall from part of what is left over from the bowel. This procedure, called an ostomy, allows stool to leave the body by emptying into a bag that is placed over the opening.
Sometimes the ostomy is only for a short time to allow the colon or rectum to heal after surgery. Then it comes back. Sometimes the ostomy is irreversible and stays for life.
Removal of lymph nodes. During colon cancer surgery, nearby lymph nodes are usually removed and examined for cancer.
Surgery for advanced cancer
When it is not possible to remove the cancer with surgery, the surgeon may try to relieve symptoms rather than cure the cancer. This surgery can remove blockages in the colon and relieve symptoms, such as bleeding or pain.
Sometimes cancer has spread only to the liver or lungs in a person who is otherwise healthy. Surgery or other local treatments can remove the cancer. Chemotherapy may be used before or after this type of procedure . This approach gives you a chance to be cancer free in the long run.