Cancer Surgery

Surgery has been used to treat cancer for many, many years. Surgery also plays a key role in diagnosing cancer and finding out how far it may have spread.

Understanding Cancer Surgery

Ongoing advances in surgical techniques allow surgeons to operate on a growing number of patients and have good outcomes.

Surgery is used to prevent, diagnose, stage, and treat cancer. Surgery can also relieve (palliate) discomfort or problems related to cancer. Sometimes, one surgery can take care of more than one of these goals. In other cases, different operations may be needed over time. You will find specific cancer operations discussed in treatment information for each cancer type.

Surgery is one way to help diagnose cancer. In most cases, the only way to know if a person has cancer and what kind of cancer it is, is by taking out a small piece of tissue (called a sample) and testing it. The diagnosis is made by looking at cells from the sample with a microscope or by doing other lab tests on it.

This procedure is called a biopsy. Biopsies taken during surgery are often referred to as surgical biopsies.

How a sample is taken depends on where the tumor is and what type of cancer is suspected. For example, the method used for prostate biopsies is different from those used for lung biopsies.

Learn more about different types of biopsies in Testing Biopsy and Cytology Specimens for Cancer.

Staging surgery is done to find out how much cancer there is and how far it has spread. During this surgery, the area around the cancer including lymph nodes and nearby organs is examined. This is important because it provides information to guide treatment decisions and predict how people will respond to treatment. To learn more about this, see our information on Cancer Staging.
Curative or primary surgery is usually done when cancer is found in only one part of the body, and it’s likely that all of the cancer can be removed. In this case, surgery can be the main treatment. It may be used alone or along with other treatments like chemotherapy or radiation therapy, which can be given before or after the operation.
Debulking surgery is used to remove some, but not all, of the cancer. It’s sometimes done when taking out the entire tumor would cause too much damage to nearby organs or tissues. For example, it may be used for advanced cancer of the ovary and some lymphomas. In these cases, the doctor may take out as much of the tumor as possible and then treat what’s left with radiation, chemotherapy, or other treatments.
This type of surgery is used to treat problems caused by advanced cancer. Palliative surgery can be used to correct a problem that’s causing discomfort or disability. For example, some cancers in the belly (abdomen) may grow large enough to block off (obstruct) the intestine. If this happens, surgery can be used to remove the blockage. Palliative surgery may also be used to treat pain when the pain is hard to control by other means. Palliative surgery helps ease problems caused by cancer and helps people feel better, but it’s not done to treat or cure the cancer itself.
Supportive surgery is done to help make it easier for people to get other types of treatment. For example, a vascular access device such as a Port-A-Cath® or Infusaport® is a thin, flexible tube that can be surgically placed into a large vein and connected to a small drum-like device that’s placed just under the skin. A needle is put into the drum of the port to give treatments and draw blood, instead of putting needles in the hands and arms each time.
Reconstructive surgery is used to improve the way a person looks after major cancer surgery. It’s also used to restore the function of an organ or body part after surgery. Examples include breast reconstruction after mastectomy or the use of tissue flaps, bone grafts, or prosthetic (metal or plastic) materials after surgery for head and neck cancers. For more on these types of reconstructive surgery, see Breast Reconstruction After Mastectomy and Oral Cavity and Oropharyngeal Cancer.

Preventive or prophylactic surgery is done to remove body tissue that’s likely to become cancer – even though there are no signs of cancer at the time of the surgery.

Sometimes an entire organ is removed when a person has a condition that puts them at very high risk for having cancer there. The surgery is done to reduce cancer risk and help prevent the chance of cancer, but it doesn’t guarantee cancer prevention.

For example, some women with a strong family history of breast cancer have an inherited change in a breast cancer gene (called BRCA1 or BRCA2). Because the risk of breast cancer is very high, removing the breasts (prophylactic mastectomy) may be considered. This means the breasts are removed before cancer is found. .

We have a lot more information that you might find helpful. Explore or call our National Cancer Information Center toll-free number, 1-800-227-2345. We’re here to help you any time, day or night.

Conventional surgery makes large incisions (or cuts) through the skin, muscle, and other layers of the body. When most people think of surgery, they picture a doctor using a scalpel and other surgical instruments to cut into and remove, repair, or replace parts of the body affected by disease. Learn more about conventional cancer surgery in How Surgery is Used for Cancer.

Newer surgical techniques are less invasive, use different types of surgical instruments, and lead to less pain and shorter recovery times. Some of these techniques are described here.

A laser is a highly focused and powerful beam of light energy which can be used for very precise surgical work. It can be used instead of a blade or scalpel to cut through tissue. It can also be used to burn and destroy (vaporize) tumors or precancerous growths and treat cancers of the cervix, penis, vagina, vulva lung, and skin.

Some laser surgery involves less cutting and damage (they’re less invasive) than standard surgery. For instance, with fiber optics and special scopes the laser can be directed inside a natural body opening without having to make a large cut. The laser is then precisely aimed to destroy the tumor.

Lasers are also used in a type of surgery called photoablation or photocoagulation to destroy tissues or seal tissues or blood vessels. This type of surgery is often used to relieve symptoms, such as when large tumors block the windpipe (trachea) or swallowing tube (esophagus), causing problems breathing or eating.

You can learn more details about lasers in Lasers in Cancer Treatment.

Cryosurgery uses a liquid nitrogen spray or a very cold probe to freeze and kill abnormal cells. This technique is sometimes used to treat pre-cancerous conditions, like those affecting the skin, cervix, and penis. Cryosurgery can also be used to treat some cancers, like those in the liver and prostate. A scan (like an ultrasound or CT scan) might be used to guide the probe into the cancer and watch the cells freeze. This limits damage to nearby healthy tissue.
A high-frequency electrical current can be used to destroy cells. This may be done for some cancers of the skin and mouth.
In radiofrequency ablation, or RFA, high-energy radio waves are sent through a needle to heat and destroy cancer cells. RFA may be used to treat cancer tumors in the liver, lungs, kidney, and other organs.

Mohs micrographic surgery is also called microscopically controlled surgery. It’s used to remove certain skin cancers by shaving off one very thin layer at a time. After each layer is removed, the doctor looks at the tissue with a microscope to check for cancer cells. This procedure is repeated until all the cells in a layer look normal.

Mohs surgery is used when the extent of the cancer is not known or when as much healthy tissue as possible needs to be saved, such as when treating skin cancers near the eye.

Chemosurgery is an older name for surgery like this and refers to certain drugs that may be put on the tissue before it’s removed. Mohs surgery does not use chemotherapy drugs.

A laparoscope is a long, thin, flexible tube that can be put through a small cut to look inside the body. It’s sometimes used to take pieces of tissue to check for cancer. In recent years, doctors have found that by making small holes and using special long, thin instruments, the laparoscope can be used without making a large cut. This can help reduce blood loss during surgery and pain afterward. It can also shorten hospital stays and allow people to heal faster. Laparoscopic surgery is used commonly today for many other operations.

Laparoscopic surgery can be used in cancer treatment, but not for all cancers. Doctors can safely and effectively to use laparoscopic surgeries for some cancers of the colon, rectum, liver, prostate, uterus, and kidney, among others. Uses on other types of cancer are still being studied.

A thoracoscope is a thin tube with a tiny video camera on the end that can be put through a small cut into the chest after the lung is collapsed. This allows the doctor to see inside the chest. Tissue samples of any areas of concern on the lining of the chest wall can be taken out, fluid can be drained, and small tumors on the surface of the lung can be removed.

This type of surgery leads to less cutting and has even been used to remove parts of the lung that contain cancer. Studies have shown that for early-stage lung cancer, results using this approach are much the same as removing part of the lung through a cut in the side of the chest.

Robotic surgery is a type of laparoscopic (or thoracoscopic) surgery where the doctor sits at control panel and uses precise robotic arms to control the scope and other special instruments. The advantages of this type of surgery are largely the same as laparoscopic and thoracoscopic surgery: it can help reduce blood loss during surgery and pain afterward. It can also shorten hospital stays and let people to heal faster.

Robotic surgery is sometimes used to treat cancers of the colon, prostate, and uterus. It has also been cleared for use by the FDA in operating on other body systems. It’s not yet clear if robotic surgery leads to better long-term results than operations where the surgeon holds the instruments directly.

Doctors are always looking for new ways to remove or destroy cancer cells. Some of these methods are blurring the line between what we commonly think of as surgery and other forms of treatment.

Researchers are testing many new techniques, like using high-intensity focused ultrasound, microwaves, and even high-powered magnets to try to get rid of unwanted tissue. These techniques are promising, but still largely experimental.

As doctors have learned how to better control the energy waves used in radiation therapy, some newer radiation techniques that work almost as well as surgery have been found. By using radiation sources from different angles, stereotactic radiation therapy delivers a large precise radiation dose to a small tumor area. The process is so exact that this is sometimes called stereotactic surgery, even though no cut is actually made. In fact, the machines used to deliver this treatment have names like Gamma Knife® and CyberKnife®, but no knife is involved. The brain is the most common site that can be treated using this technique, but it’s also used on some head, neck, lung, spine, and other tumors. Researchers are looking for ways to use it to treat other types of cancer, too.

The best chance of a cure from many types of cancer is to remove all of the cancer as soon as possible after diagnosis. If you have a solid tumor, sometimes surgery alone will cure the cancer, but you might need chemotherapy, radiation therapy, or other treatment, too. Your health care provider will discuss your best treatment options with you.

If you have any concerns about surgery or cancer, discuss this issue with the people who know your situation best – your surgeon and other members of your cancer care team.

We have a lot more information that you might find helpful. Explore or call our National Cancer Information Center toll-free number, 1-800-227-2345. We’re here to help you any time, day or night.

Before you decide to have surgery or any other procedure, it’s important that you understand the risks. Any type of medical procedure has risks. Different procedures have different kinds of risks and side effects. Be sure to discuss the details of your case with your health care team, who can give you a better idea about what your risks might be. It is important that the expected benefits of the surgery outweigh the possible risks.

Your surgical team will take many steps to reduce your risk of side effects and complications. This includes things like shaving and cleaning the area before cutting the skin to avoid infection, use of special leg pumps and low-dose blood thinners to avoid blood clots, and breathing treatments (respiratory therapy) to help prevent pneumonia. Ask your doctor about the possible complications of your surgery and what can and will be done to help prevent them.

Possible complications during surgery may be caused by the surgery itself, drugs used , and your overall health. Generally speaking, the more complex the surgery is, the greater the risk of side effects.

Minor operations and taking tissue samples (biopsies) usually have less risk than a bigger surgery. Pain at the surgery site is the most common problem. Infections at the site and reactions to the drugs used to numb the area (local anesthesia) are also possible.

Some side effects are possible during and after surgery. Generally, these side effects are not expected to be life threatening. They can include:

  • Bleeding
  • Blood clots
  • Damage to nearby tissues
  • Drug reactions
  • Damage to other organs
  • Pain
  • Infections
  • Slow recovery of other body functions