Cancer surgery: Physically removing cancer

Cancer surgery is a common part of diagnosing and treating cancer. Here's a look at how surgery is used to care for people with cancer.

How is cancer surgery used?

Common reasons you might have cancer surgery include:

• Cancer prevention. For some types of cancer, it's possible to remove an organ before cancer develops. In this way, surgery helps prevent cancer.
• Diagnosis. Surgery might be used to get a piece of tissue for testing. The sample is tested in a lab to see if it's cancerous. Other tests might look at the genetic makeup of the cells. The results help your health care team plan your treatment.
• Staging. Cancer surgery can show the size of the cancer and whether it has spread. This information is used to figure out the cancer's stage. The cancer's stage tells your provider how serious your condition is and whether you need aggressive treatment.
• Primary treatment. For many cancers, surgery is the main treatment.
• Debulking. Sometimes surgery can't remove all of the cancer. A surgeon may remove as much as possible. This is called debulking.
• Relieving symptoms or side effects. Surgery is also used to improve your quality of life. For example, it can get rid of pain caused by a cancer that's pressing on a nerve or bone. It could be used to remove a cancer that's blocking the intestine.

Surgery is often used with other cancer treatments. These treatments can include chemotherapy, radiation therapy and other treatments. Which treatments are best for you depends on the type of cancer you have, its stage and your overall health.

How is cancer surgery typically performed?

When it's possible, the goal of cancer surgery is to remove all of the cancer from the body. To do this, the surgeon uses cutting tools to remove the cancer and some healthy tissue around it.

The surgeon may also remove some lymph nodes in the area. The lymph nodes are tested to see if they contain cancer cells. If cancer spreads to the lymph nodes, there's a chance that the cancer could spread to other parts of the body.

What other techniques are used in cancer surgery?

Many other types of operations can be used to treat cancer. Researchers continue to look at new methods. Some other types of cancer surgery include:

• Cryosurgery. This surgery uses very cold material, such as liquid nitrogen spray or a cold probe. The cold freezes and destroys cancer cells.
• Electrosurgery. In this type of surgery, electric current is used to kill cancer cells.
• Laser surgery. Laser surgery uses beams of light to shrink or get rid of cancer cells.
• Mohs surgery. This method carefully removes cancer layer by layer. As each thin layer is removed, it's studied under a microscope to look for signs of cancer. This is repeated until all the cancer is removed. Mohs surgery is used for cancers on sensitive areas of the skin, such as around the eye.
• Laparoscopic surgery. This minimally invasive surgery uses several small cuts in the body rather than one large cut. A tiny camera and surgical tools are inserted through the cuts. A monitor shows what the camera sees. The surgeon uses this to guide the tools to remove the cancer. The smaller cuts mean you get better faster and may have fewer problems after surgery.
• Robotic surgery. During robotic surgery, the surgeon sits away from the operating table. They watch a screen that shows a 3D image of the area being operated on. The surgeon uses hand controls that tell a robot how to move surgical tools to perform the operation. Robotic surgery helps the surgeon operate in hard-to-reach areas. People who have this type of surgery might get better faster and have fewer problems after surgery.

• Natural orifice surgery. Natural orifice surgery is a way to operate on organs in the belly without cutting through the skin. Instead, surgeons pass surgical tools through a natural body opening, such as the mouth, rectum or vagina.

  For example, a surgeon might put surgical tools down the throat and into the stomach. A small cut is made in the wall of the stomach. Surgical tools then move into the area around the stomach. The tools could take a sample of liver tissue or remove the gallbladder.

  Natural orifice surgery is a new type of surgery. Surgeons hope it can lower the risk of infection, pain and other problems after surgery.

Cancer surgery continues to change. Researchers are looking at other types of less invasive surgery.

What can you expect before and after cancer surgery?

How you get ready for and heal from cancer surgery depends on the operation. In general, you can expect certain things to be the same, including:

• Getting ready. Expect to have some tests before surgery. These might include blood tests, urine tests, X-rays and other imaging tests. The results help your surgeon plan your procedure. The results can show whether you have any conditions that might make surgery risky.
• Anesthesia. If you're having surgery, you'll likely need some type of anesthetic to block pain. What kind of anesthesia you have will be based on the type of operation.
• Recovery. Depending on your surgery, you may stay in the hospital for a while before going home. Your health care team will give you specific directions for your recovery. They'll talk about how to care for any wounds, what foods or activities to avoid, and what medicines to take. Be sure you understand what you can and can't do after surgery. Ask for help if you care for other family members, such as children or older relatives.

What are the risks of cancer surgery?

The risks of surgery will depend on the type of operation you're having. In general, most cancer operations have a risk of:

• Pain. Pain is a common side effect of most operations. Some cause more pain than others. Your health care team will tell you how to keep your pain low. They will also provide medicines to lower the pain.
• Infection. Your health care team will show you how to care for your wound after surgery. Follow these instructions to avoid infection. Infections can make the recovery time longer. If you do get an infection, your provider might give you medicine to fight the infection.

• Loss of organ function. To remove your cancer, the provider may need to remove an entire organ. For example, a kidney may need to be removed if you have kidney cancer.

  For some such operations, the remaining organ can work well enough that you'll feel like you did before surgery. In other situations, you could have some problems after surgery. For instance, removal of a lung may make it harder to breathe.

• Fatigue. After surgery, you may not have much energy. You might have trouble concentrating. This is typical and it will get better.
• Bleeding. All operations have a risk of bleeding. Tell your provider what medicines you are taking. Some medicines may increase the risk of bleeding.

• Blood clots. Recovery from surgery gives you a higher risk of developing a blood clot. Though the risk is small, this can be serious.

  Your health care team will take steps to reduce your risk of blood clots. They will get you up and out of bed as soon as possible after your operation. They may also recommend a blood-thinning medicine to reduce the risk of a clot.

• Altered bowel and bladder function. Right after surgery, you may have trouble with bowel movements or urination. This typically gets better after a few days, depending on your operation.