Surgery means removing tissue from the body. It is one of the main treatments for many types of cancer.
It can be used to:
- diagnose cancer
- treat cancer (on its own or with other treatments)
- reduce your risk of getting a particular type of cancer (if you already have a high risk)
Is surgery suitable for you?
Whether surgery is the most suitable option for you depends on many factors.
- your cancer type
- size of the cancer, and whether it has spread (stage)
- where the cancer is in your body
- your general health
Surgery is not used for some types of cancer of the blood system (leukaemia), or lymphatic system (lymphoma), because cancer cells might be spread throughout the body. If the cancer is in many areas, surgery won’t get rid of it all.
Where the cancer is in your body
Sometimes surgery is not possible because the cancer is near to very delicate tissues, or a blood vessel. In this situation, you might have other treatments instead.
Whether your cancer has spread
If your cancer has spread, surgery might not be the best treatment for you. It may be better to have a treatment that reaches all parts of your body, such as chemotherapy, targeted cancer drugs or hormone therapy. You may also have
You might have surgery as an inpatient or an outpatient (day surgery). It usually means having a local anaesthetic to numb the area first, or a general anaesthetic so you are asleep during the operation.
Surgery and cancer
There are different ways that surgery can be used for cancer:
To diagnose cancer, your surgeon usually removes a small piece of tissue from the abnormal area. This is called a biopsy. A specialist (pathologist) looks at the tissue under a microscope. This shows whether there are any cancer cells, what type of cancer it is, and how slowly or quickly it might grow (grade).
Surgery is one of the main treatments for cancer. It might be the only treatment you need. Sometimes, it aims to cure cancer, if cancer is only one area of your body. It is a local treatment.
Usually, the earlier a cancer is found the easier it is to remove it.
Your surgeon removes the tumour and some normal tissue from around it (known as a clear margin). They might also remove the lymph nodes nearest to the cancer, in case they contain cancer cells. Lymph nodes are part of the lymphatic system. This is a network of tubes and glands that filter lymphatic fluid, and fight infection and other illnesses.
A specialist (pathologist) looks at the tumour and surrounding tissue under a microscope to check for cancer cells. This gives more information about the cancer.
Other treatments before surgery (neo adjuvant treatment)
Some people have treatment before surgery to help shrink a cancer and make it easier to remove. This is called neo adjuvant treatment.
Other treatments after surgery (adjuvant treatment)
Doctors decide whether you need any further treatment to reduce the risk of the cancer coming back. This is called adjuvant treatment and is most often chemotherapy or radiotherapy.
During an operation, surgeons sometimes find that a cancer has spread further than they expected. When this happens, the operation might take longer than planned, or may have to be stopped altogether.
If cancer has spread to another part of the body, surgery can't usually cure it. But with some types of cancer, surgery can help people to live for a long time and may sometimes lead to a cure. When a cancer has spread, it might be better to have a treatment that works throughout your body, such as chemotherapy.
If you have part of your body removed, it might be possible to have reconstructive surgery. The part of the body is recreated using other body tissues or a false body part (prosthesis).
For example, after removal of a breast (mastectomy) it might be possible to have breast reconstruction. Or if you have your bladder removed it may be possible to make a new bladder.
If you are at high risk of a particular type of cancer, you might be able to have surgery to reduce that risk.
For example, people who have a rare inherited condition called Familial Adenomatous Polyposis (FAP) have an increased risk of bowel cancer. So they might choose to have surgery to remove their large bowel.
Women who have a high risk of breast cancer may choose to have their breasts removed.
Your doctor gives you advice to help you make the decision to have surgery or not.
People might have surgery to relieve symptoms if their cancers can't be completely removed, or cured with other treatments. For example, cancers in the tummy (abdomen) can sometimes block the bowel and cause sickness and pain. An operation to remove or bypass the blockage can relieve these symptoms.
Surgery might also help to control pain by removing cancer that is pressing on a body organ or nerve.
Occasionally it is possible to remove cancer that has spread into nearby organs or to another part of the body. For example, people who have kidney cancer that has spread to the lung might be able to have surgery to remove the lung tumours. The surgery is unlikely to cure the cancer but might reduce symptoms and help some people to live longer.
You might have an operation so that you can have other treatments for cancer.
For example, you might have a small operation to put a thin tube called a central line into a main vein in your chest. The tube stays in throughout your treatment. It makes having chemotherapy or targeted therapy easier because you don’t need to have a needle put into a vein each time you have treatment. You can also have blood taken from the tube.
Some operations are done to help doctors give treatments to areas inside the body. The operation allows surgeons to give treatments such as:
- radiofrequency ablation (a treatment using heat made by radio waves to kill cancer cells)
- cryotherapy (a treatment using extreme cold to destroy cancer cells)