Find out when you might have surgery for cancer, including to diagnose it, treat it, or reduce your risk of getting cancer.
Surgery means removing tissue from the body. It's one of the main treatments for many types of cancer.
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.
Whether surgery is an option depends on:
- the type of cancer you have
- the size of the cancer and whether it has spread (the stage)
- where the cancer is in your body
- your general health
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, biological therapy or hormone therapy. You may also have radiotherapy to shrink the tumour and help control symptoms.
Surgery is not used for some types of cancer of the blood system (leukaemia). It is also not used for some types of cancer of the lymphatic system (lymphoma), if the cancer cells are spread throughout the body. If the cancer is in many areas, surgery won’t get rid of it all.
Sometimes surgery is not possible because of the position of the tumour. For example, if the tumour is near a blood vessel or other delicate tissue. Your doctor might use other treatments instead.
Surgery and cancer
There are different ways that surgery can be used for cancer:
To diagnose cancer, a surgeon may remove a small piece of tissue from the abnormal area. This is called a biopsy. If the biopsy contains cancer cells, it can show what type of cancer it is and how slowly or quickly it may grow (the grade).
Surgery is one of the main treatments for cancer. It might be the only treatment you need.
Surgery is a local treatment – it only treats the part of the body operated on. So it may cure cancer that is completely contained in one area and hasn't spread. 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.
Your surgeon sends the tissue to the laboratory, where it is looked at under a microscope. This gives more information about the cancer. Doctors then 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.
Some people have treatment before surgery to help shrink a cancer and make it easier to remove. This is called neo adjuvant treatment.
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 (RFA) or cryotherapy.