Surgery means removing tissue from the body. It is one of the main treatments for many types of cancer.
You can have surgery 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)
Who can have surgery for cancer?
Surgery is often the main treatment for cancer. You might have it on its own or together with other treatments.
But surgery isn't suitable for all types of cancer, or for all situations. Whether surgery is a treatment option for you depends on many factors.
- your cancer type
- the size of your cancer, and whether it has spread (stage)
- where the cancer is in your body
- your general health
Surgery is not a treatment option for some types of cancer. These include cancers of the blood system (leukaemia), or lymphatic system (lymphoma). This is because these cancers have often spread throughout the body. Surgery won’t get rid of all the cancer if it is in many different parts of the body.
Where the cancer is in your body
Sometimes surgery is not possible because the cancer is near to very delicate tissues, or a vital body part. For example, the cancer might be very close to major blood vessels. This means the surgeon cannot remove all of the cancer. In this situation, you might have other treatments instead.
Whether your cancer has spread
Surgery might not be the best treatment for you if your cancer has spread. It may be better to have a treatment that reaches all parts of your body. For example, chemotherapy, targeted cancer drugs or hormone therapy. You might also have
Having an anaesthetic
You have an anaesthetic so that you can’t feel anything during the operation. You have this in the anaesthetic room, next to the operating theatre.
There are different types of anaesthetic. The type you have depend on what surgery you need, as well as your general fitness.
You might have:
- a local anaesthetic to numb the area
- a regional anaesthetic to numb a large area or part of your body
- a general anaesthetic so you are asleep during the operation
You might have surgery as an inpatient or an outpatient (day surgery).
How do doctors use surgery for cancer?
There are different ways that doctors can use surgery for cancer:
To diagnose cancer, your surgeon usually removes some 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).
To diagnose cancer, the surgeon either removes:
- part of the lump or a sample of tissue
- the whole lump or abnormal area
Surgery can provide more information about the size of your cancer and how far it has spread. This is called pathological or surgical staging.
During surgery, the surgeon examines the nearby lymph nodes and organs to look for signs of cancer. Lymph nodes are part of the lymphatic system. This is a network of tubes and glands. Cancer can spread into nearby lymph nodes.
After the operation they send any tissue or lymph nodes they remove to the laboratory. A specialist (pathologist) looks at the tumour and surrounding tissue under a microscope to check for cancer cells. This gives more information about how far the cancer has spread.
Pathological staging is generally the most precise way to find out how far your cancer has spread.
Surgery is one of the main treatments for cancer. It might be the only treatment you need. It aims to cure cancer if cancer is only in one area of your body. And if the surgeon can completely remove all of the cancer.
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.
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 they may have to stop the operation.
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.
It might be possible to have reconstructive surgery if your surgeon removes part of your body. Your surgeon recreates the part of the body 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.
Surgery can help to relieve symptoms of advanced cancer. So you might have surgery even if your surgeon can't completely remove your cancer, or cure it 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. For example, the surgeon can remove 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.
You have some operations 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)
How your surgeon does your operation
There are different ways of doing cancer surgery. Sometimes surgeons combine these. You might have:
- open surgery - the surgeon makes a large cut (incision) through the skin
- keyhole (laparoscopic) surgery - the surgeon makes several small cuts through the skin and uses a
laparoscopeto look inside your body and remove tissue through the cuts
- robotic surgery - the surgeon uses a robotic machine to help with keyhole surgery
- endoscopic surgery - the surgeon removes or destroys tissue through a tube (endoscope) which they pass into your body, usually through your mouth or back passage (rectum)
You can read more about these types of surgery in the treatment section for your cancer type.