Surgical Oncology

Dating back to the early 1800s, surgical oncology is a field of medicine that focuses on the surgical treatment of tumors. Today, doctors with a background in surgical oncology often have a multi-disciplinary approach to diagnosing, treating, and preventing the recurrence of all types of cancer.

Some oncologists, such as ear, nose, and throat doctors specializing in head and neck cancer, concentrate on certain areas of the body likely to be affected by abnormal growths.

Surgery is one of the most common and oldest treatments for cancer. With tumors that aren’t cancerous, surgery is typically done if the growths are compressing nerves or causing other difficulties for patients. With cancerous tumors, the purpose of surgery is to remove the growth and affected tissues.

It’s generally preferable to remove the entire tumor. But if this isn’t possible, part of the tumor may be removed (debulking) to increase the effectiveness of other treatments. Some healthy tissue within the surgical area is often removed as a preventative measure to minimize the risk of recurrence.

The role of an oncologist begins prior to surgery. They usually provide a recommendation for how to treat a tumor based on results from a biopsy and related image testing. Surgery may works best for solid tumors that haven’t spread beyond the affected area. While sometimes a standalone treatment, as may be the case with small tumors detected in an early stage, there are times when surgery is combined with other treatments, some of which may include:

• Radiation therapy
• Chemotherapy
• Immunotherapy
• Targeted drug therapy

Even when chemotherapy and radiation therapy are performed pre- or post-operatively, the quality of the surgery that’s done plays a significant role in the results typically seen with treatment. If the tumor is relegated to a single area, surgery is often performed with local or regional anesthesia.

Excision (removal) of lymph nodes is sometimes necessary if cancer has spread to these tissues. Many procedures performed today to remove tumors involve the use of minimally invasive techniques that include smaller incisions and the use of specialized instruments that provide a better view of the affected tissues for surgeons.

After removal of a tumor, there’s sometimes a defect that will need to be corrected with reconstructive surgery. Defects may result if other structures have to be removed to access the tumor or if the affected area is highly visible and important to perform certain functions (e.g., lower lips, nose, tongue, or parts of the larynx). The goal with reconstructive techniques is to improve a patient’s quality of life and limit the impact from the surgical removal of a tumor.

When surgery for cancer is necessary, many precautions are taken to minimize patient risks and maintain comfort as much as possible. Medication is usually given to ease discomfort during recovery. Depending on the type of size, nature, and location of the tumor, follow-up chemotherapy and/or radiation therapy may be recommended to ensure that all affected tissues and cells are treated. Early detection and treatment of potentially harmful growths increases the odds of responding well to surgery.