Cancer is a condition characterized by abnormal growth and division of cells and the ability to live when healthy cells die. Continuous development and division lead to the accumulation of those abnormal cells, forming a mass or a lump.
Primary cancer implies cancers that originate from tissues or cells of an organ. In contrast, metastatic cancer is a cancer that develops in a particular organ or tissue and spreads to nearby or distant organs.
Cancer surgery refers to the operative removal of the tumor that has developed in various organs or tissues of the body.
Cancer surgery can be considered from two perspectives depending on the aim of the surgery (primary treatment, diagnosis, staging, and reducing tumor size – debulking) and the methods used.
Although the primary goal is the complete removal of the tumor from the organ or the tissue, possible options include full or partial removal of an organ. Moreover, suppose your surgeon decides that surgery is indicated. In that case, it is also possible to aim to reduce the size of a massive tumor by removing the cancer as much as possible (debulking). Therefore, although the significant goal of cancer surgery is the "primary treatment," it may also serve to diagnose and stage the tumor and to relieve symptoms (palliative care) as well as combinations thereof.
The presence of a tumor can be identified by physical examination, health history, family history, laboratory tests (blood, urine, and body fluids), genetic tests, imaging methods, and other advanced examinations. However, it may not be possible to take a biopsy specimen or a biopsy specimen taken in operation, as surgery is already necessary to treat a tumor. Thus, the intraoperative material is examined in a pathology laboratory, and a histopathological cancer diagnosis is made.
Each tumor is staged according to its size, local or distant metastasis, and involvement of lymph nodes. The stage of the cancer not only shows how much the tumor spread, but it also guides the treatment. On the other hand, your surgeon can obtain data about the tumor, such as the size of the tumor and involvement of nearby tissues and lymph nodes, in operation in addition to the tumor's location. Consequently, the tumor stage determined by preoperative workup can be verified or amended in an operation.
Finally, suppose your health history and family history point to a high risk for a particular cancer. In that case, cancer surgery can be considered based on your request or your surgeon's advice (e.g., breast cancer, colorectal cancer, etc.)
The method used for cancer surgery is determined according to many factors. These include the patient's general health condition, location and size of the tumor, equipment available in the healthcare facility, and surgeon's training and experience.
Conventional open surgery, laparoscopic surgery, or robotic surgery can be used to remove the cancer. The tumor and a part of healthy tissue around the tumor are removed, while it is also possible to kill cancer cells using very-high or very-low heat or electric energy. The method used in the surgery requires a meticulous preoperative assessment.
Although preoperative preparation is broadly the same after cancer surgery is decided, a unique surgical plan is made for each tumor. After the cancer is diagnosed with physical examination, blood and urine tests, advanced laboratory tests, and imaging methods, and the location is determined, your surgeon may require additional tests to assess potential risks.
An anesthesiologist will preoperatively evaluate you in order to minimize possible postoperative problems. In this evaluation, the type of anesthesia is decided that will be used in the surgery.
Your surgeon and anesthesiologist will make a series of advice to manage intraoperative risks and maximize postoperative comfort. The most important one is to quit smoking. On the other hand, the prescription and over-the-counter medicines, herbal products, and vitamin supplements you use will be carefully reviewed, and you will be informed about the medications you need to stop taking before the surgery.
You will also be instructed to stop eating and drinking at a particular time before the surgery. You should strictly follow this instruction to undergo surgery as scheduled.
The risks of cancer surgery depend on multiple factors, such as the type and location of the tumor and the surgery, and almost every type of surgery poses unique risks. In addition, common risks that can be faced after almost all operations include pain, infection, fluid accumulation (seroma) or blood accumulation (hematoma) at the incision site, bleeding, and formation of blood clots.
Although all possible measures that modern medicine allows are taken to prevent the occurrence of risks, it is by no means likely to warrant that the risks will be eliminated.
Your surgeon will explain in detail whether those risks apply to you or, if so, the rate of occurrence.
Ask all your questions to your surgeon and other relevant healthcare practitioners before the cancer surgery to alleviate your concerns about the operation and make realistic expectations regarding the results of the surgery.