Cancer is a condition that is characterized by abnormally growth and division of cells and ability to live when healthy cells die. Continuous growth and division lead to accumulation of those abnormal cells, resulting in formation of a mass or a lump.
Primary cancer implies cancers that originate from tissues or cells of an organ, while metastatic cancer refers a cancer that develops in a particular organ or tissue and spreads to nearby or distant organs.
Cancer surgery points out 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 size of the tumor – 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 complete or partial removal of an organ. Moreover, if your surgeon decides that surgery is indicated, it is also possible to aim reducing the size of a very large tumor by removing the tumor as much as possible (debulking). Therefore, although the major goal of the cancer surgery is the “primary treatment”, it may also serve to diagnose and/or stage the tumor and/or to relieve symptoms (palliative care) as well as combinations thereof.
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 a necessity in treatment of a tumor. Thus, the intraoperative material is examined in a pathology laboratory and histopathological diagnosis of the tumor is made.
Each tumor is staged according to its size, local or distant metastasis and involvement of lymph nodes. The stage of the tumor 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 size of tumor and involvement of nearby tissues and lymph nodes, in an operation in addition to the location of tumor. Consequently, the tumor stage determined by preoperative workup can be verified or amended in an operation.
Finally, if your health history and/or family history points to high risk for a certain cancer, 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 general health condition of the patient, location and size of the tumor, equipment available in the healthcare facility, and training and experience of the surgeon.
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 that will be used in the surgery requires a meticulous preoperative assessment.
Although preoperative preparation is broadly same after cancer surgery is decided, a very 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 your anesthesiologist will make a series of advices in order 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 and 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 and you should strictly follow this instruction in order to undergo the surgery at the scheduled date.
The risks of the cancer surgery depend on multiple factors, such as type and location of tumor and the surgery, and almost each 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 occurrence of risks, it is no means possible to warrant that the risks will be completely 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 in order to alleviate your concerns about the operation and make realistic expectations regarding results of the surgery.