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Types of Surgical Oncology & Cancer Surgeries

Cancer is a complex disease that necessitates a comprehensive approach to therapy. Surgical oncology is an important part of cancer management since it aims to remove tumours and prevent their spread. In this blog post, we will go over numerous types of cancer surgeries in surgical oncology that are possible today. 

Biopsy is the first step in the diagnosis of cancer. It entails removing a tiny tissue sample from a suspicious location and examining it under a microscope. Several biopsy procedures are performed depending on the location and size of the tumour. It is the first and most important step, without which any specific cancer treatment cannot be given. 

  • Needle Biopsy: A tiny needle is introduced into the tumour to harvest cells or a tiny tissue sample for examination.
  • Surgical Biopsy: It entails surgically removing a portion or the complete tumour as well as nearby healthy tissue.

Curative Surgery
Curative surgery is intended to entirely remove the diseased tumour. It may entail removing the tumour as well as adjacent lymph nodes and tissues. This procedure is frequently used to treat solid tumours such as breast, colon, lung, head cancer, abdominal tumours and prostate cancer to name a few. Curative surgery is performed either before or after cancer therapies such as chemotherapy or radiation therapy which are frequently used to target any leftover cancer cells that may have moved beyond the surgical site or is not visible to naked eye of the surgeon at the time of operation.

Reconstructive Surgery
Following the removal of a tumour, reconstructive surgery is performed to restore functionality or look of a body part. It has a tremendous impact on a patient's self-esteem and quality of life.

Techniques for reconstructive surgery differ depending on the impacted region:

  • Skin Grafts: This surgery entails removing a patch of healthy skin from one part of the body (the donor site) and transplanting it to the operative site. It aids in covering of wounds,  healing, and enhancement of aesthetics.
  • Tissue Expansion: This is a typical procedure in breast reconstruction. A silicone balloon-like device is inserted beneath the skin near the afflicted breast. The balloon progressively fills with saline solution over time, expanding the skin and making room for a permanent implant.
  • Microvascular Surgery: Microvascular surgery is used when greater tissue transfers or reattachment of blood vessels are required with the help of healthy tissues which are farther away from surgical site.
  • Local / Regional Flaps: these include insertion of healthy tissue from around the surgical site into the surgical defect.

Palliative Surgery
Palliative surgery attempts to improve the quality of life of patients with advanced cancer by alleviating symptoms and lowering discomfort. Unlike curative surgery, the purpose of palliative surgery is to relieve pain, obstruction or bleeding caused by tumours rather than to completely eradicate the cancer.
The following are examples of common Palliative Surgical procedures:

  • Tumour Debulking: It is a surgery that includes removing a portion of a tumour in order to lessen its size and alleviate symptoms such as pain, troublesome breathing, bleeding or non-passage of flatus or feces.
  • Stent Placement: It entails putting a tiny tube-like device known as a stent into a blocked route caused by tumours. It normalises the flow of body fluids or air and alleviates strain on organs.

Minimally Invasive Surgery
The discipline of surgical oncology has been transformed by minimally invasive surgery, often known as laparoscopic or robotic surgery. To accomplish the surgery, tiny incisions are made and specialised devices and cameras are used.
Benefits of Minimally Invasive Surgery:

  • Decreased discomfort
  • Significantly smaller scars than standard open surgery
  • Faster Recovery
  • Lesser blood loss
  • Lesser cost to the patient
  • Early discharge

Laser Surgery
A focused beam of light is used in laser surgery to eliminate or destroy malignant cells. It is often used to treat malignancies of the skin, mouth, vocal cord or cervix. Laser surgery is precise, results in less bleeding, and promotes faster recovery.

The laser beam is directed at the tumour thereby cutting it precisely away from surrounding healthy tissues of body. There are various advantages to laser surgery, including:

  • Reduced Scarring 
  • Lesser blood loss
  • Reduced Infection Risk

HIPEC (Hyperthermic Intraperitoneal Chemotherapy) Surgery refers to the instillation of heated chemotherapy in the abdominal or chest cavity after complete surgical removal of cancer in same setting, where heated chemotherapy drugs have enhanced effect of killing microscopic residual cancer cells. This surgery is performed for cancer of ovary, colon, rectum, mesothelioma and appendix.

Few other Interventional Cancer treatment options:
Cryosurgery involves eliminating cancer cells by freezing them with liquid nitrogen. It is often used to treat malignancies of the skin, prostate, and liver. The surgeon uses a special probe during the treatment to send extremely cold temperatures to the tumour, which causes cancer cell breakdown and lysis. The body's natural systems gradually absorb and remove the frozen tissue.

RFA (Radiofrequency Ablation)
The use of high-frequency electrical currents to heat and eliminate cancer cells is known as radiofrequency ablation (RFA). It is very beneficial for malignancies of the liver, lungs, and kidney for which ultrasound or computed tomography (CT) guidance may be used. A specialised needle-like electrode is placed directly into the tumour during RFA. The electrode then generates heat that kills cancer cells by emitting high-frequency electrical currents. 

All types of cancer surgeries cover a wide range of operations aimed at detecting, treating, and enhancing the quality of life for cancer patients and render them disease free completely.

It is vital to consider that the type and stage of cancer, the patient's overall condition and the tumour board recommendations, all influence the choice of surgical treatment. Consultation with medical professionals is essential for personalised advice and treatment planning.

Dr. Archit Pandit, Director & Head of the Department

Surgical Oncology

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