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Treatment - Surgery

QOL Tree Treatment Before Treatment Ceremony Surgery Radiation Chemotherapy After Treatment Palliative Care Hospice and EOL

Surgery

  • Historical perspectives
    • Oldest form of cancer treatment
    • “When in doubt, cut it out”
    • Works best for solid tumors

Role of Surgery

  • Establish a tissue diagnosis (biopsy)
  • Determine the stage of the disease
  • Treat disease
    • ­It is not used for leukemia (a type of blood cancer) or for cancers that have spread
  • Salvage
  • Palliation (reduce pain or discomfort)

Role of surgery for Diagnosis/ Extent of Disease

  • Biopsies identify if cancer
    • Incisional
    • Excisional
  • Remove tumor with affected organs/ tissues
  • Show extent of disease
  • Mark residual tumor for treatment

Role of Surgery to Treat Disease

  • Primary treatment
  • Remove malignant tumor and a margin of normal tissue
  • Adjuvant treatment
  • Removal of tissues to decrease incidence, progression or recurrence 
  • Cytoreductive surgery
  • Reduction of tumor volume
  • Salvage
    • Use of an extensive surgical approach after the use of a less extensive approach
    • Example:  mastectomy following lumpectomy or prior to radiation therapy
  • Palliation
    • Promote comfort and quality of life
  • Combination treatment
    • Use of surgery with other treatments/methods (chemo, RT, etc)
  • Therapeutic/supportive hardware
    • Feeding tubes
    • Implanted vascular access catheters/ports
    • Radioactive implants
  • Second look procedures
    • Reconstruction or repairs
  • Additional Surgical Methods
    • Cryosurgery (cryotherapy)
    • Extreme cold produced by liquid nitrogen or argon gas to destroy cells
    • Can be circulated through a probe to freeze an area
    • Forms an ice ball (internal – absorbed; external scab)
    • Skin cancers, retinoblastoma, precancerous growths (skin, cervix); liver cancer/mets
  • Lasers (cyberknife, light amplification by stimulated emission of radiation)
    • Specific wave length; focused in a narrow beam (can cut thru steel/diamonds)
    • Precise surgeries; focus on tiny areas
    • Powerful light beam to shrink/ destroy
    • Treat tumors on body surface or inside lining of internal organs (basal cells carcinoma)
  • Hyperthermia
    • Expose tumor to high temperatures
    • High heat damages/kills cells
    • Makes cells more sensitive to radiation
  • Radiofrequency ablation – high-energy radio waves
    • Local, regional or whole body
  • Photodynamic Therapy (PDT)
    • Uses a photosensitizer drugs that react to a specific wavelength of light light
    • Drug injected into bloodstream
    • 24-72 hrs later, expose tumor to light
    • Photosensitizer absorbs light, produces active form of oxygen, kills nearby cancer cells
    • Most commonly used to treat/relieve symptoms of esophageal and Non-Small Cell Lung Cancer (NSCLC)