Role of Surgery in Cancer Treatment
Cancer surgery / Onco Surgery / Surgical Oncology is an important part of cancer treatment. It is basically extirpation of tumor along with margins and draining lymph nodes.
It the main treatment for early-stage cancer, be it Breast, Oral (mouth), thyroid, Gastrointestinal or Gynecological cancers. Majority of times, the cancer can be adequately controlled with surgery and patient is not subjected to chemotherapy and / or radiation. The mutilation, morbidity and loss function is minimal at early stages. Surgery can also be done by minimally invasive or robotic means.
In Advanced stages especially when tumor size is large and lymph nodal involvement is present, surgery is generally performed after neo adjuvant therapy i.e., patient is given few cycles of chemotherapy to control the disease spread and this helps the treating team to understand the disease biology. Patients who respond to Neo adjuvant therapy have better prognosis. This especially holds true for breast, ovary, oropharyngeal, stomach, para nasal sinuses and esophageal cancers.
In Metastatic Disease surgery has a limited role. It is generally used to palliate adverse or lifesaving conditions. In a Breast cancer for a bleeding painful pus discharging tumor a Toilet Mastectomy is done; similarly in a distal stomach / bile duct / pancreatic cancer for obstruction caused to food or bile flow, bypass surgeries such as gastrojejunostomy or hepaticojejunostomy are done. In certain special situations like differentiated thyroid cancers, luminal A breast cancers removal of primary mass leads to improvement in survival making the surgery therapeutic rather than palliative.
We at Art of Healing Cancer focus on providing patients with treatment options for advanced cancers. There are certain type of surgeries which are especially used in such situations.
Cancer surgery is usually done by a surgeon who specializes in this type of surgery. The surgeon will work with a team of other doctors, such as medical oncologists and radiation oncologists, to plan the best treatment for you. We offer a variety of surgical options for treating advanced cancers, including minimally invasive surgery, robotic surgery, and traditional open surgery. We also offer novel treatments such as cryoablation. Our goal is to provide our patients with the most effective treatment possible and to help them return to their normal lives as soon as possible. You may have just one type of cancer surgery, or you may need a combination of different types of surgery, depending on your individual situation. Surgery is often combined with other treatments, such as chemotherapy, radiation therapy, or targeted therapy.
Oncoplastic breast conservation surgery (OBCS) combines aspects of both traditional breast cancer surgery and plastic surgery. The goal of OBCS is to remove the breast cancer with adequate margins without the loss of breast even in patient with large tumors provided the disease has a single focus or limited in one quadrant or part of the breast. It is done either using Volume displacement techniques i.e., restructuring the breast by mobilizing tissues from the residual breast present after removal of tumor/cancer or Volume replacement i.e., mobilizing tissues from other parts of the body to fill the defect caused by tumor removal.
AOHC Advanced Breast Cancer Program
If you have been diagnosed with breast cancer and are considering surgery, you should speak with your doctor about all your options, including OBCS. While OBCS may not be right for every patient, it may be an option worth considering if you would like to preserve the appearance of your breasts following surgery.
A large majority the above mentioned Head Neck Cancer recur or remain in the primary site or on the draining lymph nodes, distant metastasis may not occur or occur in the later course of disease. For e.g., oral(mouth) cancer coming back at the primary site, residual or preserved bone, Infratemporal fossa or skull base or laryngeal or Oropharyngeal cancers remaining after being treated by radiation or chemoradiation. Salvage surgery is performing radical compartmental excision with reconstruction for such situations for e.g. Composite bite resection with ITF clearance for buccal cancer recurrences, Laryngopharangectomy for post RT laryngeal cancers; compartmental glossectomy for recurrent tongue especially base of tongue cancers.
Patients should talk to their doctor about all treatment options before deciding on salvage surgery. The decision to undergo salvage surgery should be made carefully, as it is a major procedure with significant risks. Recovery from salvage surgery can be long and difficult, but many patients are able to return to a good quality of life after treatment. Our study suggests more than 60% disease control after 2yrs in oral cavity salvage.
HIPEC surgery, also known as hyperthermic intraperitoneal chemotherapy, is a type of cancer surgery that uses heated chemotherapy drugs to treat cancer cells in the abdomen. It is useful in primary peritoneal malignancies, ovarian cancers, stomach and colorectal cancers with ascites and peritoneal metastases. It can also be used to treat other types of cancers that have spread to the abdomen, such as pancreatic cancer and mesothelioma.
HIPEC gives best results if it is preceded by radical surgery in form of total peritonectomy along with standard surgical procedure like cytoreduction for ovarian cancer. Post peritonectomy before abdominal wound closure, cannulas are put for inserting a special heated chemotherapy drug into the peritoneal cavity, which is the space between the organs in the abdomen. The heat also helps to kill the cancer cells while also preventing them from spreading to other parts of the body.
HIPEC surgery is usually performed as part of a multi-modal treatment plan that may also include traditional chemotherapy, radiation therapy, and/or surgery. The decision to use HIPEC surgery will be made by a team of cancer specialists at Art of Healing Cancer based on the specific type and stage of cancer, as well as the overall health of the patient.
Palliative surgery is a type of surgery that is performed to relieve symptoms, but not to cure the underlying disease. It is an important part of palliative care and can be used to treat a wide variety of conditions.
Palliative surgery can be used to relieve pain, improve quality of life, and extend life expectancy. It is often used in conjunction with other treatments, such as chemotherapy and radiation therapy.
Palliative surgery is not a cure for cancer, but it can be an important part of treatment for many people with cancer. If you are considering palliative surgery, talk with doctors at Art of Healing Cancer about your goals for treatment and what you can expect from the procedure.
Cryoablation is a surgical technique that involves the use of extreme cold to destroy tissue. It is commonly used to treat primary tumor in case of metastatic disease and or ablate metastatic sites such tumors in liver or lung, but can also be used to treat non-cancerous conditions such as arrhythmias. It should ideally not be used to treat early-stage tumors because in cryoablation, final histopathology is not possible.
The most common type of cryoablation procedure uses argon gas. Argon gas is cooled to -196°C (-320°F) and then circulated through a special probe that is inserted into the body. The probe is placed next to the tissue that needs to be treated. As the argon gas circulates, it freezes the surrounding tissue, causing it to die.
Cryoablation is a minimally invasive procedure, which means that it requires only small incisions. This results in less pain and scarring, and a quicker recovery time. Cryoablation is usually performed as an outpatient procedure, which means that you will not need to stay in the hospital overnight.