Oncological Surgery: Cancer Operations and Treatment
For patients diagnosed with cancer, one of the most common questions during the treatment process is whether surgery is necessary. Questions such as “Can the tumor be removed surgically?”, “Which part of the organ needs to be removed?”, “Why are lymph nodes removed?” and “Will additional treatment be needed after surgery?” depend on the type of cancer and the extent of the disease.
Oncological surgery is an important part of cancer treatment that involves the surgical removal of cancerous tissue and, when necessary, surrounding tissues and lymph nodes. However, surgery is not performed in every cancer patient. The decision to operate is made by evaluating the organ affected by the tumor, the stage of the disease, its relationship with surrounding tissues, the presence of distant spread, and the patient’s overall health condition.
In this article, we will discuss what oncological surgery involves, which cancers can be treated surgically, how surgical decisions are made, open and minimally invasive surgical techniques, lymph node surgery, additional treatments after surgery, and the recovery process.
Prof. Dr. Adem Dervişoğlu has more than 30 years of surgical experience and has performed over 10,000 surgical procedures. He is involved in the evaluation and treatment of patients in the fields of general surgery and cancer surgery.
What Is Oncological Surgery?
Oncological surgery is a treatment approach that aims to remove cancerous tumors through surgical procedures. During surgery, not only the visible tumor but also a certain amount of surrounding healthy tissue and regional lymph nodes may be removed when necessary.
The extent of surgery varies depending on the organ affected by the cancer. For example, in stomach cancer, part or all of the stomach may be removed, while in colon cancer, the section of the intestine containing the tumor may be surgically removed.
Which Cancers Can Be Treated with Oncological Surgery?
Oncological surgery can be used in the treatment of many solid tumors. Surgery is particularly important in the treatment of digestive system cancers.
- Colon and rectal cancer
- Stomach cancer
- Pancreatic cancer
- Liver cancer
- Bile duct and gallbladder cancers
- Esophageal cancer
- Certain neuroendocrine tumors
- Certain soft tissue and other solid tumors
The type of surgery performed for each cancer depends on the anatomical location of the tumor and the extent of the disease.
When Is Cancer Surgery Performed?
The timing of cancer surgery is not the same for every patient. Some patients can undergo surgery directly. In other cases, chemotherapy, radiotherapy, or other systemic treatments may be administered before surgery.
The relationship between the tumor and major surrounding blood vessels, the condition of the lymph nodes, and the presence or absence of distant metastases are particularly important when determining whether surgery is appropriate.
How Is the Decision for Oncological Surgery Made?
The decision to perform surgery is generally based on several factors evaluated together. Imaging results, pathology reports, blood tests, the anatomical location of the tumor, and the patient’s overall health condition are essential components of treatment planning.
In particular, for pancreatic, liver, stomach, colon, and rectal cancers, the relationship between the tumor and neighboring organs and blood vessels plays an important role in determining the surgical approach.
Which Tests Are Required Before Cancer Surgery?
Various examinations may be performed before surgery to assess the extent of the disease and determine whether the patient is suitable for surgery.
- Computed tomography (CT)
- Magnetic resonance imaging (MRI)
- Ultrasonography
- Endoscopic examinations
- PET-CT, when appropriate
- Pathology and biopsy evaluations
- Blood tests
Not every patient requires all of these tests. The necessary examinations are determined according to the type of cancer and the planned surgical procedure.
Why Are Lymph Nodes Removed During Oncological Surgery?
In certain types of cancer, cancer cells can spread to regional lymph nodes through the lymphatic system. For this reason, specific lymph nodes in the area surrounding the tumor may need to be removed during cancer surgery.
The removed lymph nodes are examined pathologically to help determine whether the cancer has spread and establish the stage of the disease. These findings may also play an important role in planning additional treatments after surgery.
Open and Minimally Invasive Surgery in Oncological Treatment
The surgical technique used in oncological surgery is determined according to the characteristics of the tumor and the patient’s condition. Some procedures are performed using open surgery, while others may be performed laparoscopically or robotically in suitable patients.
| Feature | Open Surgery | Minimally Invasive Surgery |
|---|---|---|
| Incision | Larger surgical incision | Smaller incisions |
| Technique | Direct surgical access | Camera and specialized surgical instruments |
| Suitability | Depends on tumor characteristics | Suitable for selected patients |
| Decision | Based on cancer characteristics and the patient’s overall health | Based on surgical requirements and patient suitability |
Laparoscopic or robotic surgery is not automatically suitable for every cancer patient. The priority when selecting a surgical technique is to ensure that the tumor can be safely removed with appropriate surgical margins.
What Are Surgical Margins in Oncological Surgery?
Surgical margins refer to the edges of the tissue removed during surgery. After the operation, a pathologist may examine these margins under a microscope.
The condition of the surgical margins, tumor characteristics, and lymph node findings in the pathology report help guide the evaluation of subsequent treatment options.
Oncological Surgery for Pancreatic Cancer
Surgical planning for pancreatic cancer depends on the location of the tumor within the pancreas and its relationship with surrounding blood vessels and organs.
For certain pancreatic head tumors that are considered surgically removable, the Whipple procedure may be performed. For some tumors located in the body or tail of the pancreas, distal pancreatectomy may be considered.
In pancreatic cancer, the decision to operate is not based solely on tumor size. Factors such as vascular involvement, lymph node involvement, and distant metastases are also evaluated in detail.
Oncological Surgery for Liver Cancer
Surgical treatment for liver cancer may be considered depending on the location, number, and size of the tumors, as well as the condition of the remaining liver tissue.
In suitable patients, the portion of the liver containing the tumor can be surgically removed. The extent of liver surgery is determined according to tumor characteristics and the amount of healthy liver tissue expected to remain after the procedure.
Oncological Surgery for Stomach Cancer
Depending on the location of the tumor, part or all of the stomach may need to be removed in stomach cancer surgery. The removal of appropriate lymph nodes and their pathological examination are also important components of the procedure.
The extent of surgery is planned according to factors such as tumor location, size, relationship with surrounding tissues, and disease stage.
Oncological Surgery for Colon and Rectal Cancer
In colon cancer surgery, the section of the intestine containing the tumor is removed together with the associated lymph nodes. The remaining ends of the intestine may then be reconnected in suitable patients.
In rectal cancer, the distance of the tumor from the anal region, its relationship with surrounding tissues, and the extent of the disease are important factors in surgical planning. Some patients may require chemotherapy and radiotherapy before surgery.
When Is a Colostomy Necessary in Oncological Surgery?
A colostomy is a surgical procedure in which the large intestine is brought through an opening in the abdominal wall.
In certain colon and particularly rectal cancer operations, a colostomy may be necessary when reconnecting the intestinal ends is not appropriate.
Whether the colostomy is temporary or permanent depends on the type of surgery, tumor location, and the patient’s surgical condition.
Is Chemotherapy Necessary After Oncological Surgery?
Whether additional treatment is required after surgery depends on pathology findings and the characteristics of the disease. Some patients may require chemotherapy, radiotherapy, targeted therapy, or other systemic treatments following surgery.
Therefore, in certain types of cancer, surgery may represent one stage of a broader treatment plan rather than the entire treatment process.
Recovery After Oncological Surgery
Recovery time varies depending on the type of surgery, the amount of organ or tissue removed, whether open or minimally invasive surgery is performed, and the patient’s overall health condition.
After surgery, important aspects of recovery include dietary adjustments, gradual mobilization, wound care, medication use, and evaluation of pathology results.
What Are the Risks of Oncological Surgery?
As with any surgical procedure, oncological surgery carries certain risks, including bleeding, infection, wound-healing problems, blood clots, and complications specific to the organ being operated on.
The type and likelihood of complications vary depending on the extent of surgery, the patient’s overall health, and the surgical technique used. An individualized risk assessment is performed before surgery.
What Is Multidisciplinary Cancer Treatment?
Cancer treatment may require collaboration between different medical specialties, including surgical oncology, medical oncology, radiation oncology, radiology, and pathology.
In advanced-stage cancers or cases involving complex treatment decisions, bringing together the opinions of different specialists helps ensure a comprehensive evaluation of the disease.
Why Is Follow-Up Important After Oncological Surgery?
Follow-up after cancer surgery involves more than simply checking the surgical site. Depending on the type of cancer, regular medical examinations, blood tests, and imaging studies may be recommended.
The frequency and scope of follow-up are determined according to the type and stage of cancer, pathology findings, and treatments received.
Which Doctor Should You Consult for Oncological Surgery?
Patients who may require oncological surgery can be evaluated by a general surgeon experienced in the relevant cancer type or a surgeon specializing in surgical oncology.
For cancers affecting organs such as the pancreas, liver, stomach, colon, rectum, and bile ducts, surgical planning must be tailored to the specific characteristics of the disease.
Why Is Specialist Evaluation Important in Oncological Surgery?
Following a cancer diagnosis, treatment plans may differ even among patients with the same type of cancer. Factors such as tumor location, pathology characteristics, disease stage, vascular involvement, lymph node status, and distant spread can all influence treatment decisions.
For this reason, evaluating imaging studies and pathology reports together is an essential step in determining the most appropriate surgical approach for each patient.
You can contact Prof. Dr. Adem Dervişoğlu’s Clinic to learn more about individual evaluation and available treatment options.
Frequently Asked Questions About Oncological Surgery
Can Oncological Surgery Completely Eliminate Cancer?
The aim of surgery in suitable patients is to remove cancerous tissue. However, surgical outcomes and the need for additional treatment depend on the type and stage of cancer and its pathological characteristics.
Is Oncological Surgery Performed on Every Cancer Patient?
No. The need for surgery is determined by evaluating the type and stage of cancer, its spread, anatomical location, and the patient’s overall health condition.
How Long Does Oncological Surgery Take?
The duration of surgery varies depending on the organ or tissue being removed, the extent of the procedure, and the surgical technique used. Therefore, it is not possible to specify a single duration for all oncological operations.
Can Oncological Surgery Be Performed Using Minimally Invasive Techniques?
Some cancer operations can be performed laparoscopically or robotically in suitable patients. However, the appropriateness of these techniques depends on tumor characteristics and surgical requirements.
Is Chemotherapy Always Necessary After Oncological Surgery?
Not every patient requires chemotherapy. The need for additional treatment is determined by evaluating pathology results and the characteristics of the disease after surgery.
Do Lymph Nodes Need to Be Removed During Oncological Surgery?
Depending on the type of cancer and the extent of surgery, regional lymph nodes may need to be removed. These lymph nodes are sent for pathological examination.
How Long Does Recovery Take After Oncological Surgery?
Recovery time varies depending on the type of surgery, whether open or minimally invasive techniques are used, and the patient’s overall health condition.
Is Oncological Surgery Risky?
Like any surgical procedure, oncological surgery involves certain risks. These risks vary according to the extent of surgery and the patient’s condition and are evaluated individually before the operation.
Which Tests Are Required Before Oncological Surgery?
Depending on the type of cancer, different examinations may be used, including CT, MRI, PET-CT, endoscopy, ultrasonography, biopsy, and blood tests. The necessary tests are determined individually for each patient.
How Is Follow-Up Performed After Oncological Surgery?
Follow-up may include medical examinations, blood tests, and imaging studies when necessary. The frequency of follow-up depends on the type and stage of cancer and the treatments received.
Disclaimer: This article is intended for general informational purposes only. Please consult your doctor for an individual medical evaluation and treatment plan.
