Surgery can be used in many ways to treat cancer patients. It offers the best chance for cure in cancers that have not spread to other parts of the body, but it can also be used in cancer diagnosis, staging, and supportive care.

Surgery as a treatment option will differ for every patient depending on the type of surgery, the specific cancer, and the general health of the patient.

There are several types of surgery used in cancer treatment. In some cases these surgical procedures will be used in combination with other cancer treatments. Below is a list and brief explanation of surgical procedures commonly used to treat cancer.

1. Preventive Surgery

Preventive surgery is used to remove non-cancerous tissue that has a high risk of developing into a cancerous tumor. An example of this would be the removal of polyps to prevent colon cancer.

2. Diagnostic and Staging Surgery

Even when biopsy and lab results have confirmed a diagnosis of cancer, staging surgery helps doctors to establish a more accurate assessment of how far the cancer has spread within the body. This assessment is extremely important in determining the type of treatment used. An example of this would be a diagnostic laparoscopy (putting a small scope with camera) to determine any spread into the abdomen before giving an extensive surgery to the patient.

3. Curative Surgery

The goal of curative surgery is to remove a tumor that is confined to a specific part of the body. This type of treatment is often referred to as primary treatment. Curative surgery may be used alone or with other types of cancer treatment, such as radiation or chemotherapy in order to prevent a recurrence.

4. Debulking Surgery

Debulking surgery is used when a tumor cannot be removed completely because removal of the tumor may cause too much damage to an organ or surrounding areas. In this case the surgeon will remove as much of the tumor as possible and treat the remaining area with radiation therapy or chemotherapy. This type of surgery is also called Cytoreduction.

5. Palliative Surgery

In advanced stages of cancer palliative surgery is used to relieve pain and discomfort caused by the tumor or treatments used to treat the tumor. This type of surgery does not work as a cure for the cancer. An example is a bypass surgery in an advanced pancreatic cancer where gallbladder and stomach are joined to intestine directly because of tumor causing blockage to bile duct and intestine.

6. Supportive Surgery

Supportive surgery is used to help aid other types of cancer treatment. An example of supportive surgery would be the placement of a port or catheter into a large vein to deliver chemotherapy treatment or draw blood for testing. This helps to reduce the amount of needle sticks.

7. Restorative / Reconstructive Surgery

Restorative surgery is used to restore the patient’s appearance or the function of a body part following other surgeries. An example of restorative surgery would include breast reconstruction after the removal of the breast for breast cancer.

Chemotherapy is the treatment of cancer with medicines / drugs that can destroy cancer cells. These drugs are also called “anticancer” drugs. Normal cells grow and die in a controlled way. When cancer occurs, abnormal cells in the body keep dividing and forming more cells without control. Anticancer drugs destroy these rapidly dividing cancer cells by stopping them from growing or multiplying. However these medicines are unable to always recognise the bad cells and healthy cells of the body can also be harmed. Harm to healthy cells is what causes side effects.

Most of the side effects are temporary because most healthy cells can repair themselves after chemotherapy is complete. However, some chemotherapy side effects don’t reverse on their own and other therapies or medications may be needed, so it is important that you discuss possible side effects with your healthcare team before beginning treatment.

Chemotherapy is used mainly:

  • To control the cancer: Control means keeping the cancer from spreading; slowing the cancer’s growth, and killing cancer cells that may have spread to other parts of the body from the original tumor.
  • To relieve symptoms that the cancer may cause: Relieving symptoms such as pain can help patients live more comfortably.

Chemotherapy is given in several different ways:

  • By vein (intravenous or IV treatment). Chemotherapy is usually given administered by placing a thin needle into a vein on the hand or arm at the beginning of the treatment session and removing it following treatment. A single chemotherapy treatment session can last from 30 minutes up to eight hours, depending on the drug that has been prescribed.
  • A catheter, port, or pump may be placed if you are having multiple treatments in a short period of time. (Click here to know more about chemotherapy port)
  • By mouth (orally). The drug is given in pill capsule or liquid form. You swallow the drug in pill, capsule, or liquid form, just as you do for other medications.

A common treatment for cancer is radiation therapy. Radiation therapy can be used as primary or initial treatment to shrink the tumor, or after primary treatment (such as surgery or chemotherapy) to prevent remaining cells from dividing.

The two main goals of radiation therapy are to either treat the cancer, or to help relieve symptoms such as pressure and pain (palliative care).

Radiation therapy — also called radiotherapy or irradiation — is the use of high-energy x-rays, gamma rays, radioactive isotopes, or electron beams to kill cancer cells. Radiation destroys cancer cells by a process called ionization. The cancer cells either die immediately from direct contact with the radiation beam, or the damage to the chromosomes and DNA causes the cancerous cells to stop dividing.

Because radiation can also harm healthy cells, doctors carefully limit the amount of radiation a part of the body receives and spread the treatment over a period of time. They also shield as much surrounding healthy tissue as possible while they administer the radiation.

Radiation is generally given daily for five days a week. The duration of treatment can range from two to eight weeks depending on the tumor, dosage, and type of treatment used.

Types of Radiation Therapy

There are many different methods of delivering radiation therapy. Your radiation oncologist along with your primary physician, medical oncologist, and surgeon will determine the dose, administration, and duration of treatment.

  • External beam radiation is delivered from a machine outside the body that does not touch your skin or the tumor. The machine aims radiation through the skin directly at the tumor and surrounding tissue to destroy the primary tumor and any nearby cancer cells.
  • Before radiation treatments begin, your radiation oncologist will plan the dosage and how to direct the beam with the help of x-rays, CT scans, or other imaging studies in a process called simulation. During simulation you will lie on a table, and your doctors will use a simulator machine to identify the area of your body where you will receive radiation (the treatment field). Although simulation can take up to two hours, the actual radiation treatments will only take a few minutes. Depending on the type of treatment you will be receiving, devices to keep you from moving called body moulds may also be made during simulation. At the end of the simulation visit, very small ink marks or tattoos may be put on your body to identify the area to be treated. These marks help the radiation technologists accurately set up your treatment fields each day.

External radiation does not cause your body to become radioactive. Being around others poses no risk of radiation exposure.

  • Internal radiation is also called brachytherapy. In this treatment doctors implant a radiation source as close as possible to the primary tumor and surrounding cells. The type of implant and the implantation method depends on the size and location of the tumor. The implant may be permanent or temporary. This type of treatment allows doctors to deliver higher doses of radiation to the tumor with minimal exposure to surrounding tissue. Internal radiation is done by implanting the radioactive material into the tumor either through a thin wire, catheter, or seed.
  • While the actual radiation treatment is painless, some patients do have some side effects that include fatigue, sensitive or irritated skin to the area receiving radiation, and in some cases, loss of hair in the area being treated.

Hormones are chemicals produced by glands, such as the ovaries and testicles. These hormones help some types of cancer cells to grow, such as breast cancer and prostate cancer and hormone therapy may involve surgically removing a gland that is producing the hormones.

In other cases, hormones can kill cancer cells, make cancer cells grow slowly, or stop them from growing. In such cases hormone therapy as a cancer treatment may involve taking medications that interfere with the activity of the hormone or stop the production of the hormones.

How does hormone therapy work?

Usually a hormone receptor test is recommended to help determine treatment options and to learn more about the tumor. This test can help to predict whether the cancer cells are sensitive to hormones.

If the test is positive, it is indicating that the hormone is probably helping the cancer cells to grow. In this case, hormone therapy may be given to block the way the hormone works and help keep the hormone away from the cancer cells (hormone receptors).

If the test is negative, the hormone does not affect the growth of the cancer cells, and other effective cancer treatments may be given.

Hormonal treatments are most commonly used for treatment of breast and prostate cancers.

Immunotherapy, a new approach to cancer treatment, uses specially created antibodies made to recognize specific cancer cells.

The motive of such treatment is to stimulate or restore the ability of the immune system to fight infections, cancer, and other diseases. Immunotherapy is also known as biological therapy, biotherapy, or biological response modifier (BRM) therapy.

The immune system of body includes spleen, lymph nodes, tonsils, bone marrow, and white blood cells. These all help to protect oneself from getting infections and diseases. When the immune system works the way it should, it can tell the difference between “good” cells that keep you healthy and “bad” cells that make you sick. But sometimes this doesn’t happen.

Doctors are doing research to learn why some immune systems don’t fight off diseases like cancer. Cancer vaccines are a form of biological therapy that may help your body fight the cancer and keep it from coming back.

While other vaccines (like ones for measles or mumps) are given before you get sick, cancer vaccines are given after you have cancer. Cancer vaccines may help your body fight the cancer and keep it from coming back.

Doctors are learning more all the time about cancer vaccines. They are now doing research about how cancer vaccines can help people diagnosed with some cancers such as melanoma, lymphoma, and kidney, breast, ovarian, prostate, colon, and rectal cancers.

Examples of immunotherapy / biological response modifiers include Trastuzumab ( Herceptin) for treatment of breast cancer and use of Bevacizumab (Avastin) and Cetuximab (Erbitux) in treatment of Colon Cancers.