Surgery’s Role in Cancer Management

Surgery removes the tumour along with a small amount of surrounding healthy tissue known as margin. Surgery is used in various stages of cancer management:

• A surgery or biopsy is considered while diagnosing various cancer types. A biopsy helps oncologists in determining the type, stage and size along with various other parameters related to particular cancer.
• Surgery removes the tumour and tumour-affected lymph nodes and organs and prevents cancer from spreading to other regions.
• Surgery might also help reconstruct the body parts that were operated on to treat cancer.
• Surgery may also be performed as a part of palliative care to ease the cancer symptoms.

There are a number of factors that surgical oncologists consider, before recommending surgery for a cancer patient. The key factors include the type of cancer, size, stage of the tumour, location and grade along with general parameters such as the patient’s age, underlying medical conditions and the overall physical condition.

Surgery is often combined with other treatment modalities such as radiation therapy, chemotherapy or hormone therapy. This multimodal approach is proven to be more effective in managing cancer and preventing recurrence than single line treatment.

Advanced Surgical Procedures at HCG

Organ Preservation Surgery:

During organ preservation surgery, the specialists remove the tumour only and not the entire organ. Organ preservation surgeries play an important role in the management of breast cancer, tongue cancer, throat cancer, prostate cancer, etc.

The key advantages of organ preservation surgeries:

• Organ preservation surgery promotes faster treatment recovery
• Organ preservation surgeries cause less damage to the surrounding healthy tissues
• These surgeries help in preserving the quality of life and sense of confidence among the patients.

Reconstruction Surgery:

For a few cancers, the cancer-affected organ has to be removed along with the surrounding tissues and sometimes lymph nodes, too. These organ-removal surgeries may change the appearance or reduce the functioning of the cancer-affected organ, which could be the head and neck region, breast, bladder, colon, etc. Therefore, post-cancer surgery, reconstruction surgery is needed in order to restore the appearance or functioning of the organ that was once cancer-affected.

Reconstruction surgery involves the transferring of tissues or bone from a different part of the body to the part where the cancer surgery is performed. These tissues could come from the abdomen, upper back, buttocks or inner thighs.

Reconstruction surgery has the following advantages:

• Reconstruction surgeries help in restoring the functions of the organ that was affected by cancer.
• Reconstruction surgeries restore the appearance of the surgically removed organ to a larger extent and positively impacts the aesthetics.
• These surgeries could help patients regain their confidence and sense of self. Reconstruction surgeries can have an overall positive impact on the psychosocial wellbeing of cancer patients.

Latest technologies like 3D prints are helping surgical oncologists today to convert scanned 2D MRI/ PET/ CT images into a detailed, visible 3D model. This can help oncologists with more efficient treatment planning. The 3D modelling also helps in reconstruction surgeries by giving a better picture of the damage caused by cancer.

Minimally-Invasive Surgery

Minimally-invasive surgeries, unlike open surgeries, require very few, smaller incisions, to operate and remove the tumours. These surgeries cause less damage to the surrounding healthy tissues. Other advantages of minimally invasive surgeries include lesser pain and blood loss, faster recovery, shorter hospital stay and overall fewer complications.

Endoscopic Surgery or keyhole surgery uses an endoscope to study the internal organs and look for any abnormalities through very small incisions. During endoscopic surgery, a thin and flexible tube with a camera and light along with a surgical instrument is inserted through small incisions or natural orifices like nostrils and mouth. Thoracoscopy, laparoscopy, gastroscopy and colonoscopy are some of the common endoscopic procedures.

Laser Surgery uses high-intensity light beams to damage cancer cells. Laser surgeries can be used to shrink or destroy cancerous and precancerous growths. This form of surgery is most commonly used to manage superficial cancers like early-stage cancers of the cervix, vagina, lungs and skin. Laser surgeries are also used to alleviate the cancer symptoms, control the spreading and delay the disease progression.

Robotic Surgery is a mode of surgical approach that redefines precision and flexibility and thereby makes the surgical management of cancers more effective. Robotic surgeries give more control to the oncologists – this helps them precisely operate the tumour without causing much damage to the surrounding healthy tissues. Just like other minimally invasive procedures, robotic surgery uses tiny incisions to reach the tumour and operate it.

During robotic surgery, the robotic arms perform the surgery, and these arms are controlled by the surgeon who sits at the console. The high-definition 3D imaging available helps the surgeon understand the tumour location and perform the surgery more precisely.

The key advantages of robotic surgery include lesser pain, reduced infection risks, shorter hospital stay, reduced scarring and faster recovery.

At HCG, we house the groundbreaking da Vinci robotic surgery system that allows the surgeon to perform surgery more freely and precisely than ever. This robotic surgery system allows surgical oncologists to perform complex surgeries comfortably and improve the chances of positive clinical outcomes. The system’s intuitive EndoWrist technology enhances the efficiency of the procedure by offering a wider range of arm motions.

We, at HCG, begin the treatment planning with a thorough assessment of the patient’s overall condition. Then comes the prognosis of various treatment approaches and possible side effects along with methods to proactively manage them. A team of onco dieticians, rehabilitation experts and other clinicians work alongside the surgical oncologist to help the patients heal holistically and have a better quality of life after the surgery.