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Surgical Oncology in India

by Rishabh

What is Surgical Oncology?

Oncology that specializes in treating cancer by the means of surgery or by removing cancerous tissue or tumors is known as surgical oncology.

Surgery is considered as one of the oldest treatment for cancer that not only helps in staging and diagnosing but also helps in curing many types of cancer. A surgery is also effective in treating those cancers that have not spread to any other body organ.

Conditions Treated by Surgical Oncology

  • Soft tissue sarcomas
  • Head and neck cancers
  • Breast cancer
  • Gastrointestinal cancer
  • Stomach
  • Pancreas
  • Esophagus
  • Liver
  • Rectum and Colon
  • Melanoma
  • Endocrine Cancer
  • Multiple Endocrine Neoplasia Types 1 and 2
  • Thyroid
  • Adrenal Gland
  • Parathyroid
  • Neuroendocrine Tumors of the Gastrointestinal Tract

Surgical Oncology Procedures

Thyroidectomy : This procedure involves the removal of half or the entire thyroid for diagnosing and treating thyroid cancer.

Pancreatico duodenectomy or Whipple: This surgical procedure involves the removal of the head of the pancreas, growth on the duodenum and bile duct. A Whipple procedure may also be performed for strictures of the pancreatic duct or the bile and also for severe pancreatitis.  The last part of the surgery aims at reconstructing the pancreas, the bile duct and the stomach.

Breast Surgery: Mastectomy, biopsy and segmental or lumpectomy are some of the types of surgical procedures that are included in breast surgeries for treating breast cancer.

Melanoma Excision : The risk of recurrence of melanoma (a skin cancer) is reduced by making a wide excision of normal healthy skin around the affected part. The depth of the melanoma determines the width of the resection.

Rectal or Colon Resection : The rectal or colon cancer involves the removal of a part of the rectum or colon. In some cases, the bowel is re-connected so as to avoid an ostomy or stoma.

Distal Pancreatectomy : The end of the pancreas is surgically removed by performing a distal pancreatectomy. Injury, pancreatic cancer, pancreatic pseudocysts and chronic pancreatitis can be treated with the help of this procedure.

Gastrectomy: Gastrectomy is a procedure that involves the removal of a part or the entire stomach. The procedure is performed for treating stomach cancer or gastric cancer.

Liver Resection : This is considered as a treatment option for primary liver cancer and sometimes for metastatic liver cancer. Different types of liver tumors can be removed by performing the surgical procedure of liver resection. The primary aim is to remove all affected tissue and the tumors by leaving as much liver as possible.

Lymph Node Dissection: This procedure is primarily performed for treating skin or breast cancer. This can be either completion lymph node dissection or sentinel lymph node. The completion lymph node dissections involve the removal of all the lymph nodes from an area of the body that include groin or armpit. On the other hand, sentinel lymph node involves the removal of the first few lymph nodes that drain the affected area.

Esophagectomy: This procedure is performed for removing a part or the entire of the esophagus. The aim of the procedure is to treat esophagus cancer.

Surgical Oncology Techniques

Endoscopic Ultrasound (EUS): This surgical oncology technique allows –

  • To obtain samples by passing a needle inside the tumor that provides for a quick and precise diagnosis.
  • It also helps in determining the location and size of the tumor in the pancreas by providing a clear visualization of the pancreas and the digestive tract.

Minimally Invasive Surgery: Very small incisions are made for performing this minimally invasive surgery. This surgery makes use of certain specialized techniques either robotically with the Da Vinci surgical robot or laparoscopically. The procedure is performed by using high definition monitors, miniature cameras with microscopes and tiny fiber-optic flashlights. Only an incision or a stitch is required for performing this procedure. The major benefit of this procedure is that it results in less blood loss and quick recovery.

Stereotactic Breast Biopsy: This minimally invasive is considered as a safe form for breast biopsy. This technique is used for taking small samples of an abnormal breast mass for examining them. A breast abnormality is cancerous or non-cancerous is confirmed by these biopsies.

Radiofrequency Ablation: A thin needle guided by an ultrasound or computed tomography (CT) is inserted through the skin into the tumor. The tumor is heated and destroyed by delivering electrical energy by the needle. In majority of cases, a tumor can be effectively treated with the help of radiofrequency ablation in just one treatment session.

Reconstructive Surgery : The primary aim of a reconstructive surgery is to reconstruct an affected area from where surgical removal of the cancer has been done. This type of surgery is mainly used by plastic surgeons.

Sentinel Lymph Node (SLN) Biopsy: The first lymph node from where the cancer spreads from the primary tumor is known as the sentinel lymph node. Sentinel lymph node is the first lymph node where cancer cells first appears. More than one sentinel lymph node may also be present. The presence of cancer cells is determined and examined under a microscope by performing a SLN biopsy procedure that involves the removal of the sentinel lymph node.

Mohs’ Surgery: The cancer from the sensitive areas of the skin is removed with the help of this surgery. The cancer layer is carefully removed with the help of scalpel that is then examined under a microscope.

Electrosurgery: Cancer cells are destroyed by applying high-frequency electrical currents.

Cryosurgery: A cold probe or liquid nitrogen (a very cold material) is used for freezing and destroying the cancer cells.

Robotic Surgery: This surgery can be easily operated by a surgeon who sits away from the operating table and views the 3-D image on the screen of the area being treated. A surgeon controls the movement of a robot and also tells him how to use surgical tools for performing the operation. Robotic surgery is considered very beneficial for treating various types of cancer.

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