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Surgery for Cancer

By

Robert Peter Gale

, MD, PhD, Imperial College London

Last full review/revision Sep 2020| Content last modified Sep 2020
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  • Before surgery (neoadjuvant therapy) to reduce the size of the tumor before surgery

  • After surgery (adjuvant therapy) to ensure that as many cancer cells as possible are eliminated

If the cancer has not metastasized, surgery may cure the person. However, it is not always possible to be sure before surgery whether the cancer has or has not spread. During surgery, doctors often remove lymph nodes Overview of the Lymphatic System The lymphatic system is a vital part of the immune system. It includes organs such as the thymus, bone marrow, spleen, tonsils, appendix, and Peyer patches in the small intestine that produce... read more Overview of the Lymphatic System near the tumor (sentinel nodes) to see whether the cancer has spread to them. If so, the person may be at a high risk of having the cancer recur and may need chemotherapy or radiation therapy after surgery to prevent a recurrence.

Surgery is not the main treatment once a cancer has metastasized. However, surgery is sometimes used to reduce primary tumor size (a procedure called debulking), so that radiation therapy and chemotherapy may be more effective. Or surgery may be done to relieve symptoms, such as the severe pain or nausea or vomiting caused when a tumor blocks (obstructs) the intestine. Surgically removing metastases rarely results in a cure because finding all the tumors is difficult. Tumors that remain usually continue to grow. However, in certain cancers (such as renal cell cancer) that have a very small number of metastases, particularly to the liver, brain, or lungs, surgical removal of the metastases can be beneficial.

After a tumor has been removed, additional surgery may be needed to improve the person's comfort or quality of life (for example, reconstruction of a breast after mastectomy).

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