Surgery

Surgery is the most common type of cancer treatment and is often used in combination with other therapies. Surgery may be the best option to cure many types of cancer, especially those that have not metastasized, or spread.

Definition of treatment

Traditional surgery, which has been the standard of care for years, involves a large "open" incision, or cut, that may be as long as 10 inches. Even though traditional or open surgery is still done for certain procedures, it has increasingly been replaced by "closed" surgical procedures, or laparoscopy, which uses small, keyhole-sized incision. Robotic surgical systems are increasingly being used for minimally invasive or laparoscopic surgery.

Types of treatment

The more common types of cancer surgeries:

  • Curative surgery involves removing a cancerous tumor. 
  • Debulking surgery involves removing some, but not all, of the tumor so that nearby organs or tissues are not damaged.
  • Preventive surgery is used to keep your cancer from occurring in the first place. For example, a woman at high risk for breast cancer might opt to have a mastectomy.
  • Diagnostic surgery (biopsy) involves removing a tiny portion of a tumor to determine if it is cancerous. A biopsy can be done in several ways:
    • Fine needle aspiration (FNA) involves removing material from a tumor via a needle for microscopic inspection.
    • Incisional or excisional biopsy requires that a surgeon remove a piece of a tumor (incisional) or the entire mass (excisional) for further examination.
  • Staging surgery is performed to determine the extent of your cancer; tissue samples can be obtained through an incision, endoscope or laparoscope.
  • Supportive surgery is used in conjunction with other cancer treatments such as chemotherapy, which sometimes requires a port (connecting device) to be inserted under the skin.
  • Reconstructive surgery returns your body to normal or near-normal appearance or function after cancer treatment.
  • Palliative surgery is used to lessen pain, disability or other complications associated with advanced cancer.

UC San Diego Health System expertise

UC San Diego Health System surgeons use many cutting-edge surgical techniques for the treatment of various types of cancer, in addition to open and laparoscopic surgery. In addition, we offer patients with cancer the latest in minimally-invasive surgical approaches through the use of the da VinciTM robotic system.

The Center for the Future of Surgery at UC San Diego Health System is advancing scarless surgery techniques by investigating, developing, testing, and teaching procedures that will revolutionize the field of surgery. The goal of the Center for the Future of Surgery is to continually improve and expand surgery options using emerging technology so that patients experience less pain and better outcomes.

Cancers in the abdominal cavity, which may include colorectal, appendiceal or peritoneal (lining of abdomen)

Heated intraperitoneal chemotherapy (HIPEC), often called a ‘chemo bath,’ is a solution that is circulated in the abdominal area after an abdominal tumor has been surgically removed. The solution has been heated to about 106 degrees and circulates in the peritoneal cavity for about 90 minutes. Once the time is up, the surgeon removes the solution and closes the incision. HIPEC is only available at a handful of leading U.S. cancer centers.  Studies have shown that heat works especially well with chemotherapy to kill tumor cells, which have an impaired ability to deal with heat. In normal chemotherapy, the drugs diffuse within a few millimeters. In HIPEC, a higher concentration of chemotherapy is used and is able to penetrate deeper into bulky tissue for greater tumor cell kill.  Learn more about HIPEC at Moores Cancer Center.

UC San Diego Health System is also the only place in San Diego performing robotic-assisted colorectal surgery, having successfully performed more than 45 cases since 2006; it was one of the first hospitals in California and the country to do so.

Pancreatic cancer

The surgical technique most used for patients with pancreatic cancer is the Whipple procedure, or a pancreaticoduodenectomy, which involves the removal of the pancreas head and then the duodenum, the first portion of the small bowel. Sometimes the body of the pancreas and nearby lymph nodes may be removed. Whipple takes several hours because there are many blood vessels around the tumor, and the reconstruction is extensive as surgeons must make new connections between the small bowel, the pancreas and bile duct (so that bile can flow for proper food digestion), and a new connection between the small bowel and the stomach. 

Prostate cancer

Patient outcomes following robotic-assisted radical prostatectomy have been excellent, with cancer control, continence recovery and sexual potency recovery similar to the outstanding outcomes achieved by UC San Diego Health System surgeons using open retropubic radical prostatectomy–with the benefits of less bleeding, lower transfusion rate, less postoperative pain and quicker return to full activities.

Brain cancer

Surgeons have extensive experience in treating brain tumors with frameless stereotactic radiosurgery, a technique that uses a medical linear accelerator or Gamma Knife machine to send precisely focused, high-energy radiation beams directly to brain tumor–sparing the surrounding healthy tissues. The actual treatment takes about 30 minutes and the entire process, from physician consultation to treatment delivery, can be completed in less than a day.

Kidney cancer

Single-incision laparoscopic surgery through the belly button is being used to remove a total kidney that contains a tumor, as well as just the tumors in both the kidney and colon, thus preserving the kidney and colon. This pivotal advancement in cancer care, call Laparo-Endoscopic Single-Site Surgery (LESS), offers patients a shorter recovery time, less need for pain medication, and an improved cosmetic outcome.

FAQs

What will surgery be like?
This will depend on many things, including your type of cancer, as well as the type of operation and your overall health.

What are possible side effects of surgery?
As with any medical procedure, there is a risk of complications from surgery including bleeding, damage to internal organs and blood vessels, drug reactions, pain, infection and loss of function. Your health care team will go over all risks of surgery at the time of your consultation.

Are there different types of surgery?
Yes, including:

  • Laser surgery, which uses a focused beam of light energy to cut through tissue or to burn and destroy cancerous tumors,
  • Cryosurgery, which uses a liquid nitrogen spray or a cold probe to freeze and kill abnormal cells,
  • Electrosurgery, which uses a high-frequency electrical current to destroy cells, and 
  • Mohs micrographic surgery, which involves shaving off one thin layer of skin at a time to remove certain skin cancers.