What Is Surgical Oncology (Cancer Surgery)?

Cancer is defined as uncontrolled, abnormal cell division. These abnormal cells come together to form a tumour. Not every tumour means cancer. Tumours are divided into two groups: benign and malignant. Both types can develop in any part of the body. However, only malignant tumours metastasise (spread) to other areas, and these are called cancer. A definitive cure for cancer has still not been found. However, as advancing technology is reflected in healthcare, work continues to develop and improve treatment options. Today there are several options for treating cancer. These are:

• Radiation therapy

• Chemotherapy

• Hormone therapy

• Immunotherapy

• Bone marrow transplantation

• Targeted therapy and

• Surgical oncology

Surgical oncology is one of the first-line treatment options used for cancer. Chemotherapy and radiation therapy, which are used very frequently, emerged in the last century, whereas surgery dates back much further. Surgical oncology can be used for all types of cancer. It means removing the tumour from the body using surgical methods and techniques. Surgical treatment can be performed at any stage of cancer. However, as the tumour grows and spreads, the operation may become more difficult, or treatments to shrink the tumour may be given beforehand. You may be a suitable candidate for surgical oncology in the following situations:

• To prevent cancer if you are at risk of developing it in a particular part of the body

• To remove an area that is likely to turn into cancer, both before and after cancer

Surgery can be difficult in advanced and complex types of cancer. For this reason, it is worth making sure that the healthcare institution you choose has experienced medical specialists. During your examination you can ask your doctor about the advantages and disadvantages of the treatment methods and share your concerns. Your doctor will create a treatment plan for you, taking into account factors such as the size and type of the tumour, your general health and your genetic predisposition. Your suitability for surgery is also assessed at this stage. During treatment, you may need to work with several healthcare professionals in addition to your doctor.

What Is Surgical Oncology (Cancer Surgery) Performed For?

Surgical oncology is a type of cancer treatment. Its main aim is to remove cancerous tissue from the body using surgical methods. However, it can also be performed for other reasons. The aims of surgical oncology are:

• Preventing cancer: If there is a risk of disease developing in any part of the body, an oncologist will want to prevent it before it occurs. Surgical oncology can be used for this purpose. For example, it may be preferred if a person has a strong family history of breast cancer or mutations in genes associated with breast cancer. A breast that is likely to develop cancer can be removed with surgery.

• Making a diagnosis: It is not possible to know whether a mass seen in the body with an imaging method is cancerous tissue. To find out whether the tumour is benign or malignant, a piece of the tumour is removed. The sample is examined in a laboratory to determine whether it contains cancer cells. This procedure is also called a biopsy.

• Determining the extent of cancer: Once cancer is diagnosed, the first questions that come to mind are often what stage it is and how serious it is. To find out, the size of the tumour is checked, along with whether it has spread to the lymph nodes or other areas and, if so, how large an area it has spread to.

Which Diseases Is Surgical Oncology (Cancer Surgery) Used For?

Surgical oncology may not be used for every type of cancer. However, it is an effective treatment option for many of them.

General Surgery

It covers diseases occurring in practically all parts of the body, affecting the head and neck, digestive system, breast, skin, soft tissue, endocrine and vascular systems. The role of the general surgeon includes diagnosing the cancer, staging it and determining its spread. Where necessary, they may also perform preventive surgery.

Thoracic Surgery

Thoracic surgery covers any operation in the chest area. Cancerous tissue in the heart, lungs, oesophagus, trachea (windpipe), diaphragm and chest wall (the area including the breastbone and surrounding muscles) falls within the field of thoracic surgery. Because this region contains many vital organs, much thoracic surgery is major. Both open and closed (minimally invasive) surgery can be used in thoracic surgery.

Gynaecologic Oncology

Gynaecologic oncology covers the structures and organs of the female pelvic region. The uterus, ovaries, cervix, fallopian tubes, vagina and vulva are some of these areas. Every woman is at risk of gynaecological cancer, and the risk increases with age. Early diagnosis can increase the effectiveness of treatment.

ENT Oncology

ENT oncology, ENT standing for ear, nose and throat, is also known as head and neck cancer. It covers cancerous tissue occurring anywhere in the head and neck region except the brain and eyes. Cancer can develop in the sinuses, inside or behind the nose, in the mouth, larynx or salivary glands.

Neuro-Oncology

Tumours of the brain and nerves, nervous system metastases and tumours of the spinal cord fall into this category. As with other types of cancer, a multidisciplinary treatment plan is applied. Thanks to new methods and devices developed with advancing technology, neuro-oncology has achieved small but definite improvements in survival.

Oncologic Head and Neck Surgery

These are cancers that originate in the head and neck region. They can include benign and malignant tumours of the salivary glands, oral cavity, pharynx, larynx, thyroid and parathyroid glands. Although the exact cause of these cancers is not fully known, smoking contributes greatly to cancers in this region.

Orthopaedic Oncology

It covers sarcomas, tumours arising in bone or soft tissue, and cancer cells that start elsewhere in the body and metastasise to bone.

Digestive System Surgery

It covers cancers of the structures and organs of the digestive system and abdominal cavity, such as the pancreas, duodenum, liver, gallbladder, colon and rectum.

Urologic Oncology

It covers the urinary tract of both men and women and the male reproductive organs, such as the kidneys, bladder, prostate, penis and testicles.

When Can Surgical Oncology Not Be Performed?

Surgical oncology may not be suitable for every patient or every type of cancer. Every method carries some risks and side effects, and some side effects may be more likely in particular groups. For these reasons, cancer treatment is planned individually. During your treatment, your doctor will decide whether surgical oncology is needed and in which situations it can be used. When planning your treatment, your doctor may take into account:

• The type of cancer

• The size of the cancerous tissue

• Whether the cancer has metastasised

• Where in the body the cancerous tissue is located

• Your general health

Our Technologies in Surgical Oncology

There are two main approaches used in surgical oncology: open surgery and minimally invasive surgery. The other methods are sub-branches of these two main approaches. Open surgery is conventional surgery, performed by fully opening the area to be treated through a large incision. However, disadvantages such as a long recovery period and a higher risk of complications created the need for a new approach. Minimally invasive treatment emerged as a result of these disadvantages. It is also known as closed surgery. Minimally invasive surgical techniques include:

Laparoscopy: The surgeon begins by making a few small incisions over the area to be treated. A thin tube with a camera at its tip (laparoscope) is then inserted through one of the incisions to reach the tumour. Various surgical instruments that help remove the tumour cells are placed through the other incisions. It is one of the most widely preferred minimally invasive surgical options.

Laser Therapy: Involves using a high-intensity beam of light to remove the tumour.

Cryosurgery: A treatment method in which cancerous tissue is destroyed by freezing. Liquid nitrogen is used for this.

Robotic Surgery: This is very similar to laparoscopic surgery. Unlike laparoscopy, however, computer-controlled surgical arms are used instead of hand-held surgical instruments.

Hisar Hospital Intercontinental is a hospital providing services to JCI standards. As in all its departments, it uses approved technologies in surgical oncology. Thanks to its patient- and environmentally friendly anaesthesia device, patients can receive low-flow anaesthesia before surgery. The surgical microscope used in delicate brain and nerve surgery helps protect the patient from the risk of paralysis. With its high-resolution endoscopy system offering HD-quality images, digestive system cancers can be detected at an early stage.

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da Vinci Robotic Surgery

The da Vinci robotic surgery system is one of the devices used in minimally invasive treatment. Its use in laparoscopic surgery was approved in 2000 by the FDA (U.S. Food and Drug Administration). The da Vinci robotic surgery system has:

• an easy-to-use, functional surgeon console,

• a high-quality vision system,

• arms that resemble the human arm but have far more flexible movement, and

• a patient cart with four interactive robotic arms.

Thanks to this system, human error is prevented, especially in high-risk operations. The computer-controlled robotic arms make this type of surgery essential for operations that require dexterity and precision. In addition, short incisions of 1–2 cm can be used instead of large, long incisions, allowing complex and delicate procedures to be performed accurately.