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How Surgery Is Used for Cancer

Surgery is used to prevent, diagnose, stage, and treat cancer. Surgery can also relieve (palliate) discomfort or problems related to cancer. Sometimes, one surgery can take care of more than one of these goals. In other cases, different operations may be needed over time. You will find specific cancer operations discussed in treatment information for each cancer type.

Surgery to diagnose cancer

Surgery is one way to help diagnose cancer. In most cases, the only way to know if a person has cancer and what kind of cancer it is, is by taking out a small piece of tissue (called a sample) and testing it. The diagnosis is made by looking at cells from the sample with a microscope or by doing other lab tests on it. This procedure is called a biopsy. Biopsies taken during surgery are often referred to as surgical biopsies. How a sample is taken depends on where the tumor is and what type of cancer is suspected. For example, the method used for prostate biopsies is different from those used for lung biopsies.

Learn more about different types of biopsies in Testing Biopsy and Cytology Specimens for Cancer.

Surgery to stage cancer

Staging surgery is done to find out how much cancer there is and how far it has spread. During this surgery, the area around the cancer including lymph nodes and nearby organs is examined. This is important because it provides information to guide treatment decisions and predict how people will respond to treatment. To learn more about this, see our information on Cancer Staging.

Curative surgery

Curative or primary surgery is usually done when cancer is found in only one part of the body, and it’s likely that all of the cancer can be removed. In this case, surgery can be the main treatment. It may be used alone or along with other treatments like chemotherapy or radiation therapy, which can be given before or after the operation.

Surgery to debulk cancer

Debulking surgery is used to remove some, but not all, of the cancer. It’s sometimes done when taking out the entire tumor would cause too much damage to nearby organs or tissues. For example, it may be used for advanced cancer of the ovary and some lymphomas. In these cases, the doctor may take out as much of the tumor as possible and then treat what’s left with radiation, chemotherapy, or other treatments.

Palliative surgery

This type of surgery is used to treat problems caused by advanced cancer. Palliative surgery can be used to correct a problem that’s causing discomfort or disability. For example, some cancers in the belly (abdomen) may grow large enough to block off (obstruct) the intestine. If this happens, surgery can be used to remove the blockage. Palliative surgery may also be used to treat pain when the pain is hard to control by other means. Palliative surgery helps ease problems caused by cancer and helps people feel better, but it’s not done to treat or cure the cancer itself.

Supportive surgery

Supportive surgery is done to help make it easier for people to get other types of treatment. For example, a vascular access device such as a Port-A-Cath® or Infusaport® is a thin, flexible tube that can be surgically placed into a large vein and connected to a small drum-like device that’s placed just under the skin. A needle is put into the drum of the port to give treatments and draw blood, instead of putting needles in the hands and arms each time.

Restorative (reconstructive) surgery

Reconstructive surgery is used to improve the way a person looks after major cancer surgery. It’s also used to restore the function of an organ or body part after surgery. Examples include breast reconstruction after mastectomy or the use of tissue flaps, bone grafts, or prosthetic (metal or plastic) materials after surgery for head and neck cancers. For more on these types of reconstructive surgery, see Breast Reconstruction Surgery and Oral Cavity and Oropharyngeal Cancer.

Preventive (prophylactic) surgery

Preventive or prophylactic surgery is done to remove body tissue that’s likely to become cancer – even though there are no signs of cancer at the time of the surgery. Sometimes an entire organ is removed when a person has a condition that puts them at very high risk for having cancer there. The surgery is done to reduce cancer risk and help prevent the chance of cancer, but it doesn’t guarantee cancer prevention.

For example, some women with a strong family history of breast cancer have an inherited change in a breast cancer gene (called BRCA1 or BRCA2). Because the risk of breast cancer is very high, removing the breasts (prophylactic mastectomy) may be considered. This means the breasts are removed before cancer is found.

How Is Chemotherapy Used to Treat Cancer?

Chemotherapy is the use of any drug to treat any disease. But to most people, the word chemotherapy means drugs used for cancer treatment. It’s often shortened to “chemo.” Surgery and radiation therapy remove, kill, or damage cancer cells in a certain area, but chemo can work throughout the whole body. This means chemo can kill cancer cells that have spread (metastasized) to parts of the body far away from the original (primary) tumor.

What is radiation therapy?

Radiation therapy uses high-energy particles or waves, such as x-rays, gamma rays, electron beams, or protons, to destroy or damage cancer cells. Your cells normally grow and divide to form new cells. But cancer cells grow and divide faster than most normal cells. Radiation works by making small breaks in the DNA inside cells. These breaks keep cancer cells from growing and dividing and cause them to die. Nearby normal cells can also be affected by radiation, but most recover and go back to working the way they should.

Unlike chemotherapy, which usually exposes the whole body to cancer-fighting drugs, radiation therapy is usually a local treatment. In most cases, it’s aimed at and affects only the part of the body being treated. Radiation treatment is planned to damage cancer cells, with as little harm as possible to nearby healthy cells.

Some radiation treatments (systemic radiation therapy) use radioactive substances that are given in a vein or by mouth. Even though this type of radiation does travel throughout the body, the radioactive substance mostly collects in the area of the tumor, so there’s little effect on the rest of the body.

What Is Targeted Cancer Therapy?

Researchers have learned about some of the differences in cancer cells (or other cells near them) that help them grow and thrive. This has led to the development of drugs that “target” these differences. Treatment with these drugs is called targeted therapy.

Targeted therapy drugs, like other drugs used to treat cancer, technically are considered chemotherapy. But targeted therapy drugs don’t work the same way as standard chemotherapy (chemo) drugs. For example, many targeted drugs go after the cancer cells’ inner workings – the programming that makes them different from normal, healthy cells, while leaving most healthy cells alone. These drugs tend to have side effects different from standard chemo drugs.

Targeted therapy is a special type of chemotherapy that takes advantage of differences between normal cells and cancer cells. It’s sometimes used alone, but most often other cancer treatments are used with targeted therapy.

Targeted drugs can be used as the main treatment for some cancers, but in most cases they’re used with other treatments such as chemo, surgery, and/or radiation therapy.

What Is Cancer Immunotherapy?

Immunotherapy is treatment that uses certain parts of a person’s immune system to fight diseases such as cancer. This can be done in a couple of ways:

  • Stimulating your own immune system to work harder or smarter to attack cancer cells
  • Giving you immune system components, such as man-made immune system proteins

Some types of immunotherapy are also sometimes called biologic therapy or biotherapy. In the last few decades immunotherapy has become an important part of treating some types of cancer. Newer types of immune treatments are now being studied, and they’ll impact how we treat cancer in the future. Immunotherapy includes treatments that work in different ways. Some boost the body’s immune system in a very general way. Others help train the immune system to attack cancer cells specifically. Immunotherapy works better for some types of cancer than for others. It’s used by itself for some of these cancers, but for others it seems to work better when used with other types of treatment.