Principles

The main purpose of surgery is to treat cancer by removing it from the body. Sometimes surgery alone may be all that is needed to treat solid tumours. It is most successful if the cancer is early stage, localized and has not spread.

• Usually the surgeon removes the tumour and a surrounding margin of normal tissue to ensure that all the cancer is removed. The amount of normal tissue removed varies with the type and location of the tumour.
• In some cases, the lymph nodes nearest the tumour are also removed.
• A pathologist examines the tissues and lymph nodes removed during surgery under a microscope to see:
  • if the surgical margins are clear or not. Clear margins:
    • don't have any cancer cells in them
    • decrease the chance of cancer cells being left behind in the local tumour bed
  • if any of the lymph nodes contain cancer. This helps assess the need for further treatment.

Surgery with other therapies

Sometimes other therapies are used before surgery (neoadjuvant). Chemotherapy and radiation therapy are used to:

• shrink the tumour
• make it easier to do the surgery
• reduce the amount of tissue that has to be removed

Sometimes other therapies are used after surgery (adjuvant). Chemotherapy and radiation therapy are used to:

• destroy cancer cells that may have spread through the body
• reduce the risk of cancer coming back

The timing of adjuvant therapy varies, as both radiation and chemotherapy can affect wound healing if used too soon. A recovery period is usually preferred.

Surgery and cancer spread

Some people are concerned that having a biopsy or exposing cancer to the air during surgery will spread the cancer:

• there is only an extremely small chance that a needle biopsy causes cancer to spread
• exposure to air does not cause cancer to spread
• doctors take precautions to prevent cancer from spreading into healthy tissue during surgical procedures
• the benefits of doing the procedure usually clearly outweigh the risks