Laser surgery uses a laser (an intense beam of light) to make bloodless cuts in tissue. It is also called laser therapy, photoablation or photocoagulation.
Why laser surgery is done
As a cancer treatment, laser surgery may be used to:
- destroy cancer cells
- remove tumours or abnormal tissue on or near the surface of an organ or the skin
- relieve symptoms caused by tumours, such as bleeding, pain, shortness of breath and blockages
Laser surgery isn’t used to treat all types of cancer. It is useful in treating:
- precancerous conditions of the cervix such as cervical intraepithelial neoplasia (CIN) and carcinoma in situ of the cervix
- esophageal cancer
- laryngeal cancer
- lung cancer
- precancerous conditions of the vagina
- precancerous conditions of the vulva
- penile cancer
- non-cancerous tumours of the skin
How laser surgery is done
Laser surgery is usually done in a clinic or hospital operating room. You may be given an anesthetic or sedative before the procedure. The doctor may use an endoscope (a tube-like instrument with a light and lens) to find the tumour, aim the laser at the tissue to be treated and transmit the laser beam.
The laser beam heats and vaporizes abnormal cells. It can also be used to remove a small piece of tissue to be examined under a microscope. When the doctor is finished, the laser is turned off and the endoscope, if used, is removed.
Different types of lasers can be used in laser surgery. They differ in how deep the laser cuts into tissues. The following 3 types of lasers are most commonly used in cancer treatment.
Carbon dioxide (CO2) laser removes thin layers from the surface of the skin without going into deeper layers. It is used to treat tumours on the surface of the skin or organ (they have not grown deeply into the tissue). It is also used to treat certain precancerous conditions, such as cervical intraepithelial neoplasia (CIN) or carcinoma in situ of the cervix.
Dye lasers are used in photodynamic therapy (PDT), which uses drugs that become active when they are exposed to light (called photosensitizers) to destroy cancer cells. The laser passes through layers of tissue close to the surface. It cannot pass through more than 3 mm (about 1/10 in) of tissue. Dye lasers are used in eye surgery. They are also used to treat tumours on or just under the skin and on the lining of internal organs, such as the lungs, esophagus, gastrointestinal tract and bladder. Dye lasers are being replaced by smaller, less expensive lasers.
Neodymium:yttrium-aluminum-garnet (Nd:YAG) lasers can go deeper into tissue than other types of lasers. This type of laser can be carried through fibre optic cables in an endoscope to treat parts of the body that are hard to reach. Nd:YAG lasers are used to treat certain types of cancer, including throat, skin, liver and prostate cancers. They are also used to stop bleeding or remove abnormal cells from the skin.
Side effects can happen with any type of treatment, but everyone’s experience is different. While laser surgery can cause some side effects, they are less severe than the side effects of other cancer treatments. Side effects of laser surgery will depend mainly on the area of the body treated.
Side effects can happen any time during, immediately after or a few days or weeks after laser surgery. Most side effects go away when treatment is over. Generally, people do not have long-term side effects after laser surgery.
Tell your healthcare team if you have these side effects or others you think might be from your laser surgery. The sooner they are aware of any problems, the sooner they can suggest ways to help you deal with them.
Pain often occurs because of trauma to the tissue during laser surgery. It may take time for pain to lessen after laser surgery, depending on the procedure done and how the person heals or copes with pain. Pain-relieving medicines may be offered to control pain. Check with your doctor if pain doesn’t go away or pain medicines do not relieve the pain.
Find out more about pain.
Bleeding is less likely to occur with laser surgery than after other surgical techniques because heat from the laser seals off the blood vessels. Tell your doctor or healthcare team if have heavy bleeding after laser surgery.
The laser makes heat, which sterilizes the site and lowers the chance of infection. Tell your healthcare team if you have signs of infection, such as unusual drainage and fever. They may prescribe medicine to treat an infection if it occurs.
Find out more about infection.
Special considerations for children
Being prepared for a test or procedure can lower anxiety, increase cooperation and help the child develop coping skills. Parents or caregivers can help prepare children by explaining to them what will happen, including what they will see, feel and hear during the procedure.
How you help a child prepare for laser surgery depends on their age and experience. Find out more about helping children cope with tests and treatment.
Questions to ask about laser surgery
To make the decisions that are right for you, ask your healthcare team questions about laser surgery.
Treatment with drugs that become active when exposed to light (photosensitizers).
During PDT, the photosensitizer is applied to the skin or injected into a vein and cancer cells absorb it. After a period of time, the cancer cells are exposed to light, which activates the photosensitizer and destroys the cancer cells.
Also called photochemotherapy, photoradiation therapy and phototherapy.