Surgery is the traditional approach to cancer treatment. In addition to being a highly effective treatment, surgery is often used to diagnose and stage (determine the extent) of the cancer. Thanks to advances in the surgical field, there are now less invasive techniques that remove cancerous tumors. Most cancer patients have some kind of surgery. Surgery offers the best chance for a cure in many different kinds of cancer, especially when the diagnosis is made early.
Prophylactic cancer surgery is done as a preventive measure. This type of surgery is performed on tissue that isn't currently malignant, but has a high chance of becoming malignant later. Prophylactic cancer surgery is typically done in patients with a precancerous condition, for example polyps within the colon. Preventive surgery may involve the removal or partial removal of an organ. An example is a mastectomy or radical lumpectomy on women who carry the breast cancer gene (BRCA1 or BRCA2.)
There are several different techniques used in diagnostic cancer surgery. In a biopsy, a small quantity of tissue is removed from the area of suspected cancer. Biopsy techniques include fine needle aspiration, needle core biopsy, excisional biopsy, and incisional biopsy. In an endoscopy, the surgery involves the use of an endoscope — a flexible tube that includes a magnified lens or video camera. This allows the surgeon to see close-up views of areas like the stomach, the throat, the colon, the bladder, and the respiratory tract. In laparoscopy, thoracoscopy, and mediastinoscopy the surgeon uses small incisions to see the body's interior and to obtain tissue for biopsy, if needed. When other diagnostic procedures don't yield the information needed, open surgery like laparotomy, thoracotomy, or mediastinotomy may be done.
There are now many different options in cancer treatment surgery. These include laser surgery to destroy cancerous growths, cryosurgery to freeze and destroy some precancerous conditions of the cervix, electrosurgery to kill cancer cells with electrical current, chemosurgery to use chemicals to help destroy cancerous tissues, and Mohs surgery to gradually shave away skin cancers in layers. Laparoscopic surgery allows for cancerous tissue removal in a minimally invasive way. It's often used to remove gallbladders and may be useful in cancer treatment in the future.
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