Oncology is a medical discipline dedicated to the diagnosis and treatment of cancer. Within the vast realm of cancer treatment, surgical procedures play a crucial role in removing tumours, preventing their spread, and restoring function and aesthetics. In this blog, we will delve into the world of oncosurgery, speciality surgical oncology, and explore the various types of surgical oncology procedures performed in the field, including resection, excision, and reconstruction.
Definition and Scope
Oncosurgery, also known as surgical oncology, involves the surgical management of cancer. It encompasses a wide range of surgical procedures aimed at removing tumours, nearby lymph nodes, and other affected tissues. The primary goal of oncosurgery is to eradicate cancer while preserving healthy tissues and organs.
The collaboratіve approach to cancеr treatment еntails close cooperation between surgical oncologist, medіcal oncologіsts, radiatіon oncologists, pathologіsts, and other spеcіalіsts, wіth surgіcal oncology playіng a crucіal rolе. This collaboration ensures comprehensive and tailored care for each patient.
Specialty Surgical Oncology
Surgіcal oncology has spеcialized fields that concentratе on particular cancеr types or body parts. Speciality surgical oncologists are highly trained and experienced in managing particular cancers, enabling them to offer the most effective treatment options. These specialists possess in-depth knowledge of the disease, the latest surgical techniques, and advancements in cancer care.
Types of Surgical Oncology Procedures
Here are the types of surgical oncology procedures:
- Tumour Resection: Tumour resection involves the removal of cancerous tissue while sparing as much healthy tissue as possible. The extent of the resection depends on the size, location, and stage of the tumour. There are three primary types of tumour resections:
- Wide Local Excision: Wide local excision, also known as partial resection, involves removing the tumour along with a margin of surrounding healthy tissue. This technique is commonly used for small, localised tumours.
- Segmental Resection: Segmental resection refers to the removal of a segment of an organ affected by cancer. It is performed when the tumour involves a larger portion of the organ but does not require its complete removal.
- Radical Resection: Radical resection is the complete removal of the tumour, along with surrounding tissues, such as lymph nodes, adjacent organs, or structures. This procedure is typically performed for advanced-stage cancers or cases where the tumour has infiltrated nearby structures.
- Lymph Node Dissection: Lymph node dissection involves the removal of lymph nodes near the primary tumour. It is crucial for staging the cancer and determining its spread. There are two main kinds of lymph node dissection:
- Sentinel Lymph Node Biopsy: Sentinel lymph node biopsy is a slightly invasive process performed to identify the first lymph node(s) to which cancer is likely to spread. By analysing these sentinel nodes, the surgeon can determine the extent of cancer spread and plan further treatment accordingly.
- Regional Lymph Node Dissection: Regional lymph node dissection involves the removal of lymph nodes in the region surrounding the primary tumour. This procedure helps in preventing the spread of cancer to other parts of the body and aids in determining the stage of the disease.
- Local Excision: Local excision is the removal of small tumours or lesions along with a margin of surrounding healthy tissue. It is commonly used for early-stage cancers that have not spread to nearby lymph nodes or distant organs. Examples of local excision procedures include lumpectomy (removal of a breast lump) and endoscopic resection (removal of tumours using minimally invasive techniques).
- Organ-Specific Excision: Organ-specific excision involves removing an entire organ affected by cancer. The choice of the procedure depends on the type and stage of cancer. Prostatеctomy, mastectomy, colеctomy, and nephrectomy arе somе examples of surgical procedures usеd to trеat cancеr. Prostatectomy іs thе removal of the prostate gland in casеs of prostatе cancеr, mastectomy is the removal of thе brеast іn casеs of breast cancеr, and nephrectomy is thе rеmoval of thе kіdnеy in cases of kidnеy cancеr.
Introduction to Reconstruction
Reconstruction in surgical oncology refers to procedures performed after tumour removal to restore form and function, improve aesthetics, and enhance the quality of life for cancer patients. It can involve reconstructing the breast, jaw, limbs, or other affected areas.
Types of Reconstruction
- Flap Reconstruction: Flap reconstruction involves transferring tissue, including skin, fat, and muscle, from one part of the body to another to reconstruct the affected area. The tissue may be taken from regional or free flap locations. Flap reconstruction is commonly used in breast reconstruction after mastectomy or in head and neck cancer reconstruction.
- Implant-based Reconstruction: Implant-based reconstruction utilises silicone or saline-filled implants to restore the shape and volume of the affected area. This method is commonly employed in breast reconstruction.
- Tissue Expansion: Tissue expansion involves placing a balloon-like device beneath the skin near the affected area. Over time, the device is gradually filled with a saline solution, stretching the skin and creating space for subsequent reconstruction.
Surgical procedures in oncology, including resection, excision, and reconstruction, play a vital role in the management of cancer. Oncosurgery, a specialised field within surgical oncology, offers tailored treatment options for different types and stages of cancer. Collaboration between surgical oncologists and multidisciplinary teams ensures comprehensive care for cancer patients.
By understanding the different types of surgical procedures and their applications, patients and their families can make informed decisions and work closely with their healthcare providers to determine the most suitable treatment plan for their specific situation.