Surgery for childhood leukemia

Surgery has a very limited role in the treatment of childhood leukemia. Because leukemia cells spread throughout the bone marrow and to many other organs through the blood, it is not possible to cure this type of cancer by surgery. Aside from a possible lymph node biopsy, surgery rarely has any role even in the diagnosis, since a bone marrow aspirate and biopsy can usually diagnose leukemia.

Often before chemotherapy is about to start, surgery is needed to insert a small plastic tube, called a central venous catheter or venous access device (VAD), into a large blood vessel. The end of the tube stays just under the skin or sticks out in the chest area or upper arm. The VAD is left in place during treatment to give intravenous (IV) drugs such as chemotherapy and to take blood samples. This lowers the number of needle sticks needed during treatment. It is very important for parents to learn how to care for the catheter to keep it from getting infected.

In cases where a boy with leukemia has a relapse of the disease in a testicle, surgery may sometimes be done to remove the testicle (along with giving chemotherapy to treat the rest of the body).