A Guide to Cancer Surgery

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How is surgery used for cancer?

Surgery is done for many reasons. Some types of surgery are minor and may be called procedures, while others are much bigger operations. The more common types of cancer surgeries are reviewed here.

Preventive (prophylactic) surgery

Preventive or prophylactic surgery is done to remove body tissue that’s likely to become cancer – even though there are no signs of cancer at the time of the surgery. For example, pre-cancerous polyps may be removed from the colon during a colonoscopy.

Sometimes preventive surgery is used to remove an entire organ when a person has an inherited condition that puts them at a much higher risk for having cancer someday. (An inherited condition is passed on from parent to child.) For example, some women with a strong family history of breast cancer are found to have an inherited change (mutation) in a breast cancer gene (called BRCA1 or BRCA2). Because their risk of getting breast cancer is high, these women may want to consider prophylactic mastectomy. This means the breasts are removed before cancer is found.

Diagnostic surgery

Surgery is often used to help diagnose cancer. In most cases, the only way to know if a person has cancer and what kind of cancer it is, is by taking out a piece of tissue (called a sample) and testing it. This is often called a biopsy. The diagnosis is made by looking at the cells of the sample under a microscope or by doing other lab tests on it. There are many ways to get a sample of cells from an area that looks like it might be cancer. These are described in more detail in the section called “Surgery to diagnose and stage cancer.

Staging surgery

Staging surgery is done to find out how much cancer there is and how far it has spread. The physical exam and the results of lab and imaging tests are used to figure out the clinical stage of the cancer. But the surgical stage (also called the pathologic stage) is usually a more exact measure of how far the cancer has spread. To learn more about this, see our information on Staging.

Examples of surgical procedures commonly used to stage cancers, like laparotomy and laparoscopy, are described in the section called “Surgery to diagnose and stage cancer.

Curative surgery

Curative surgery is usually done when cancer is found in only one part of the body, and it’s likely that all of the cancer can be removed. In this case, curative surgery can be the main treatment. It may be used alone or along with other treatments like chemotherapy or radiation therapy, which can be given before or after the operation. Sometimes radiation therapy is actually used during an operation. (This is called intraoperative radiation therapy.)

Debulking surgery

Debulking surgery is used to remove some, but not all, of the cancer. It’s sometimes done when taking out all of the tumor would cause too much damage to nearby organs or tissues. For example, it may be used for advanced cancer of the ovary and some lymphomas. In these cases, the doctor may take out as much of the tumor as possible and then treat what’s left with radiation, chemotherapy, or other treatments.

Palliative surgery

This type of surgery is used to treat problems caused by advanced cancer. Palliative surgery can be used to correct a problem that’s causing discomfort or disability. For example, some cancers in the belly (abdomen) may grow large enough to block off (obstruct) the intestine. If this happens, surgery can be used to remove the blockage. Palliative surgery may also be used to treat pain when the pain is hard to control by other means. Palliative surgery helps ease problems caused by cancer and helps people feel better, but it’s not done to treat or cure the cancer itself.

Supportive surgery

Supportive surgery is done to help make it easier for people to get other types of treatment. For example, a vascular access device such as a Port-A-Cath® or Infusaport® is a thin, flexible tube that can be surgically placed into a large vein and connected to a small drum-like device that’s placed just under the skin. A needle is put into the drum of the port to give treatments and draw blood, instead of putting needles in the hands and arms each time.

Restorative (reconstructive) surgery

This type of surgery is used to improve the way a person looks after major cancer surgery. It’s also used to restore the function of an organ or body part after surgery. Examples include breast reconstruction after mastectomy or the use of tissue flaps, bone grafts, or prosthetic (metal or plastic) materials after surgery for head and neck cancers. For more on these types of reconstructive surgeries, see Breast Reconstruction After Mastectomy and Oral Cavity and Oropharyngeal Cancer. They can be read online or you can get a copy by calling 1-800-227-2345.

Last Medical Review: 09/03/2014
Last Revised: 09/29/2014