Advanced Cancer

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Surgery for advanced cancer

In cancer treatment, surgery is most often used for cancer that is localized, or limited to one area. Most of the time, the intent of surgery is to cure the cancer. Sometimes, though, surgery for a localized cancer may be used to remove only the major part of the tumor, and then other treatments such as radiation and chemotherapy are used to get rid of the rest.

If the cancer has spread to only one other part of the body and it’s not large, in some cases it may be possible to remove all of it. For example, if colon cancer has spread to the liver and there are only 1 or 2 tumors, surgery may be used to remove all of the tumors.

Surgery is not often used to treat advanced cancer, but it can be helpful in some cases. For example:

Surgery to relieve symptoms and improve your life

Surgery can improve your quality of life and may help you live longer, even when cancer has spread too far to be cured. For instance, cancer can sometimes block the bowel (intestine). This can be very painful and can be dangerous if the bowel is blocked completely. Surgery may be done to bypass the blockage so the bowel can work normally again. Another option is surgery to let the bowel drain outside the belly into a bag (called a colostomy [kuh-lahs-tuh-me]).

Sometimes, simple surgery is used to put in feeding tubes or to put small tubes into blood vessels for giving medicines to relieve pain.

Surgery to stop bleeding

Surgery may be done if the cancer is causing a lot of bleeding from the stomach, bowel, or airways. Often, the doctor will first look for the source of bleeding with an endoscope (a thin flexible tube that has a camera inside). The scope can be put in through the mouth or the rectum. The patient is given drugs to sleep while this is done. The doctor may be able to stop bleeding by burning the bleeding vessel closed with a tool passed through the scope (cauterizing). If this can’t be done, surgery to stop the bleeding may be an option.

Another way to find out where the bleeding is coming from is to use angiography (an-jee-AH-gruh-fee). For this test, a long, thin tube called a catheter is put into a large artery (such as the one in the groin) and threaded up to the arteries of the intestines or lungs. A dye is injected that allows the doctor to pinpoint the blood vessel that is bleeding. Often, substances can be injected through the catheter and into the vessel to stop the bleeding.

Surgery to stop pain

Sometimes a tumor may be pressing on a nerve. Either injecting something into the nerve to kill it, cutting the nerve, or taking out the tumor may relieve the pain.

Surgery to prevent or treat broken bones

Cancer that spreads to the bones may weaken them, causing breaks (fractures) that tend to heal very poorly. If a bone looks weak on an imaging test, surgery may be done to put in a metal rod to support it and help keep it from breaking. This is most often done in the thigh bone. If the bone is already broken, surgery can quickly relieve pain and help the person be more active.

Whether surgery will help depends on your overall physical condition. Major surgery is hardly ever helpful if you cannot get out of bed. The stress of the surgery can set you back even further. On the other hand, surgery may be a good idea if you are feeling fairly well and are active.

Surgery to treat cancer that is pressing on the spinal cord

If a tumor is pressing on the spinal cord, it can lead to a loss of muscle control and function below the level of the tumor. Surgery may be needed to remove the tumor and stabilize the bones in the spine so that the patient can continue to walk and function.

You can learn more about surgery in Understanding Cancer Surgery: A Guide for Patients and Families.


Last Medical Review: 02/07/2014
Last Revised: 03/06/2014