Surgical Oncology or cancer surgery as it is commonly known is the branch of cancer medicine, which deals with the removal of cancerous growths in an organ. Typically the cancers amenable to surgical treatment are called solid organ cancers as distinct from those involving the blood or bone marrow elements [leukemias or blood cancer] or lymphatic glands [lymphomas].
Solid organ cancers include those involving the mouth, throat, voice box, intestinal system, liver and pancreas, genitourinary organs, breast, brain and bones. In almost all these cancers, surgical intervention is necessary to obtain a diagnosis or to cure the patient.
The field is continuously evolving and some of the latest advances which we have incorporated into practice and which we offer at Apollo hospitals are as below:
Organ preservation surgery:
Previously, cancer surgery was mutilating and associated with functional and cosmetic defects. Modern cancer treatment uses radiation and chemotherapy to shrink tumours, so that a less mutilating but equally effective operation can be performed. For instance, in rectal cancers, almost half the patients would normally require complete removal with a permanent bag to drain intestinal contents [colostomy], now we are able to shrink tumours with radiation, such that the majority of patients are able to have a normal intestinal passage without need for a bag.
Breast cancer is another tumour wherein the majority of women do not need complete removal of the breast. Chemotherapy can be used to shrink the tumour followed by removal of the lump and the nodes in the armpit, preserving the form and function of the breast. This is especially important as we see more women with cancers at a young age.
Minimally invasive surgery:
Until recently, cancer surgery was always open using large incisions. Numerous studies have shown that ‘keyhole’ surgery using laparoscopic techniques is equally effective, has similar cure rates, is less painful and has a quicker return to normal activities than open surgery. We offer minimally invasive surgery for cancers of the foodpipe [esophagus], stomach, pancreas, large intestine [colon] and rectum and for gynaecologic cancers involving the uterus and cervix.
robot assisted prostate cancer surgery
Is a new technology wherein a computer interface is used to perform meticulous surgery for abdominal and chest cancers. The surgeon performs ‘key hole’ surgery sitting at a console, which has controls to manipulate the robotic instruments inside the patient. The Robot is completely under the surgeons’ control at all times. The advantages of robotic technology include highly magnified 3 D vision and instruments, which are able to reach the narrowest of spaces to clear the cancer. This results in a more radical cancer operation with better preservation of nerves and other critical structures. The benefits to the patient include less blood loss, shorter length of stay, quicker return of normal function and less pain as compared to laparoscopy and open surgery. Several cancers are amenable to removal by robotic technology including all the cancers treatable by laparoscopy, with the greatest benefit in cancers of the rectum, cervix and uterus.
Published Dr. Ajit Pai-Surgical Oncologist (General, Visceral, Laparoscopic and Robotic cancer surgery) on behalf of Apollo Hospital