What is Cancer Surgery?

Aprobado por la Junta Editorial de Cancer.Net, 06/2023

Cancer surgery is an operation or procedure to remove a tumor from the body. Sometimes, some surrounding healthy tissue is also removed. It is the oldest kind of cancer treatment, and it still works well to treat many types of cancer today.

A doctor who specializes in cancer surgery is called a surgical oncologist. Cancer surgeries may also be done by other types of doctors who specialize in cancer or other types of surgery.

You might have surgery to remove a tumor, help your body work the way it used to, or relieve side effects. You may also need surgery to find out:

  • If you have cancer

  • Where the cancer is located

  • If it has spread or is affecting other organs in the body

Surgery can be performed in an doctor's office, clinic, surgery center, or hospital. Where the surgery is done depends on the type of surgery and how much time you will need to recover under the care of your health care team. If you do not need to be monitored for long after your surgery, you can go home the same day or the next day. This is called outpatient surgery or ambulatory surgery. If you need to be monitored for more time, you may stay at the hospital for more than one night. This is called inpatient surgery.

Your surgery may require medication to block the awareness of pain, called anesthesia. There are different types of anesthesia depending on the type and extent of surgery. Learn more about anesthesia.

This article is about the basics of cancer surgery and the different types. Learn more about what to expect when having surgery and the side effects of surgery.

What are the different types of cancer surgery?

Surgery can be done for many different reasons in a person's cancer care.

Diagnosis. A biopsy is the main way to diagnose many types of cancer. There are different kinds of biopsies. During a surgical biopsy, your doctor will make a small cut to remove some tissue. They may take a small sample or the entire tumor. Other types of biopsies, including fine needle aspiration and image-guided biopsies, use needles instead of surgery. Learn more about the different types of biopsies used for diagnosis.

After a biopsy, a pathologist looks at the tissue under a microscope. A pathologist is a doctor who looks at cancer cells, tissues, and organs to find disease. They tell your oncologist what the pathology report shows.

Staging. Surgeons do staging surgery to learn how large a tumor is, if it has spread, and if so, where. Your doctor may remove the entire tumor or take a sample. They may also take some lymph nodes near the cancer to learn if it has spread there. Lymph nodes are small, bean-shaped organs that help fight infection. They are often the first place a cancer spreads.

A pathologist will look at the tissue and talk with your oncologist about what they find. The results of staging surgery and other tests helps you and your doctor decide on treatment. The results can also help predict your chance of recovery.

As imaging scans get more advanced, more and more staging is done using such tests as ultrasounds, CT scans, MRIs, and X-rays. You may have scans along with surgery to help get accurate staging.

Tumor removal. Removing a tumor is a common type of cancer surgery. This may also be called a resection or excision. Your doctor usually takes out the tumor and some of the healthy tissue near it. The tissue around the tumor is called the margin.

Tumor removal generally requires a larger incision, or cut, than a biopsy. There may be less invasive surgical options for tumor removal, like a laparoscopic surgery or robotic surgery. These use small instruments and small incisions. With a less invasive surgery, you usually have less pain and recover faster.

Sometimes, surgery is the only cancer treatment needed. Or, you might also have additional treatments before or after your surgery. Treatment that is given before surgery to help shrink the tumor is called neoadjuvant treatment. Treatment that is given after surgery to treat any remaining cancer cells is called adjuvant treatment.

Debulking. Debulking surgery removes part, but not all, of a tumor. This surgery is done when the entire tumor cannot be removed. Debulking surgery may be recommended for some types of cancer if removing the entire tumor would damage other parts of your body or if the tumor is too large. Debulking removes as much of the tumor as possible.

Chemotherapy, radiation therapy, or other treatments might be given before or after this type of surgery. This can help shrink the tumor and treat the cancer.

Palliative surgery. The goal of palliative surgery is to relieve side effects caused by cancer and improve your quality of life. Examples are operations that can:

You may have palliative surgery at any point during your cancer care, but it is often a part of treatment for advanced cancer.

Reconstructive surgery. Treating cancer can change the way you look or how your body works. Reconstructive surgery can help with the effects of cancer treatment. Reconstructive surgery may be done at the same time the tumor is removed or after you have healed or had other treatments.

Examples of reconstructive surgery include breast reconstruction after a mastectomy and surgery to restore appearance and function after head and neck surgery.

Learn more about reconstructive surgery.

Prevention. Surgery can help lower the risk of getting cancer. For example, if a small growth called a polyp is found during a colonoscopy, surgery is usually recommended to remove it. This is because polyps can turn into colon cancer.

Another example is when some people with a high risk of breast or ovarian cancer have their breasts or ovaries removed before cancer develops. This might be because they have a strong family history of these types of cancer or mutations to the BRCA1 or BRCA2 gene. People with these mutations are more likely to get breast and ovarian cancers. Having preventive surgery lowers their risk.

The type of surgery depends on the type of cancer and/or the person's specific cancer risk. You can learn more about common types of surgery for specific types of cancer in another section of this website.

What are the different surgical techniques?

Cancer surgery is often major surgery. That's why researchers continue to work on ways to reduce surgery's overall effects on the body.

In open surgery, 1 large cut (incision) is often needed. Recovery from open surgery may be longer than other types of surgery that use smaller incisions. Before having surgery, be sure to talk about the expected recovery time period with your health care team. This conversation should include what kind of support you will need at home during your recovery so you and your loved ones can make a caregiving plan. And, understanding how you will feel and what to expect can also help reduce stress.

Sometimes, the surgeon may have an option to use a less invasive surgical technique. Minimally invasive surgery uses smaller incisions compared to open surgery. This approach also uses a camera, small instruments, and other equipment. Generally, the benefit of minimally invasive surgery is a faster recovery time with less pain. At-home caregiving may still be needed. Some of the common types of minimally invasive surgery are listed below.

Laparoscopic surgery. During laparoscopic surgery, the doctor makes several small cuts in the skin. A thin, lighted tube with a camera is inserted through one of the incisions. Then, the surgeon inserts small instruments through the other cuts to do the operation. There are different types of laparoscopic surgery, depending on the area where it is done. Your doctor may also use a robot to do this type of surgery, which may be called robot-assisted surgery. The instruments are controlled through robotic arms.

Laser surgery. A narrow beam of high-intensity light is used to destroy tissue.

Cryosurgery. During cryosurgery, liquid nitrogen is used to freeze and destroy abnormal cells.

Mohs surgery. This type of surgery is done to treat some types of skin cancer. It is also called microscopically controlled surgery. One thin layer of the cancer is removed at a time. They look at each layer under a microscope, and keep taking layers until every cell in the layer looks normal. Learn more about Mohs surgery for skin cancer.

Endoscopy. This type of surgery takes samples of tissues for your doctor or a pathologist to look at. An endoscopy can be used to look at tissue within organs, like your colon, stomach, bladder, or elsewhere in the body. It uses a thin, flexible tube with a light and camera on the tip. Your doctor puts the tube into your body through your mouth, nose, or other opening. They can also use a tiny instrument to take samples of tissue. Learn more about the different types of endoscopy.

New surgery techniques are being developed on a regular basis. Ask your doctor what all your surgical options are and how they compare to each other in terms of treatment effectiveness, side effects, recovery time, and cost.

Questions to ask the health care team

Before your cancer surgery, your health care team will provide you with important details, such as where the surgery will take place, when to arrive, any necessary pre-surgery preparations, and post-surgery recovery and follow-up care. Ask questions about anything that is not clear or about any concerns you may have. Knowing what to expect throughout this process can help you feel less nervous and help you regain a sense of control during this time of uncertainty. Below are a list of questions to consider asking when preparing for your cancer surgery and recovery.

  • What is the purpose of this surgery?

  • What tissue will be removed?

  • Will I need further tests or scans to help plan my surgery?

  • What will we learn about the tumor by doing this surgery? When will I get those results?

  • Will I need to have any cancer treatments in addition to surgery?

  • What types of surgical options are available to me? How do they compare?

  • Which surgical approach do you recommend for me? Why?

  • What will my surgery be like?

  • How long will the operation take?

  • Who will perform this surgery? How experienced is the surgeon in this type of operation?

  • What type of anesthesia will I receive?

  • What are the possible complications from this surgery?

  • Will I need someone to drive me home after this surgery?

  • Will I need to stay overnight or longer in the hospital?

  • What is the cost of this surgery under my health insurance plan?

  • If I am very nervous or anxious about having this surgery, what are ways I can cope with these feelings?

  • What side effects should I watch for after the surgery?

  • Who should I contact about any side effects I experience? How soon?

  • Are there side effects that I should tell you about right away?

  • Who should I contact if I have a question or need help after hours?

  • What will my recovery be like?

  • How will I need to take care of the surgical area/wound when I'm at home?

  • Will I need help at home during my recovery? For how long?

  • Are there things I can do at home to help my recovery?

  • Are there things I should avoid doing during my recovery?

  • Will I need rehabilitative services, such as physical therapy?

  • When can I return to work or school after this surgery?

  • When can I start exercising after this surgery?

  • When is my follow-up appointment to see my doctor after surgery?

Related Resources

What to Expect When Having Surgery

Side Effects of Surgery

Making Decisions About Cancer Treatment

Improvements in Surgery for Cancer: The 2020 Advance of the Year

More Information

American College of Surgeons: Surgical Patient Education for a Better Recovery

National Cancer Institute: Surgery for Cancer