Surgical oncology is one of a few interventional modalities available and used for the management of cancer. In the past surgical oncology was the only cancer treatment with a chance of success. Ancient Egyptians described techniques for removing breast tumors as early as in the 7th century.
The invention of anesthesia in 1846 significantly helped the progress of the oncological surgery as a cancer treatment. Finally surgeons were able to perform complex cancer operations like removing entire tumors together with lymph nodes. Later, Stephen Paget, a brilliant English surgeon, formulated a hypothesis that cancer cells were spread from primary tumor to other places through the blood stream. He described the process of forming metastasis as an unintended outcome of an oncological surgery. He also noted that metastasis could develop only in some organs and not the others. Understanding the mechanisms of cancer spreading became one of the key principles in recognizing the limitations of surgery as treatment for cancers.
Since then, oncological surgery has advanced and evolved into a modern discipline of surgery with focus on surgical treatment of various malignant tumors. As a modern modality, it has been founded on experience-related and research-proven primary principles for operating on cancerous tumors.
These critical principles, used in oncological surgeries, include the following:
- The no touch isolation technique — refers to the surgical removal of tumors with a minimum of manipulation, in order to prevent the shedding of cells during the operative procedure, to avoid causing distant metastases.
- The technique of lymphatic dissection — refers to the removal of lymph vessels, draining the tumour area and lymph node metastases.
- Tumour extraction without contamination — in other words, isolated surgical removal of the tumor to prevent “spilling” effect of the regional metastases of the removed tumour into other organs or tissues.
- Additional treatment of the tumour bed for thorough prevention and minimization of possibilities of regional recurrences. For this purpose, the clinic’s surgeons utilize specialized Regional Chemotherapy (RCT) techniques. These RCT techniques are usually arterial infusion and isolated perfusion of individual organs or segments of the body.
- Low-complication surgery has a direct impact on the quality of patient’s life. Such procedures would focus on minimizing operating time/duration as well as of the loss of blood. Focus on these issues helps to minimize and to avoid occurrence of postoperative complications, therefore, allowing to improve quality of care and of patient’s life.
- Reconstruction — particularly following extensive procedures for tumour removal. Avoidance of mutilating operations whenever possible is also an important element in maintaining good quality of patient’s life.
- Setting indications for surgery —this is especially important for patients with tumors in advanced stages. Surgical treatments are performed in a manner that is suitable for specific stage of the tumour and administered at the proper time. What is not less important, it is the extent of the surgical intervention. This factor is determined in accordance with the patient’s level of resilience, given his or her state at the time of assessment.