Surgical oncology is a specialized area of oncology that engages surgeons in treating cancer with surgery.
It is actually an alternative therapy seeking unconventional methods in cancer treatment.
Surgical oncology includes the routine procedures related to the cancer patient's cure, palliative care, and also
deals with quality of life. Surgical oncology is most effectively performed on local tumor excision, regional
lymph node removal, the handling of cancer recurrence, and in rare cases, with surgical resection of metastases from the primary tumors
With the advancement of biology, pathophysiology, diagnostics, and staging of malignant tumors cancer has become a medical specialty warranting its own surgical area. Traditionally surgeons used to treat cancer patents with resection and radical surgeries of tumors. The management of cancer and the patients was left to other specialists. With the advancement in the early diagnosis of cancer, the staging of tumors, microscopic analyses of cells together with increased understanding of cancer biology has greatly helped in broadening the range of nonsurgical cancer treatments. Which includes systematic chemotherapy, hormonal therapy, and radiotherapy.
There may be many reasons when people look towards surgery as alternative treatment for their disease. Mostly patients accepts conventional treatment, he may go for surgery as because these treatments are non toxic and may add an additional factor in bringing about cure by raising their body strength and disease fighting capacity. Sometimes patient is reluctant to go through all the hassles of a rigorous conventional treatment and seek easier solution through alternative paths which he thinks is cheaper, easier to comply with and has no side effects.
Oncosurgery is most helpful in case of local excision. Here Excision means the removal of cancer and its effect. The resection of a tumor in the colon usually ends the effect of abstruction,or the cancer can even be stoped by the removal of a breast carinoma.Resecting the tumor at the primary stage can stop it from spreading throughout the body. Usually before a local removal cancer can spread into other body system,however, giving resection there is little bearing upon cells that have already escaped the primary tumor. A new diagnostic role is offered to the surgeons using excision by the advancement in oncology through pathophysiology. Simple diagnostic information like the size, grade, and extent of the tumor, as well as more sophisticated evaluations of the cancer's biochemical and hormonal features is easily available through these advancement.
Regional lymph node removal
Involvement of the Lymph node provides surgical oncologists with major diagnostic information. In terms of prediction of cancer mortality rates, the sentinel node biopsy is much more advanced to any biological test. Every precise information regarding the extent and type of invasive effects of the primary tumor is now offered by Nodal biopsy. However patients may suffer from pain and other morbid conditions due to the removal of nodes.
Distant metastases surgery
Mostly it is less likely to controll a cancer tumor that has spreads further from its primary site through surgery. Research state that surgical removal of a distant metastasis is not warranted, except for a few instances where a metastasis is confined. Usefulness of surgery is not time-dependent as because the rapidity of discovering a distant metastasis has little effect upon cancer survival. Like for example in the case of liver metastasis, a cure depends on the pathophysiology of the original cancer and level of cancer antigen in the liver rather than the size or time of discovery. However surgery of metastatic cancer may not increase life, there can be indications for it like pain relief, obstruction removal, control of bleeding, and infection resolution.
According to specialist in Onco surgery in "a new reality in metastatic colorectal carcinoma" states that Surgery is the only curative option for the treatment of liver metastases from colorectal cancer. However, fewer than 25% of hepatic metastases are suitable for resection and as many as 70% of these will recur. A variety of factors have been identified as significant predictors of long-term survival following hepatic resection, and improved surgical techniques such as cryosurgery, radiofrequency ablation, portal vein embolization, and two-stage hepatectomy have been developed to overcome some of the negative factors that contribute to poor prognosis. It has been observed that adjunctive 5-fluorouracil-based chemotherapy has had little impact on outcome, the new platinum derivative oxaliplatin added to 5-fluorouracil plus leucovorin has improved time-dependent parameters of efficacy and successfully downstaged the disease in some patients with unresectable metastases. In a recent study in 389 such patients, 151 of which had liver-only metastases, 51% treated with oxaliplatin became resectable with some patients achieving a complete histologic response. 95 initially unresectable patients in another series who became resectable after treatment with oxaliplatin-based therapy, 41% were still alive after 4.2 years, with 64% of these being recurrence-free. To eliminate residual disease after surgery Postoperative chemotherapeutic regimes have also been developed; however, the advantage of preoperative chemotherapy is the potential to achieve a conversion from unresectability to resectability of hepatic metastases from primary colorectal cancer.
Diagnosis and Preparation for the Surgery
Surgery helps in removing the cancer cells and surrounding tissues. It is mostly combined with radiation therapy and chemotherapy. Patients should meet with the surgical oncologist for detail discussion about the procedure and get prepare for surgery. Oncological surgery might be performed to biopsy a suspicious site for malignant cells or tumor. It is also very helpful in removing tumor from such organs as the tongue, throat, lung, stomach, intestines, colon, bladder, ovary, and prostate. Surgery can also remove tumors from limbs, ligaments, and tendons. In most cases, at the same time as the biopsy is done, the biopsy and surgery to remove the cancer cells or tissues are done together.
The diagnosis and the area of the body that is to be treated by surgery mainly determines the impact of the surgical procedure. Sometimes cancer surgeries involves major organs which are most extensive type of surgical procedure like open abdominal surgery. Such surgery requires lot of medical tests to be done and work-ups must be done to judge the health of the patient just before the surgery, and decisions must be taken about adjunctive procedures like radiation or chemotherapy. Patients must be mentally prepared for cancer surgery which requires psychological readiness for a hospital stay, postoperative pain, even sometimes slow recovery, and also of complications arising from tumor excision or resection. consultation with stomal therapists may also be required while removing and replacing a section of the urinary tract or bowel with an outside reservoir or conduit called an ostomy.
Risk and Recovery
The recovery after the surgery or the type and duration of side effects depends upon many factors like where in the body the surgery was performed and the patient's general health condition. The type of risks that is present in cancer surgery, depends almost entirely upon the part of the body being biopsied or excised. Risks from surgery can be more when major organs are involved, like the gastrointestinal system or the brain. These risks must be discussed in details by the surgeon before surgery decisions are made. Results of the surgery is stated in percentage of the chance of cancer to recur or spread after the surgery. Five years after the surgery if there is no reoccurrence or spread, the patients are usually considered to be cured. As because after five years the recurrence rates decline drastically.
Mortality rates of Oncosurgery
If there is mojor organ involvement or extensive excision of major parts of the body the mortality of oncological surgery are high. Patients may be very ill at the time of surgery. Even the complications of surgery may be quite complex.The complications may be extensive due to the use of general anesthetic and the opening of body cavities. Open surgery involves general risks associated with it irrespective of the type of procedure which includes possibility of blood clots and cardiac events. The surgeon must understand the complications or risks, and discuss them during the initial surgical consultations.
Alternatives to cancer surgery exist for almost every cancer now treated in the India.There are several alternatives to surgery like chemotherapy and radiation after surgery or radiation therapy. Mostly alternative treatments are suggested and discussed by physicians dealing with cancer patients.
India has gained repute across the world for its highly qualified and experienced medical teams, which are competent enough to provide highly specialized care to medical tourists from across the world. Leading cancer hospitals in India are facilated with latest drugs with clinical research back up for such surgecal treatment. World Class cancer treatment is offered at cancer hospitals in India, comparable with any of the western countries. India has state-of-the-art Hospitals and the well qualified doctors. With the best infrastructure, the best possible Medical facilities, accompanied with the most competitive pricing, you can get the treatment done in India at the lowest charges.
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