Common questions about surgery

Many people with cancer have surgery. Although many people want to have surgery to ‘cut the cancer out’, it isn’t a suitable treatment for all cancers.

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How is surgery used for cancer?

There are several reasons why surgery is used for cancer:

  • Prevention – Preventive or prophylactic surgery aims to remove healthy tissue that doctors believe will probably become cancerous in the future. It may significantly reduce a person’s cancer risk. For example, a woman with a strong family history of ovarian cancer may have prophylactic surgery to remove her healthy ovaries. The decision to have any type of prophylactic surgery should always be made after talking to qualified health professionals, including a genetic counsellor.
  • Diagnosis – Surgery may be done to confirm a cancer diagnosis. The doctor may remove all or part of a tumour in a procedure called a biopsy.
  • Staging – Surgery can help the doctor determine the size of the tumour and whether the cancer has spread. This is called staging. The results of the surgery and other tests will help the doctor work out the stage and decide on appropriate treatment. Call Cancer Council 13 11 20 for more information about staging.
  • Primary treatment – Small, early-stage cancers that haven’t spread are often successfully treated with surgery. If the cancer is confined to one part of the body, the surgeon will remove the cancerous tissue or a whole organ. This may be the only treatment, or it may be combined with other treatments.
  • Debulking – If it is not possible to remove all the cancer without damaging nearby healthy organs, a surgical procedure called debulking is done to remove as much of the tumour as possible and to make other cancer treatments more effective.
  • Reconstructing the body – Reconstructive or plastic surgery can be done for different reasons, such as to improve your appearance and self-image, and to help with mobility or function. Examples include breast reconstruction after a mastectomy, or a skin graft after surgery for skin cancer.
  • Supporting other treatments – Supportive surgery is done to help another cancer treatment. For example, you may have day surgery to insert a tube (catheter) into a large vein in your chest so you can receive chemotherapy (e.g. via a central venous access device or port).
  • Palliative treatment – Surgery can be used to improve quality of life by easing symptoms and side effects of cancer and treatment. For example, surgery may be done if the cancer grows very large and blocks the bowel (obstruction). Other surgical procedures can help to reduce pain.
Read more about how surgery is used for cancer

How is surgery done?

The way the surgery is done (the approach or technique) depends on the type of cancer, its location, the surgeon’s training and the equipment in the hospital/operating theatre. There are many different techniques that surgeons can use.

Doctors are constantly developing new surgical techniques with the aim of improving recovery times and causing less pain.

  • Open surgery – During open surgery, the surgeon makes a single vertical cut (incision) into the body to see and operate on the organs and remove cancerous tissue. Sometimes the cut can be quite large. Open surgery might also be used to find out more information about the cancer and its stage.

    For cancers in the abdomen or the pelvic area, open surgery is the most common approach and is known as a laparotomy. When open surgery is done on the chest area, it is called a thoracotomy.

  • Keyhole surgery – Also called minimally invasive surgery, this is when the surgeon makes a few small cuts in the body instead of the one large cut used in open surgery.

    For abdominal surgery (laparoscopy), the surgeon makes about 3–5 small cuts and inserts an instrument called a laparoscope. This has a camera and a light attached to it, and the images are projected onto a TV screen. Other instruments are used to remove cancerous tissue.

    Similar surgery can be performed on other parts of the body, such as the chest. This is sometimes called thoracoscopy or video-assisted thoracic surgery (VATS). Some people have keyhole surgery followed by open surgery.

    In many cases, keyhole surgery can lead to a shorter stay in hospital and reduce bleeding, pain and recovery time.

  • Robotic surgery – This is a type of keyhole surgery where the surgical instruments are moved by robotic arms controlled by the surgeon, who sits at a console next to the operating table.
  • Laser surgery – A laser can be used to remove or destroy cancerous tissue. In some cases, laser surgery can be less invasive than other types of surgery.
  • Cryosurgery – Also called cryotherapy, this is often used to treat skin cancers. Liquid nitrogen is sprayed onto the skin to freeze and kill the cancerous tissue.
Read more about how surgery is done

Will I stay in hospital?

Often you will need to be admitted to hospital to have surgery. This is called inpatient care. The length of your hospital stay depends on the type of surgery you have, the speed of your recovery and whether you have support at home after you are discharged.

It may be possible to have surgery as an outpatient (day surgery). This means you can go home soon after the surgery – you don’t have to stay overnight in hospital, provided there are no complications. Your doctor will tell you whether you will have surgery as an inpatient or outpatient at one of
your pre-surgery appointments.


What is a surgical margin

The surrounding tissue that is removed with the cancer is called the surgical margin. It is checked under a microscope in a laboratory by a pathologist. If there aren’t any cancer cells in the tissue, it is called a clear, negative or clean margin. If there are cancer cells, it is a positive or close margin, and you may require more treatment.


Can surgery spread the cancer?

There are some situations where it is possible for surgery to spread the cancer, but these are very rare. In these cases, surgeons take precautions and will still operate if the benefits of surgery outweigh the risk of not having it.

For example, most men with testicular cancer have the entire testicle removed. This is because removing only part of the testicle can increase the chance of the cancer cells spreading during surgery.

If the surgeon has to remove tissue from more than one part of the body, they will use different instruments at each location to reduce the risk of cancer cells spreading.

Some people think cancer can spread if it’s exposed to air during surgery. This is incorrect. This myth may exist because people who feel worse after surgery than they did before might believe this is due to the cancer spreading. However, it’s common to feel unwell after surgery.

Another reason people may believe that exposure to air can spread cancer is if the surgeon finds more cancer than expected. In this case, the diagnostic tests and scans may not have shown all of the cancer, but the cancer was already there – surgery didn’t cause it to spread.

If you are concerned about the cancer spreading during surgery, talk to your surgeon or call Cancer Council 13 11 20.

Read more about spread of cancer

What other treatments might I have?

Other treatments, such as chemotherapy or radiotherapy, can be given before, during or after surgery. Call Cancer Council 13 11 20 for information about these treatments.

  • Neo-adjuvant therapy – Given before surgery to try to shrink the tumour and make it easier to remove.
  • Adjuvant therapy – Given after surgery, often when:
    • the tumour hasn’t been completely removed
    • cancer has spread to other parts of the body, such as the lymph nodes
    • there is a chance there are hidden cancer cells
    • the cancer is likely to come back
  • Simultaneous therapy – Two types of treatment are given at the same time. This is rare – an example is specialised chemotherapy called hyperthermic intraperitoneal chemotherapy, which is delivered directly to the abdomen during surgery.
Read more about other treatments you may have

Printed copies are available for free - Call 13 11 20 to order

Instructions for downloading and reading EPUB files

Apple devices

The iBooks application must be installed on your Apple device before you can read the EPUB.
Different ways to download an EPUB file to your Apple device:

  • email EPUB files to yourself and transfer the attachment to iBooks.
  • copy EPUB files into DropBox (or a similar service) and use the DropBox app to send them to iBooks.
  • open EPUB files directly from Mobile Safari and open them in iBooks, where they are saved automatically by downloading the EPUB from the website.

Need more help? Visit: http://support.apple.com/kb/HT4059

Kobo

To download an EPUB file to your Kobo from a Windows computer:

  • download and save the EPUB directly onto your desktop.
  • connect your Kobo to your computer using the USB cable and tap “Connect” on your eReader.
  • select “Open folder to view files” to view the contents of your Kobo.
  • navigate to where you have stored your EPUB file in “Finder”, in documents or downloads, and drag and drop it into the Kobo window. You can now disconnect your Kobo to read the eBook.

To download an EPUB to your Kobo from a Mac:

  • download and save the EPUB directly onto your desktop.
  • connect your Kobo to your computer using the USB cable and tap “Connect” on your eReader.
  • open your “Finder” application.
  • select “Kobo eReader” from the listed devices to view the contents of your Kobo.
  • navigate to where you have stored your EPUB file in “Finder”, probably in documents or downloads, and drag and drop it into the Kobo window. You can now disconnect your Kobo to read the eBook.

Turn on your Kobo and your EPUB will be located in “eBooks”, while a PDF will be located in “Documents”.
Need more information? Visit: http://www.kobo.com/help/koboaura/response/?id=3784&type=3

Sony Reader

To download an EPUB file on your Sony Reader™:

  • ensure you have already installed the Reader™ Library for PC/Mac software
  • select the eBook you want from our website and click the link to download it.
  • connect the Reader™ to your computer.
  • open the Reader™ Library software and click “Library” in the left-hand pane and select the eBook to view it.

Need more help? Visit: https://au.readerstore.sony.com/apps_and_devices/

Amazon Kindle 2nd Generation devices

EPUB files can’t be read on the Amazon Kindle™. However, like most eReaders, Kindle™ 2nd Generation devices are able to display PDFs. We recommend that you download the PDF version of this booklet if you would like to read it on a Kindle™.
To transfer a PDF to your Kindle™ via USB cable from your computer or Mac:

  • download the PDF directly onto your computer.
  • connect the USB cable to your computer’s USB port, and the micro USB end of the cable to your Kindle™. Note: the Kindle™ won’t be available as a reading device while it is connected to your computer until it has been disconnected.
  • open the Kindle™ drive and several folders will appear inside. The “Documents” folder is where you will need to copy or drag the PDF to.
  • safely eject your Kindle™ from your computer and unplug the USB cable. Your content will appear on the Home Screen.

Kindle also provides a Kindle Personal Documents Service that allows users to send documents as an attachment directly to your eReader. For more information on this service, visit http://www.amazon.com/gp/help/customer/display.html/ref=help_search_1-1?ie=UTF8&nodeId=200767340&qid=1395967989&sr=1-1
For more information on accessing a PDF on your Kindle™, visit www.amazon.com/manageyourkindle, log in to your account and click on Personal Document Settings.
Need more help? Visit https://www.amazon.com/gp/help/customer/display.html?nodeId=200375630

Android and PC

You can also download and open eBooks on Android devices and PCs with appropriate apps or software installed. Suitable eReader apps for Android include Google Play Books, FBReader and Moon+ Reader. Suitable software for PCs include Calibre and Adobe Digital Editions.


This information was last reviewed in April 2016
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