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Surgical Oncology
Surgical intervention plays a vital role in the treatment of many types of cancer, a disease in which early detection and care are critical for optimal results. Surgical advances provide new methods for safely and effectively removing complex tumors.
Improved patient survival can now be attributed to the integration of new surgical techniques with advances in medical oncology. The examples below are actively being incorporated in patient care at Memorial Cancer Institute.
- Breast Cancer
Sentinel lymph node biopsy is a method of locating and removing the primary draining lymph nodes for a specific cancer. It allows us to better stage a Breast Cancer with minimal morbidity and maximum information. - Gastrointestinal
Endoscopic ultrasound is used to obtain more accurate preoperative staging of tumors (esophagus, rectum, stomach, pancreas) to determine surgical options and eligibility for a research protocol.
In metastatic Colorectal Cancer to the liver, surgical resection offers the best chance for long-term survival. However, most patients present with unresectable disease and are not considered candidates for surgery. Using a combination of neoadjuvant chemotherapy, hepatic-artery-directed chemoembolization or the infusion of yttrium-90, a significant portion of these patients are converted to having resectable disease.
For patients who are not surgical candidates, radiofrequency ablation (RFA) offers an excellent option. RFA is a minimally invasive procedure in which a thin needle electrode is inserted into a liver lesion under ultrasound or CT guidance. Electrical energy is delivered through the electrode to the lesion that produces heat within the cells surrounding the electrode. Heating all cells within the lesion and surrounding margin to a temperature beyond the lethal threshold of 53°C kills the cancer cells.
Minimally invasive laparoscopic surgery is offered for colorectal, liver, spleen, gastric, adrenal, and other procedures with obvious advantages for the patient. - Melanoma
Sentinel lymph node biopsy (see breast cancer).
When patients may have widespread recurrence of melanoma in an arm or leg, a technique called isolated limb perfusion is used to stop the flow of blood to and from the extremity, allowing a higher concentration of chemotherapy to be administered with excellent results. - Genitourinary
Robotic minimally invasive surgery is often utilized in radical prostatectomy to minimize hospital stay, postoperative pain and scarring. - Cancer Protocols
Participation in research protocols incorporating pre-and post-surgery treatment options is available for most patients.