Surgery is one of the primary treatment modalities for cancer patients and can be classified based on the intent and type of procedure. Cancer surgeries are performed by specialized surgeons, often known as surgical oncologists, but may also involve other surgical specialists depending on the site of the tumor. Below is an overview of the types of cancer surgeries and the specialists who typically perform them.

1. Biopsy (Diagnostic Surgery): To obtain a tissue sample for biopsy and confirm the diagnosis of cancer.

Procedure: Includes incisional or excisional biopsy, needle biopsy, or endoscopic biopsy.

Specialists: General surgeons, surgical oncologists, interventional radiologists, or specialists like gastroenterologists for endoscopic biopsies.

2. Curative Surgery: To remove the entire tumor and any surrounding tissue that may be affected, often with the intent of curing the patient.

Procedure: This includes procedures like lumpectomy, mastectomy, colectomy, or lobectomy (removal of a lung lobe).

Specialists: Surgical oncologists, general surgeons, thoracic surgeons, or specialists like urologists for prostate cancer.

3. Debulking Surgery: To remove as much of the tumor as possible when complete removal is not feasible. This is often done to improve the effectiveness of other treatments like chemotherapy or radiation therapy.

Procedure: Often used in cancers like ovarian cancer or advanced gastrointestinal cancers.

Specialists: Surgical oncologists or gynecologic oncologists.

4. Palliative Surgery: To alleviate symptoms and improve quality of life, rather than to cure the disease.

Procedure: Includes procedures like bypass surgery for bowel obstruction or stent placements.

Specialists: Palliative surgeons, surgical oncologists, and sometimes general surgeons.

5. Reconstructive Surgery: To restore the appearance or function after major cancer surgery, particularly in cases like breast cancer or head and neck cancer.

Procedure: Includes breast reconstruction after mastectomy or facial reconstruction.

Specialists: Plastic and reconstructive surgeons, sometimes in collaboration with the surgical oncologist.

6. Preventive (Prophylactic) Surgery: To remove tissue or organs that are at high risk of developing cancer, especially in patients with strong family history or genetic predisposition.

Procedure: Includes prophylactic mastectomy or oophorectomy (removal of ovaries).

Specialists: General surgeons, gynecologic oncologists, or surgical oncologists.

7. Minimally Invasive Surgery: To reduce trauma and recovery time for the patient.

Procedure: Includes laparoscopic surgery, robotic surgery, and endoscopic procedures.

Specialists: Surgical oncologists trained in minimally invasive techniques, general surgeons, urologists (for robotic prostate surgery), and thoracic surgeons (for robotic lung surgery).

8. Cytoreductive Surgery with HIPEC (Hyperthermic Intraperitoneal Chemotherapy): To remove tumors from the abdominal cavity and directly apply heated chemotherapy.

Procedure: Often used for peritoneal cancers like mesothelioma or ovarian cancer.

Specialists: Surgical oncologists specializing in HIPEC procedures.

9. Laser Surgery: To destroy cancerous tissue using high-intensity light.

Procedure: Often used for cancers on the surface of the skin, cervix, or in the trachea.

Specialists: Surgical oncologists, dermatologists, and gynecologic oncologists.

10. Cryosurgery: To destroy cancerous tissue by freezing it.

Procedure: Typically used for skin cancers and some prostate cancers.

Specialists: Dermatologists, urologists, and surgical oncologists.

The type of surgeon involved in operating on cancer patients depends largely on the location and type of cancer. Here is a list of surgical specialties commonly involved in cancer surgeries:

1. Surgical Oncologist: Surgical oncologists are specialists who focus exclusively on the surgical management of cancer. They perform a wide range of cancer surgeries, including tumor resections, lymph node dissections, and complex procedures like debulking.

Cancers Treated: General cancer surgeries, sarcomas, and complex, multi-organ cancers.

2. General Surgeon: General surgeons often perform cancer surgeries involving the digestive tract, breast, and skin when specialized oncologic surgeons are not available. They are skilled in performing biopsies, tumor resections, and other general procedures.

Cancers Treated: Breast cancer, colorectal cancer, skin cancer, and gastrointestinal cancers.

3. Gynecologic Oncologist: Specializes in cancers of the female reproductive system, combining expertise in both gynecology and oncology.

Cancers Treated: Ovarian cancer, uterine (endometrial) cancer, cervical cancer, and vulvar cancer.

4. Thoracic Surgeon: Focuses on surgeries of the chest cavity, including the lungs, esophagus, and mediastinum. They often handle cases of lung cancer and esophageal cancer.

Cancers Treated: Lung cancer, esophageal cancer, and mediastinal tumors.

5. Colorectal Surgeon (Proctologist): Specializes in the surgical treatment of diseases of the colon, rectum, and anus.

Cancers Treated: Colorectal cancer, anal cancer, and other malignancies of the lower digestive tract.

6. Urologic Surgeon (Urologist): Specializes in the surgical treatment of cancers involving the urinary system and male reproductive organs.

Cancers Treated: Prostate cancer, bladder cancer, kidney cancer, testicular cancer.

7. Neurosurgeon: Specializes in the surgical treatment of tumors in the brain, spinal cord, and peripheral nerves.

Cancers Treated: Brain tumors (gliomas, meningiomas), spinal tumors, and metastatic lesions in the central nervous system.

8. Otolaryngologist (ENT Surgeon) / Head and Neck Surgeon: Specializes in cancers of the head and neck region, including the throat, mouth, and thyroid.

Cancers Treated: Oral cancer, throat cancer, laryngeal cancer, thyroid cancer, and salivary gland tumors.

9. Plastic and Reconstructive Surgeon: Performs reconstructive surgery after cancer resections to restore appearance and function, especially in cases like breast reconstruction after mastectomy or facial reconstruction after head and neck cancer surgeries.

Cancers Treated: Works alongside other oncologic surgeons for reconstruction in breast, head and neck, and skin cancers.

10. Orthopedic Oncologist: Specializes in the surgical treatment of bone and soft tissue cancers, such as sarcomas.

Cancers Treated: Bone cancer (osteosarcoma, Ewing’s sarcoma) and soft tissue sarcomas.

11. Dermatologic Surgeon / Mohs Surgeon: Focuses on skin cancer surgeries, often using techniques like Mohs micrographic surgery, which allows for precise removal of skin cancers with minimal damage to surrounding tissue.

•Cancers Treated: Basal cell carcinoma, squamous cell carcinoma, melanoma.

12. Hepatobiliary Surgeon: Specializes in cancers of the liver, gallbladder, pancreas, and bile ducts.

•Cancers Treated: Liver cancer, pancreatic cancer, gallbladder cancer, and cholangiocarcinoma.

13. Cardiothoracic Surgeon: Performs surgeries on the heart and chest, often dealing with complex lung cancer cases and mediastinal tumors.

Cancers Treated: Advanced lung cancer, tumors of the chest wall, and cancers involving the heart.

14. Pediatric Surgeon: Focuses on the surgical treatment of cancers in children, which may involve different types of tumors compared to adults.

Cancers Treated: Neuroblastoma, Wilms’ tumor, rhabdomyosarcoma, and other pediatric malignancies.

15. Endocrine Surgeon: Specializes in cancers of the endocrine glands, including the thyroid, parathyroid, and adrenal glands.

Cancers Treated: Thyroid cancer, parathyroid cancer, adrenal cancer.

Multidisciplinary Collaboration

In complex cases, multiple surgeons from different specialties may work together, especially when the cancer involves multiple organ systems. This approach is crucial in ensuring comprehensive and coordinated care, often facilitated through a Tumor Board or Multidisciplinary Team (MDT) meetings.

This broad range of specialized surgeons ensures that cancer patients receive tailored surgical care based on the specific needs and location of their cancer.

Cancer surgeries often involve complex procedures designed not only to remove the tumor but also to address the functional and reconstructive needs of the patient. Here is an overview of common surgical procedures performed in cancer patients, including specialized techniques like flap reconstruction, colostomies, and other interventions tailored for cancer treatment:

1. Tumor Resection:The primary surgery to remove the cancerous tumor along with some surrounding healthy tissue (margins) to ensure complete excision.

Examples: Mastectomy (breast cancer), nephrectomy (kidney cancer), and colectomy (colon cancer).

Surgeons Involved: Surgical oncologists, general surgeons, urologists.

2. Lymph Node Dissection: Removal of lymph nodes near the tumor site to check for metastasis and reduce the spread of cancer.

Types: Sentinel lymph node biopsy, axillary lymph node dissection (common in breast cancer).

Surgeons Involved: Surgical oncologists, gynecologic oncologists, ENT surgeons (head and neck cancers).

3. Colostomy and Ileostomy: A surgical procedure where part of the colon or ileum is diverted to an external opening (stoma) on the abdominal wall to allow waste to bypass the lower intestine.

Purpose: Often performed when a section of the colon or rectum is removed due to cancer, and reconnection (anastomosis) is not possible or safe.

Types: Temporary (to allow healing) or permanent (in cases of extensive resection).

Surgeons Involved: Colorectal surgeons, general surgeons.

4. Flap Reconstruction Surgery: A type of reconstructive surgery using a piece of tissue (flap) from another part of the body to rebuild or cover areas affected by cancer surgery.

Types:

Free Flap: Tissue is completely detached and reattached at the site.

Pedicled Flap: Tissue remains connected to its original blood supply.

TRAM Flap: Transverse Rectus Abdominis Muscle flap used for breast reconstruction after mastectomy.

Latissimus Dorsi Flap: Uses muscle from the back for breast or chest reconstruction.

Surgeons Involved: Plastic and reconstructive surgeons.

5. Mohs Micrographic Surgery: A precise technique where thin layers of skin cancer are removed and examined under a microscope until only cancer-free tissue remains.

Purpose: High cure rate with minimal damage to surrounding healthy tissue, commonly used for skin cancers like basal cell carcinoma and squamous cell carcinoma.

Surgeons Involved: Dermatologic surgeons, Mohs surgeons.

6. Debulking Surgery: Removal of as much of the tumor as possible when complete excision is not feasible due to the tumor’s location or size.

Purpose: To enhance the effectiveness of adjuvant therapies like chemotherapy or radiation.

Common Cancers: Ovarian cancer, advanced gastrointestinal cancers.

Surgeons Involved: Surgical oncologists, gynecologic oncologists.

7. Palliative Surgical Procedures: Surgeries aimed at relieving symptoms and improving the quality of life rather than curing the disease.

Examples:

Gastrostomy Tube Placement: To provide nutrition when the patient cannot swallow.

Stent Placement: To relieve obstruction in the bile duct or esophagus.

Pleurodesis: To prevent fluid buildup in the chest (common in lung cancer).

Surgeons Involved: General surgeons, thoracic surgeons, palliative care specialists.

8. Whipple Procedure (Pancreaticoduodenectomy): A complex surgery to remove the head of the pancreas, part of the small intestine, gallbladder, and bile duct.

Purpose: Primarily performed for pancreatic cancer or cancers involving the bile duct.

Surgeons Involved: Hepatobiliary surgeons, surgical oncologists.

9. Radical Neck Dissection: Removal of lymph nodes, muscles, and sometimes nerves from the neck area to treat head and neck cancers.

Purpose: To manage metastasis in head and neck cancers and ensure local control.

Surgeons Involved: ENT surgeons, head and neck surgeons.

10. Tracheostomy: Creating an opening in the trachea to provide an airway and assist with breathing.

Purpose: Often needed in patients with cancers of the head and neck that obstruct the airway.

Surgeons Involved: ENT surgeons, thoracic surgeons.

11. Pelvic Exenteration: A radical surgery that removes the pelvic organs, including the bladder, rectum, and reproductive organs, depending on the extent of the cancer.

Purpose: Often performed for advanced or recurrent gynecologic cancers.

Surgeons Involved: Gynecologic oncologists, colorectal surgeons, urologic surgeons.

12. Breast Reconstruction Surgery: Surgery to rebuild the breast shape after mastectomy.

Types:

Implant-Based Reconstruction: Using silicone or saline implants.

Autologous Tissue Reconstruction: Using tissue from other parts of the body (e.g., TRAM flap).

Surgeons Involved: Plastic and reconstructive surgeons.

13. Limb-Sparing Surgery: Removal of bone tumors without amputating the limb, often followed by reconstruction using metal implants or bone grafts.

Purpose: To preserve function and appearance in bone cancers like osteosarcoma.

Surgeons Involved: Orthopedic oncologists.

14. Esophagectomy: Removal of part or all of the esophagus, often followed by reconstruction using the stomach or intestine.

Purpose: For treating esophageal cancer.

Surgeons Involved: Thoracic surgeons, general surgeons.

15. HIPEC (Hyperthermic Intraperitoneal Chemotherapy): Surgery combined with heated chemotherapy applied directly to the abdominal cavity after cytoreductive surgery.

Purpose: To treat cancers like peritoneal carcinomatosis from ovarian, colorectal, or gastric cancers.

Surgeons Involved: Surgical oncologists specializing in HIPEC.

These procedures, tailored to the type and stage of cancer, are part of a comprehensive surgical oncology program and often require a multidisciplinary approach for the best outcomes.