Surgery

Man a ge men t Of Can ce r

MANAGEMENT OF CANCER CURE- complete eradication of malignant disease. CONTROL- prolonged survival and containment of cancer cell growth. PALLIATION- relief of symptoms associated with the disease.

MODALITIES COMMONLY USED IN CANCER TREATMENT -SURGERY -RADIATION THERAPY -CHEMOTHERAPY

SURGERY -remains the ideal and most frequently used treatment method. -may be the primary method of treatment, prophylactic, diagnostic, palliative, or reconstructive.

DIAGNOSTIC SURGERY -is the definitive method of identifying the cellular characteristics that influence all treatment decisions. BIOPSY- is usually performed to obtain a tissue sample for analysis of cells suspected to be malignant.

MOST COMMON BIOPSY METHODS -Excisional -Incisional -Needle

EXCISIONAL BIOPSY -most frequently used for easily accessible tumors of the skin, breast, upper and lower GI tract, and upper respiratory tracts. -often performed through endoscopy. -removal of the entire and surrounding marginal tissues as well.

INCISIONAL BIOPSY -is performed if the tumor mass is too large to be removed. -wedge of tissue from the tumor is removed for analysis. -often performed through endoscopy.

NEEDLE BIOPSIES -are performed to sample suspicious masses that are easily accessible, such as some growths in the breasts, thyroid, lungs, liver, and kidneys. -fast relatively inexpensive, and easy to perform and usually require only local anesthesia. NEEDLE CORE BIOPSY- uses a specially designed needle to obtain a small core of tissue. Most often the specimen is sufficient to permit accurate diagnosis.

SURGERY AS PRIMARY TREATMENT -goal is to remove the entire tumor or as much as is feasible (a procedure sometimes called DEBULKING) and any involved surrounding tissue, including regional lymph nodes

COMMON SURGERY FOR PRIMARY TUMORS LOCAL EXCISIONS- warranted when the mass is small. Includes removal of the mass and a small margin of normal tissue that is easily accessible. WIDE/RADICAL EXCISIONS(en bloc dissections)- include removal of the primary tumor, lymph nodes, adjacent involved structures, and surrounding tissue that may be at high risk for tumor spread. -this surgical method can result in disfigurement and altered functioning. -considered if the tumor can be removed completely and the chances of cure or control are good. SALVAGE SURGERY- is an additional treatment option that uses an extensive surgical approach to treat the local recurrence of the cancer after a less extensive primary approach is used.

PROPHYLACTIC SURGERY -involves removing nonvital tissues or organs that are likely to develop cancer. Factors considered when electing prophylactic surgery:  Family history and genetic predisposition  Presence or absence of symptoms  Potential risks and benefits  Ability to detect cancer at an early stage  Patient’s acceptance of the postoperative outcome

PALLIATIVE SURGERY -is performed in an attempt to relieve complications of cancer, such as ulcerations, obstructions, hemorrhage, pain, and malignant effusions. -major goal is a high quality of life.

RECONSTRUCTIVE SURGERY -may follow curative and radical surgery and is carried out in attempt to improve function or obtain a more desirable cosmetic effect.