What Is Surgical Oncology? An In-Depth Look

Surgical oncology specializes in treating cancer through surgical procedures, focusing on tumor removal, preventing cancer spread, and improving survival and quality of life. 

Surgical oncologists are vital in cancer care, qualified in diagnosing, removing tumors, and improving survival outcomes for cancer patients. 

This blog post will explore the essential aspects of surgical oncology, including its benefits, risks, and key procedures. We’ll also discuss the role surgical oncologists play in cancer treatment, their training and education path, and how their work contributes to patient recovery and quality of life. 

Keep reading to learn more about this vital medical specialty.

What Is Surgical Oncology?

Surgical oncology is a special area of medicine that focuses on treating cancer through surgery. It involves operations to remove tumors or cancerous tissues from the body. The main goals of surgical oncology are to get rid of as much cancer as possible, check how far the cancer has spread, and help patients feel better or live longer.

Unlike other cancer treatments like chemotherapy or radiation, which use drugs or energy to target cancer cells, surgical oncology directly removes cancer through physical procedures. This hands-on approach makes it essential for many types of cancer, especially when the tumor can be safely taken out. 

Surgical oncologists work closely with other specialists to plan treatments that are best for the patient. This teamwork ensures that surgery fits well into a broader plan to fight cancer effectively.

What Does a Surgical Oncologist Do?

A surgical oncologist is responsible for many tasks, from identifying cancer to curing it through surgery. 

The process of identifying cancer starts with examining test results, imaging, or biopsies, and deciding on the course of treatment. Then, they carefully plan and perform operations to remove tumors or cancer-affected areas, ensuring they take out as much cancer as possible.

Surgical oncologists work closely with other cancer specialists, such as medical and radiation oncologists, to create a treatment plan that suits the patient’s needs. They decide on the type and extent of surgery based on factors like the cancer’s stage, where it is in the body, and the patient’s overall health and preferences.

After surgery, these doctors also manage post-surgical care. They monitor the patient’s recovery, address any complications, and ensure the wound heals properly.

Types of Surgical Oncology Procedures

Surgical oncologists perform procedures like tumor removal, biopsy procedures, and lymph node dissection to treat cancer. Plus, they are qualified to perform reconstructive procedures to enhance appearance after surgery.

Tumor removal

Tumor removal is one of the most important procedures in surgical oncology. The goal is to take out cancerous growths from the body to either cure the cancer or stop it from spreading further. 

During surgery, the surgeon aims to achieve “clear margins,” which means removing some of the healthy tissue around the tumor to make sure no cancer cells are left behind. This helps lower the chance of the cancer coming back and can improve survival rates.

The type of surgery depends on the size, type, and location of the tumor. In some cases, only part of the tumor is removed (partial excision), while in others, the entire tumor is taken out (complete excision).

Biopsy procedures

A biopsy is a diagnostic procedure where a small sample of tissue is taken from a suspected tumor or abnormal area to determine if it is cancerous. Biopsies are usually done before surgery to confirm the diagnosis and help plan the treatment. In some cases, they may also be performed during surgery to gather more information about the tumor.

Common types of biopsies in surgical oncology include fine needle aspiration (FNA), which uses a thin needle to remove cells; core needle biopsy, which takes a larger tissue sample; and excisional biopsy, where the entire suspicious area is removed for analysis. Each method is chosen based on the tumor’s size, location, and the information needed for diagnosis and treatment planning.

Lymph node dissection

Lymph node dissection is a surgical procedure where lymph nodes are removed to check if cancer has spread beyond its original site. This helps doctors determine the cancer’s stage and decide on the best treatment plan.

This procedure is often performed when cancer is suspected to have spread to nearby lymph nodes, providing critical information about the extent of the disease. 

There are two main types: 

• Sentinel lymph node biopsy, where only the first lymph node likely to contain cancer is removed
• Extensive lymph node removal, which involves taking out multiple lymph nodes if the cancer has spread further. 

This procedure plays a key role in diagnosing and managing cancer effectively.

Reconstructive surgery

Reconstructive surgery in surgical oncology focuses on rebuilding or restoring the body’s appearance and function after cancer treatment, such as tumor removal. This procedure is often necessary when surgeries significantly impact a patient’s appearance or bodily function. Common examples include breast reconstruction after a mastectomy or facial reconstruction following head and neck cancer surgery.

While the aesthetic aspect is important, reconstructive surgery also plays a crucial role in restoring functionality, such as enabling speech or movement and improving the patient’s overall quality of life. It helps patients regain confidence and psychological well-being after undergoing life-altering cancer treatments. 

Therefore, reconstructive surgery supports both physical recovery and emotional well-being, making it an essential part of helping patients heal and regain a sense of normalcy after cancer treatment.

How to Become a Surgical Oncologist?

Becoming a surgical oncologist requires a structured educational path. Below is an outline of the key steps involved in this journey:

• Bachelor’s Degree: Start by obtaining a bachelor’s degree, typically in a science-related field, to build a strong foundation in subjects like biology, chemistry, and physics.
• Medical School: Next, attend medical school to earn a Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO) degree. Passing the Medical College Admission Test (MCAT) is a key requirement for medical school admission.
• General Surgery Residency: After medical school, complete a general surgery residency, which typically lasts 5-7 years, to gain broad surgical experience.
• Surgical Oncology Fellowship: Pursue a fellowship in surgical oncology, which usually lasts 1-2 years. This provides specialized training in cancer surgery techniques and patient management.
• Board Certification: After completing the fellowship, obtain board certification in both general surgery and surgical oncology by passing exams. Maintaining certification requires ongoing education and practice.

This educational path ensures that surgical oncologists are highly skilled in both general surgery and the specialized field of cancer treatment, allowing them to provide the best care for cancer patients.

When Is Surgical Oncology Needed?

Surgical oncology is typically recommended when cancer is localized or in its early stages, making it possible to remove the tumor through surgery to either cure the disease or reduce its spread. 

Surgery is often the first line of treatment for cancers that can be physically removed, such as those in the breast, colon, lungs, or skin. Removing primary tumors in these areas can significantly improve survival outcomes, as it eliminates the source of cancerous cells.

In some cases, surgery is combined with other treatments, like chemotherapy or radiation therapy, to enhance effectiveness. Neoadjuvant therapy is used before surgery to shrink the tumor, making it easier to remove and increasing the chances of a successful outcome. 

After surgery, adjuvant therapy may be used to destroy any remaining cancerous cells and reduce the risk of recurrence. This combined approach ensures that the cancer is treated from multiple angles, improving overall treatment success and patient survival. 

Benefits and Risks of Surgical Oncology

Surgical oncology offers health benefits by removing tumors, improving survival rates, and enhancing quality of life. However, it also carries risks such as infection, bleeding, nerve damage, organ injury, and potential cancer recurrence, depending on the procedure and patient condition.

Benefits of surgical oncology

The primary benefit of surgical oncology is its potential to cure cancer, particularly when tumors are localized and can be completely removed. When cancer is detected early, surgery can effectively eliminate the tumor, improving survival rates by preventing the spread of cancer to other parts of the body. 

In addition to improving survival, surgical oncology can significantly enhance a patient’s quality of life. Tumors that cause pain, block vital organs, or lead to other debilitating symptoms can be removed, offering relief and improving overall well-being.

Other benefits include:

• Minimally invasive procedures used in surgical oncology, like laparoscopy and robotic surgery, are quick, less painful, and overall effective.
• Surgery can enhance the effectiveness of other treatments, like chemotherapy or radiation.
• Early and complete removal of tumors can lower the risk of cancer returning.
• Successful tumor removal can provide emotional relief and a sense of control, improving the patient’s mental state during recovery.

Risks of surgical oncology

Like all surgeries, surgical oncology carries inherent risks, which can vary depending on the type of cancer, the location of the surgery, and the patient’s overall health. While these procedures are aimed at improving outcomes, patients should be aware of potential complications.

General surgical risks include:

• Infection: Surgery always carries a risk of infection, which can delay recovery and increase complications.
• Bleeding: Excessive bleeding during or after surgery may require additional treatment and affect healing.
• Anesthesia Risks: Complications related to anesthesia, such as allergic reactions or breathing difficulties, can arise, especially in patients with underlying health issues.

Specific risks of cancer surgeries are:

• Damage to Nearby Organs or Tissues: Cancer surgeries, especially those near vital organs, may unintentionally damage healthy tissue.
• Nerve Damage: Surgery, especially in areas like the head or neck, can damage nerves, leading to loss of function or sensation.
• Lymphatic Complications: Lymph node dissection can result in lymph fluid buildup or lymphedema.

Conclusion

Surgical oncology focuses on the surgical treatment of cancer, aiming to remove tumors, prevent spread, and improve survival rates. It plays a crucial role in early-stage cancer treatment, enhancing patients’ quality of life and supporting other therapies. If you’re passionate about pursuing a career in surgical oncology, consider joining the AUAMED Doctor of Medicine (MD) program for comprehensive training in this specialized field.

Frequently Asked Questions (FAQs): 

What is the difference between an oncologist and a surgical oncologist?

An oncologist specializes in the medical treatment of cancer, such as chemotherapy, while a surgical oncologist focuses on surgically removing tumors and treating cancer through surgery.

How long does it take to become a surgical oncologist?

Becoming a surgical oncologist typically takes about 13-15 years, including a bachelor’s degree, medical school, a 5-7 year general surgery residency, and a 1-2 year fellowship in surgical oncology.