What is surgery and what is it used for?

Surgery is when a surgeon cuts tissue in the body. It is often used to remove a cancer. It can be used to treat many types of cancer.

Surgery can be used for lots of reasons, such as to:

  • diagnose cancer
  • remove cancer
  • find out how big the cancer is and if it has spread to other parts of the body
  • control symptoms of cancer
  • restore parts of the body (for example, bladder reconstruction)
  • improve the appearance of part of the body (for example, breast recontruction).

Surgery can cure many cancers.

The type of surgery you have will depend on the cancer that is treated. Your doctor or nurse can give you specific information about your surgery.

What is surgery?

Surgery is used to treat different conditions by cutting body tissue. It is one of the main treatments for many cancers. The type of surgery you have and the preparation, side effects and complications will vary according to the type of cancer you have.

For more information about surgery in your case, you can ask your doctor or nurse at the hospital where you are having treatment. You may also find it helpful to read more about the cancer type you have, which will include more specific information about surgery.


Why is the surgery being done?

Surgery to diagnose cancer

Surgery can be used to help diagnose some cancers. The surgeon may remove a small piece of tissue. This is called a biopsy. The tissue is examined in a laboratory to confirm a diagnosis of cancer and to find out about the type. It may take a few days to get results but sometimes it can take longer.

Surgery to treat cancer

Where possible, surgery is used to remove the tumour and any surrounding tissues that may contain cancer cells. This may sometimes still be done even if the cancer has spread to another part of the body.

Occasionally, surgery can be used to remove cancer cells that have spread from the original tumour into another part of the body, such as the lung or liver.

Sometimes other treatments, such as chemotherapy or radiotherapy are given before surgery to reduce the size of a cancer. This can make surgery possible in some cases, or mean that less surgery is needed.

Surgery to find out the stage of the cancer

The stage of a cancer describes the size of the cancer, whether it is just in the place where it first started, or whether it may have spread to other parts of the body. Usually, tests and scans are used to stage a cancer before surgery. However, sometimes doctors need to do a small operation to find out the stage of the cancer. This might be because the tumour can’t be seen on a scan.

An example of surgery used in staging is a laparoscopy. During a laparoscopy, a surgeon will make a small cut in your tummy (abdomen). They will use an instrument called a laparoscope (a thin tube with a light and camera) to look around and assess the size of the tumour and whether it has spread.

Some people may have similar operations on other parts of the body. Doctors use information about the stage of the cancer when planning your treatment. Sometimes, a surgeon will find out about the stage at the same time as removing the tumour.

Reconstruction surgery

Surgery can be used to restore:

  • a part of the body – for example, to create a new bladder if a person has had their bladder removed
  • the appearance of a part of the body – for example, breast reconstruction to create a new breast shape after a mastectomy (an operation to remove the breast).

Reconstructive surgery is usually carried out by specialist surgeons.

Surgery to control the symptoms of cancer

If a cancer cannot be completely removed or cured, surgery can sometimes help to control symptoms. For example, surgery can be used to remove or bypass a tumour if it is causing a blockage.

If the cancer has spread by the time you are diagnosed, you may not be offered surgery. This is because surgery alone will not cure the cancer. Depending on the type of cancer, you may be offered treatment that treats cancer cells throughout your body, such as chemotherapy or hormonal therapy. Radiotherapy can also be used to help control a cancer.

You can get more information about operations for different cancers.


Can surgery cure the cancer?

Although surgery cures many cancers, it is not always possible to know at the time of surgery whether any cancer cells could have broken away and spread to tissues around the main tumour.

To try to make sure all the cancer cells are removed, the surgeon will remove the tumour and a surrounding area (margin) of normal tissue. A specialist known as a pathologist will examine the tissue that has been removed and check the margin to see if it is clear of cancer cells.

Removing all the cancer cells helps to reduce the risk of the cancer coming back. If the margin of tissue is not clear, the cancer specialists who are involved in your care will talk to you about the best way to manage this. They may suggest you have a further operation to take more tissue from the surrounding area.

For some people, there is a risk that cancer cells may have spread from the main tumour to another part of the body. These are known as micrometastases. Micrometastases are too small to be seen on scans. If there is a risk of micrometastases, your cancer specialists may recommend that you have other treatments, such as chemotherapy and radiotherapy as part of your treatment.

Occasionally, scans taken before surgery don’t show up the true extent of the cancer. During the operation, the surgeon may find that it is not possible to remove the cancer completely. If this is the case, your cancer specialists will discuss with you the best treatment possible for your situation.


Types of surgery

There are different types of surgery that can be used to treat cancer.

Usually, the surgeon will aim to remove the tumour and a margin of healthy tissue from around the tumour.

Your surgeon will also often remove some of the lymph nodes (lymph glands) that are close to the tumour. This is because the lymph nodes are a common place for cancer cells to spread to. The number of lymph nodes removed varies with the type of cancer.

A doctor who specialises in diagnosing disease by examining tissues under a microscope (a pathologist) will test the lymph nodes for cancer cells. If the nodes contain cancer cells, there may be a bigger risk of the cancer coming back in the future. In this case, you may need to have treatment such as radiotherapy, chemotherapy or hormonal therapy after your operation.

Keyhole surgery

Some people may be able to have keyhole surgery (sometimes called laparoscopic surgery) to remove some or all of a tumour.

In this type of surgery, several small cuts are made instead of one large cut (incision). The surgeon uses a laparoscope to work inside the body and remove the tumour through a small cut in the skin.

The main advantage of keyhole surgery is that it leaves a much smaller wound in the chest or tummy wall. This means that recovery time is shorter. Sometimes people who are not fit enough to have an open operation may be able to have keyhole surgery.

The results from keyhole surgery can be as good as conventional surgery. However, it needs to be done by surgeons with specialist training and experience in using laparoscopic techniques. If it is suitable for you – and you choose to have this type of surgery – you may need to travel to another hospital to have it.

Back to Surgery explained

Who might I meet?

A team of specialists will plan your surgery. This will include a surgeon who specialises in your type of cancer.

What happens after surgery?

You’ll be monitored very closely after your operation. You will be very tired so it’s important to rest and look after yourself.

Follow-up care after surgery

You will have follow-up appointments after your surgery to check on your recovery and talk about any concerns.