When is surgery used?
Surgery is the main treatment for many cancers. It can be used to diagnose and remove cancer, improve symptoms, and reduce the risk of getting cancer.
On this page
- When might you have surgery for cancer?
- Surgery to diagnose cancer
- Surgery to find out the stage of the cancer
- Surgery to remove cancer
- Surgery to control cancer or improve symptoms
- Surgery to reconstruct parts of the body
- Surgery to help prevent cancer developing
- Surgery to reduce the risk of getting cancer
- About our information
- How we can help
Surgery is a medical procedure to examine, remove or repair tissue. It can be used to:
- diagnose cancer
- find out the stage of the cancer
- remove cancer
- control cancer or improve symptoms
- reconstruct parts of the body
- help prevent cancer developing
- reduce the risk of getting cancer.
The type of surgery you have, and how long you stay in hospital for, depends on the type of cancer you have. Your healthcare team will talk to you about:
- how you can prepare for surgery
- the possible side effects and complications of the operation
- how you recover from surgery.
They will give you information explaining this before you agree (consent) to have treatment.
We have more information about surgery in general.
Surgery can be used to help diagnose some cancers. The surgeon may remove a small piece of tissue so it can be checked for cancer cells. This is called a biopsy. There are different ways of doing a biopsy. You can read more about this in our information on the type of cancer you have.
A doctor called a pathologist looks at the tissue sample under a microscope. If they find cancer cells, they can usually find out what type of cancer it is and the grade. This information helps them plan the best treatment for you.
It can take a week or longer to get the results of a biopsy.
- its size
- how far it has grown from where it started
- if it has spread to other parts of the body.
When cancer is diagnosed, you usually have further tests and scans to find out more about its stage. This is called clinical staging.
Sometimes doctors need to do surgery to find out more about the stage of a cancer. This may be because the cancer is not easy to see on a scan. Types of surgery to find out more about the stage of cancer include:
- Pathological staging
Sometimes doctors find out more about the stage of a cancer during surgery to remove the cancer. After surgery, the pathologist checks all the tissue that has been removed. They add this information to the information they have from clinical staging. They might find out that the cancer is a different stage. Doctors call this pathological staging.
- Staging laparoscopy
You may have a staging laparoscopy. This is a type of keyhole surgery. The surgeon makes a small cut in the tummy (abdomen). They then insert a tube with a light and camera on the end so that they can look inside the body. This tube is called a laparoscope. It allows the surgeon to see the position and stage of the cancer. They can see if the cancer has spread to lymph nodes (glands) or to nearby organs. The surgeon may also remove more tissue for a biopsy. After surgery, you may go home the same day or stay in hospital overnight. We have more information about different types of surgery.
Surgery is one of the main treatments for many cancers. It may be used to try to cure the cancer. Sometimes it is the only treatment you need. But often surgery is used in combination with other cancer treatments.
During surgery, the surgeon removes the cancer and an area (margin) of normal-looking tissue surrounding it. A pathologist checks all the tissue. If there are any cancer cells left in the margin, your surgeon may advise that you have more surgery to remove more tissue.
During surgery, the surgeon may also remove some lymph nodes close to the cancer. There are different ways of doing this. For example, you might have a sentinel lymph node biopsy. This is when a small number of lymph nodes are removed from the armpit. Lymph nodes are a common place for cancer cells to spread to. If they contain cancer cells, you usually need further treatment after surgery.
It is not always be possible to remove all of the cancer. Sometimes scans taken before surgery may not show the cancer clearly. During surgery, your surgeon will usually remove as much of the cancer as is safely possible. Your doctor will talk to you about other treatments you can have to treat any remaining cancer cells.
Removing the organ where the cancer started
Sometimes for certain cancers, such as kidney cancer, the surgeon may advise removing the organ where the cancer started even if it has already spread. Although this does not cure the cancer, it may help you live longer. It might also help other treatments work better and reduce cancer symptoms, such as pain or bleeding.
Removing a cancer that has spread to another part of the body
Removing or bypassing a blockage
If a cancer is causing a blockage, surgery can be used to remove or bypass the blockage. This usually improves the symptoms.
Reconstructive surgery is when surgery is used to:
- reconstruct a part of the body – for example, to create a new bladder after a person has had their bladder removed
- repair the skin – using a skin graft after surgery for skin cancer
- restore the appearance of a part of the body – for example, breast reconstruction to create a new breast shape after surgery to remove a breast (mastectomy).
Reconstructive surgery is usually done by specialist surgeons or plastic surgeons. It may be done at the same time as removing the cancer, or at a later date.
If left untreated, some pre-cancerous conditions may develop into cancer. These conditions are monitored regularly. But surgery may also be used to remove pre-cancerous tissue. For example, surgery can be used to remove abnormal cells lining the cervix (cervical intra-epithelial neoplasia (CIN)). This small surgery is called a cone biopsy.
Some people with a very high risk of developing breast or ovarian cancer may have risk-reducing surgery. This means removing healthy tissue – for example, the breasts or ovaries. This type of surgery is only offered if you have a very high cancer risk, usually because of your family history. This may be if you have inherited a cancer gene (mutation) for breast or ovarian cancer.
If you have an inherited gene mutation that causes bowel conditions such as familial adenomatous polyposis (FAP) and Lynch syndrome (LS) you have a high risk of bowel cancer. You might have surgery to the bowel to reduce your risk of getting bowel cancer.
Below is a sample of the sources used in our general surgery information. If you would like more information about the sources we use, please contact us at firstname.lastname@example.org
National Institute for Health and Excellence (NICE). Surgical site infections: prevention and treatment NICE guidelines (NG125). April 2019. Available from: www.nice.org.uk (accessed August 2019).
National Institute for Health and Excellence (NICE). Venous thromboembolism in over 16s: reducing the risk of hospital-acquired deep vein thrombosis or pulmonary embolism NICE guidelines (NG89). March 2018. Available from: www.nice.org.uk (accessed August 2019).
Wyntner-Blyth V and Moorthy K. Prehabilitation: preparing patients for surgery. BMJ 2017; 358: j3702 doi: 10.1136/bmj. j3702 (accessed August 2019).
The British Association of Urological Surgeons Limited (baus.org.uk). The BAUS Enhanced Recovery Programme. Available from: www.baus.org.uk (accessed July 2019).
This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Chief Medical Editor, Professor Tim Iveson, Consultant Medical Oncologist.
Our cancer information has been awarded the PIF TICK. Created by the Patient Information Forum, this quality mark shows we meet PIF’s 10 criteria for trustworthy health information.