What is surgery and what is it used for?

Surgery is cutting away tissue from the body. It is one of the main treatments for cancer and can be used for lots of reasons. Surgery can be used:

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

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 means treating illness by cutting away body tissue. It’s one of the main treatments for many cancers. The type of surgery you have and the details of its preparation, side effects and complications will vary according to the type of cancer you have.

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

Types of surgery

Surgery to diagnose cancer

Surgery may be used to help diagnose some cancers. The surgeon removes a small piece of tissue, which is used to confirm the diagnosis of cancer and to find out about the type of cancer. This is called a biopsy. The sample is then examined in the laboratory.

Surgery to treat cancer

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

Occasionally, it’s 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 treatment such as chemotherapy can be given before surgery to reduce the size of a cancer so that less surgery is needed.

Surgery to find out the stage of the cancer

Staging is the process that doctors use to work out the size of the cancer, whether it’s 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, occasionally doctors need to carry out small operations 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 abdomen (tummy). They will use a special instrument called a laparoscope (a thin tube with an eyepiece at one end and a light and magnifying glass at the other end) to look around and work out the size of the tumour and if it has spread.

Some people may have similar operations on other parts of the body. Information about the stage of the cancer is used to plan treatment. Sometimes, surgeons can get this information at the same time as removing a tumour.

Reconstruction surgery

Surgery can be used to restore:

  • a part of the body – for example, to create a new bladder
  • the appearance of a part of the body – for example, breast reconstruction 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 the cancer can’t be completely removed or cured, surgery can sometimes still help to control symptoms – for example, removing or bypassing a tumour to reduce blockage, discomfort or other complications.

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

You can get more information about operations for specific types of cancer by reading more about your cancer type.

Can surgery cure the cancer?

Although surgery cures many cancers, it's 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 ensure 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’s been removed and check the margin to see if it’s clear of cancer cells.

Removing all the cancer cells is important because this 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 discuss with you the best way to manage this. For some people a further operation to take more tissue from the surrounding area may be recommended.

There’s also 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 potential 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 that are taken before surgery don’t show up the true extent of the cancer and, during the operation, the surgeon finds that it isn’t 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.

How is the surgery carried out?

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

During the surgery 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 your tumour as this is 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 an increased risk of the cancer coming back in the future. So you may need to have treatment such as radiotherapy, chemotherapy or hormonal therapy after your operation.

Keyhole surgery

In some situations it may be possible to have keyhole surgery (sometimes called laparoscopic surgery) to remove some or all of a tumour from a part of the body.

In this type of surgery, small openings 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, and 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.

Keyhole surgery can produce results as good as conventional surgery. However, it needs to be done by surgeons with specialist training and experience in using laparoscopic techniques. So, if it’s 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

Surgery for kidney cancer

Surgery may be the only treatment you need. The operation you have will depend on the stage of the cancer.

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 tired so it’s important to rest and look after yourself.