Onco Surgeries

Cancer Treatment in Gurgaon

The study of cancer is called oncology and the surgeries associated with cancer are collectively called onco-surgeries. Onco-Surgeries are the primary treatment surgeries for cancer of different organs. After the diagnosis, the doctors recommend these as the first step of cancer treatment. They remove the tumour wholly or in parts depending on the spread of the tumour and the organs infected. Sometimes, it also involves the removal of nearby organs and tissues if cancer has spread ahead of its primary location. The extent of surgery depends solely on the patient's health, the doctor removes as much tissue as safely possible while protecting the patient's life. The doctors who perform cancer surgeries are called Onco-Surgeons. 

Why Is It Done?

Oncologists or Cancer doctors may recommend cancer surgeries for the following reasons.

• Primary treatment: In cases when the cancer is at a single site and has not spread, surgical resection is the primary step for eliminating the diseased tissue from the body.

• Diagnosis: Sometimes, the tumour formed is benign. In such cases, it helps to determine if the cell growth is cancerous or non-cancerous.

• Prevention of cancer: If there is a high risk of developing cancer in some organs/tissues, the doctors recommend their removal from the body before the cancer develops.

• Relieving symptoms or side effects: Enlargement of a tumour may affect some nerves, muscles or organs. Surgery helps relieve the pressure, pain and discomfort by removing the tumour.

• Debulking: If the cancer growth is in a hard-to-reach site, the doctors remove the bulk of the tumour (debulking) and further suggest Chemotherapy or Radiation Therapy to eliminate the remaining cancer cells.

• Staging: Cancer surgery helps the doctor determine the cancer stage. However, more tests are required to judge the advancement of cancer.

After the once-surgery procedure, the doctors may recommend treatments like Chemotherapy Radiation Therapy and other combination therapies to ensure recovery. 

Risks

Some common side effects associated with various on-surgeries are:

• Pain at the site of surgery.

• Infection.

• Bleeding.

• Blood clots.

• Damage to the nearby tissues.

• Damage to nearby organs.

• Slow recovery of other body functions.

• Drug reactions.

Preparation

Being informed about the operation helps the patient to prepare themselves in a better way. 

Before the procedure, the patients should discuss the following with their Oncologists. 

• Procedure

• Diagnostic tests

• Recovery period  

Knowing about the course of treatment helps the patient prepare better mentally.

Each cancer surgery is different and so is the healing journey of the patient. Medications, drugs, procedures and therapies vary from one patient to another based on their age, gender, health condition, stage of cancer and pre-existing ailments if any. 

Before the operation, the patients undergo several tests, like Blood Tests, Liver and Kidney Function Tests, Heart Function Tests, Urine Tests, X-rays and other imaging tests. These tests tell about the patient's health, help the doctor plan the treatment, and identify potential risks.

Expectations around various Onco-surgeries

Head and Neck Cancers

Oral Cavity Cancer

Different surgeries to treat oral cavity cancer are:

• Glossectomy: A surgical procedure to treat Tongue Cancer. It involves removing only a part of the tongue (Partial Glossectomy) or a significant portion. 

• Mandibulectomy: If the tumour is close to the jaw bone, the surgeons remove its part by cutting the Mandible (Jaw Bone).

• Maxillectomy is the surgical procedure to remove the hard palate or Nasal Sinuses. 

Reconstruction Plastic Surgery follows the above-stated procedures to retain maximum function.

Laryngeal or Hypo-Pharyngeal Cancer

Depending on the location, the doctors may perform the following surgeries:

• Laryngectomy is the surgical removal of part or all of the voice box. It involves making an incision outside the neck over the Adam's apple in the case of male patients. 

• Pharyngectomy removes the Pharynx to treat Hypopharynx Cancer. The doctors may remove it in part or entirely, depending on the location and size of the tumour. 

Breast Cancer

There are different types of breast cancer surgeries. Breast cancer surgeries may involve removing the cancerous breast whole or partially along with the surrounding normal tissues. The procedure may be termed a Lumpectomy, Partial Mastectomy, or Segmental Mastectomy depending on the extent of tissue removed.

• Mastectomy: It is the complete removal of the breasts along with the nearby tissues. When it involves both breasts, it is called a Double Mastectomy.

• Sentinel Lymph Node Biopsy: This procedure removes cancer that has spread to the lymph nodes of the underarm. The doctors inject a dye and remove only the Lymph Nodes that take it up. 

• Breast Reconstruction: This is a part of Mastectomy when the patient wants the doctor to rebuild and reconstruct the breast mound using fat grafts. 

• Wire Localisation Surgery: If the cancer is difficult to locate, the doctors may use a Mammogram or Ultrasound to reach the right area. It involves numbing the breast and sending a thin hollow needle to the right area using a Mammogram or Ultrasound. Next, the surgeons put a thin wire with a hook through the centre.

• Oncoplastic Breast Surgery: It is a tumour-specific immediate breast reconstruction technique that allows higher volume excision without compromising on the aesthetics of the body.

• Prophylactic Surgery for Breast Cancer is a preventive surgical technique involving the removal of one or both breasts. The doctors recommend it to patients at a higher risk of developing breast cancer.

Gastro-Intestinal(GI) Cancer

GI cancer includes cancer in the digestive tract organs like the Stomach, Pancreas, Large and Small intestines, Colon, Rectum, Food Pipe, Gallbladder, Anus, and Biliary System.
Esophagectomy treats cancer in the Oesophagus (food pipe). The Surgery involves removing the portion of the food pipe containing the tumour, the upper region of the stomach, and nearby lymph nodes. The surgeons reconnect the remaining Oesophagus to the stomach. This Surgery can be open, minimally invasive or robotic-assisted.

Gastrectomy: It removes cancer in the stomach. The surgeons may use a minimally invasive endoscopic technique to remove the tumour that has not spread. It involves making small holes in the abdomen, through which the Endoscope and surgical instruments go inside to remove the part of the stomach (Partial Gastrectomy). Traditional open Surgery involves removing the tumour and nearby Lymph Nodes. The surgeon makes an abdomen incision to remove the affected parts and closes it with sutures.  

Whipple Procedure (aka Pancreaticoduodenectomy): It is the surgical treatment of Pancreatic Cancer. The Surgery involves the removal of the Pancreas head, most of the Duodenum, the Bile Duct portion, the Gallbladder and associated Lymph Nodes. The surgeons may also remove the Pancreas body, the entire Duodenum and a stomach part. The patient stays in the hospital for one to two weeks after the Surgery.

Liver Cancer Surgery involves resection of the affected liver part or a Complete Liver Transplant. When the cancer is in one part of the liver, the surgeon removes a lobe of the liver (Lobectomy). 
A Liver Transplant surgery involves removing the entire liver and its replacement with a healthy liver from the donor. It is an open surgery, and the patient needs to get several labs and imaging tests along with a donor liver that matches theirs. 

Rectal Cancer Surgery:

The doctors approach rectal cancer through two surgical procedures.

• Trans Anal Endoscopic Microsurgery (TEM): TEM involves the insertion of a Colonoscope into the back passage and removing cancer and nearby healthy tissues using minimally invasive methods.

• Total Mesorectal Excision (TME) removes the part of the rectum containing cancer, surrounding healthy tissues, and Fatty Tissue Mesorectum.

• Rectum- Sphincter Preserving Surgery: During this Surgery, the surgeons remove the tumour from the outer tissue layers surrounding the rectum, working in the plane that keeps the Sphincter Muscles while resecting cancer.

Retroperitoneal Tumors: These are rare and reach a massive size before detection. Surgical resection is the only cure for treating them.
Cholecystectomy is the surgical removal of the Gallbladder to treat cancer that has not spread. If cancer has spread outside, the surgeons may remove parts of the liver and bile ducts surrounding the Gallbladder.

Colon Cancer Surgery: The doctors perform Open or Minimally Invasive Laparoscopic Surgery to treat Colon Cancer. During a Colostomy procedure, the surgeons make an artificial opening (Stoma) in the abdominal wall and connect the colon's healthy part to the anal opening. Next, they attach a colostomy bag to provide a new way to remove the waste.

Thyroid Cancer

Surgery for thyroid cancer involves removing the thyroid gland wholly, in parts or lobes containing cancer. It is known as a Thyroidectomy. The doctors may remove the Lymph Nodes if the cancer has spread.

A lobectomy removes one of the two lobes of the thyroid gland. 

Before the Surgery

The patient gets dietary and medication restrictions to be followed a few hours before the Surgery.

During the Surgery

The patient gets general anaesthesia that puts them to sleep during the Surgery. The surgeon makes single or multiple incisions in the lower part of the neck. It depends on the type of Surgery.

After the Surgery

• The patient may experience pain, sore throat, and hoarse voice as the body heals. 

• The doctors will recommend blood tests to check if the cancer has been removed and to look for signs of recurrence. 

• The patient may need to take thyroid hormone pills if all the thyroid glands get removed during the Surgery.

Thoracic Cancer

Thoracic Cancers involve cancer in the chest cavity. It includes Lung Cancer, Thymus Cancer and Tracheal Cancer.

Lung Cancer Surgery

• Lobectomy is the surgical removal of the cancerous lobe of the lung. Segmentectomy or wedge resection is the removal of part of the lobe. The surgeons prefer the latter if they feel the lungs will not function properly after removing the entire lobe.

• Pneumonectomy: It removes the cancerous lung. The doctors recommend this Surgery if the tumour is in the centre of the chest and if Lobectomy is not a viable option.

• Sleeve Resection Surgery involves the removal of the cancerous lobe and Bronchus (pipe connecting the windpipe and the lung). The surgeon attaches the part of the Bronchus to the remaining healthy lobe.

• Thoracotomy: This Surgery involves making incisions between the ribs on the side of the chest or the back. 

For the above-stated lung cancer surgeries, the patient gets general anaesthesia that puts them to sleep during the procedure. The doctor can perform these as Open or Minimally Invasive Laparoscopic and Robotic-Assisted Surgery. Open Surgery involves making larger incisions in the chest. 

Thymus cancer

Thymectomy is the surgical procedure to remove the entire Thymus Gland (including the tumour). The Surgery involves making an incision through the middle of the chest (Median Sternotomy) to separate the chest bone (Sternum) for easy removal of the thymus and the tumour. If cancer has spread, the surgeon may remove nearby structures like Nerves, Pleura (tissue coating the lungs), Pericardium (the sac containing the heart), and the superior Vena Cava.

Urologic Cancers

Urologic cancers affect the Bladder, Prostate, Kidneys, Penis, and Testicles.

• Prostatectomy removes the entire or part of the Prostate. It is a minimally invasive procedure. 

• Bladder Cancer: The doctors may perform the following surgeries to treat Bladder Cancer.

• Transurethral Resection: This Surgery is for early-stage bladder cancers. The Surgery involves inserting a Resectoscope through the abdomen. The Resectoscope has a wire loop at one end that removes the tumour.

• Cystectomy involves the removal of the bladder partially (Partial Cystectomy) or entirely (Radical Cystectomy). During the Surgery, the surgeons make several small incisions in the abdomen. They insert a Laparoscope and surgical tools through the incisions to remove the bladder partially. Radical Cystectomy is an extensive procedure that involves the removal of the entire bladder along with the Prostate and Lymph Nodes (for men) and, for women, the Fallopian Tubes, Uterus, Ovaries and a part of the Vagina. 

Gynecologic Cancers

Gynecologic Cancers begin in the women's reproductive organs. It involves the tumours of the Cervix, Uterus, Ovaries, and Vulva.

• Hysterectomy removes a woman's Uterus to treat Uterine Cancer. The Surgery also treats Endometrial and Cervical Cancer. For Endometrial Cancer, surgeons remove the Uterus and the Cervix. 

The doctors may perform a hysterectomy either through the abdomen or Vagina. 

• A Laparoscopic Hysterectomy involves making small incisions in the lower abdomen. They remove the Uterus in small pieces through these incisions or the Vagina.

• In a Vaginal Hysterectomy, the doctors remove the Uterus via an incision at the top of the Vagina. In an Abdominal Hysterectomy, the doctors make a six-to-eight-inch long incision in the abdomen to remove the Uterus. The doctors prefer the latter when cancer has spread to other pelvic areas.

• Salpingo-Oophorectomy (Unilateral/ Bilateral): Surgery for treating Ovarian Cancer. The doctors remove one or both the Ovaries and Fallopian Tubes during the Surgery. 

The surgeons perform this Surgery via Open Abdominal Surgery, Laparoscopic Surgery or Robotic Surgery. In Open Abdominal Surgery, the surgeons remove the Ovaries and Fallopian Tubes through an incision in the abdomen. 
In the Laparoscopic procedure, the doctors remove the Ovaries through small incisions in the abdomen. During a Robotic Salpingo-Oophorectomy, a robot arm operates and removes the Ovaries.

• Vulvectomy: It is the surgical treatment for cancer of the Vulva. It involves removing the Vulva and nearby Lymph Nodes. The doctors may use laser beams to remove Cancerous Surface Lesions.

Cytoreductive Surgery with Hipec for Gastro-intestinal and Gynecologic Cancers 

HIPEC stands for Hyperthermic Intraperitoneal Chemotherapy.

The surgeons remove the visible cancerous tumours from the abdominal cavity. It is an open procedure, and the patient gets general anaesthesia. After the tumour resection, the surgeons bathe the abdominal cavity with Hot Chemotherapy that terminates the remaining microscopic cancer cells.

Bone and Soft Tissue Cancer

Musculoskeletal Cancer develops in the bone or nearby soft tissues, like muscles.

• Bone Cancer: It is a cancer of the bone. Osteosarcoma is a Bone Cancer originating in the cells of the long bones. The surgeons may perform Limb-Sparring Surgery, Amputation, or Rotationplasty to treat cancer of the affected limb. 

• In limb-sparring surgery, the doctors remove all of the cancer. They spare the limb and its functionality. It involves the use of metal grafts and prostheses to reconstruct the bone.

The doctors may cut the affected limb during the Surgery if the cancer has spread. Prosthetic joints help in improving the outcomes and function.

• In Rotationoplasty, the surgeons remove cancer and nearby areas along with the knee joint. They rotate the foot and ankle so that the ankle functions as the knees. They use a prosthesis for the foot and lower leg.

• Soft tissue sarcoma: The surgeons remove the tumour and one or more lymph nodes. If cancer has not spread, Surgery is the primary treatment. Otherwise, doctors use it in conjunction with Chemotherapy and Radiation.

Skin Cancers

• Excisional Surgery: The surgeons excise the cancerous tissues and nearby healthy tissues during the Surgery. Excisional Surgery treats all types of skin cancers.

• Mohs Surgery: Surgeons perform this for recurrent Skin Cancers, including basal and squamous cell carcinoma. The surgeons remove the skin layers, examining each layer under the microscope until no cancerous cells remain.

Why Choose Manipal Hospitals?

Manipal Hospitals offer comprehensive cancer treatment for tumours of various organs. 

The hospital boasts a trained and experienced team of cancer specialists, Surgeons and Oncologists. The dedicated team works diligently with each patient to decide the best treatment and recovery plan. 

The Centre of Excellence of Oncology offers a holistic approach to the surgical resection of tumours.

The state-of-the-art centre has the latest medical technology to ensure the patient's seamless cancer treatment journey.

Visit our cancer hospital if you require cancer treatment in Gurgaon. 

Frequently Asked Questions

• What is the Mastectomy's recovery time?

The patient may take three to four weeks to recover after the Mastectomy Surgery.

• Who performs cancer surgeries?

Onco-Surgeons perform cancer-related surgeries like Biopsies and Tumour Resections.

• What to expect after Colon Cancer Surgery?

The patient will feel pain for a few days. They may not be able to eat for a few days till the colon heals and recovers. 

• What are the consequences of a Hysterectomy?

Hysterectomy involves surgical removal of the Uterus for cancer treatment. Consequently, the woman will not be able to conceive or have her periods after the Surgery.

• Can the liver grow back after liver cancer surgery?

If a part of the liver is cancerous, the doctors remove it—furthermore, the liver re-grows within a few weeks.

Summary

Oncosurgeries are the primary step in cancer treatment. It involves the surgical removal of the tumour wholly or in parts. The doctors may also remove the nearby tissues and organs if the cancer has spread. 
The doctors recommend surgeries as a treatment, diagnosis, staging, debulking, and prevention. Some risks associated with cancer surgeries are pain, bleeding, infection, damage to nearby organs and tissues, and drug reactions. 

Cancer surgeries are different for different organs. Post-operation medicines, therapies and recovery also vary for each patient. Patients' overall health, type and stage of cancer help Oncologists define the treatment plan. 

Before the Surgery, the patients undergo several tests reflecting their overall health. 
Surgeons perform Cancer Surgeries on various organs of the body. After the Surgery, the patients may undergo Chemotherapy and Radiation therapy to remove all the cancer cells from the body.