Surgical Oncology
Surgical oncology is a medical specialty in which surgical methods are planned and applied in the treatment of cancer diseases. Also known as cancer surgery or surgical oncology, this field covers different approaches according to the type, localisation and extent of the tumour.
What Is Surgical Oncology ?
Surgical oncology covers the applications aimed at evaluating tumoral tissues by surgical means, removing them where necessary or achieving their regional control. Unlike general surgery, it addresses not only the anatomical structure but also the biological behaviour of the tumour, lymph node distribution and surgical margin assessment in a comprehensive manner.
In surgical oncology, the decision process is not limited to surgical technique alone. The pre-diagnosis imaging findings, pathology results and stage of the disease directly determine which surgical approach is evaluated. Treatment planning is carried out in coordination with the medical oncology and radiation oncology branches.
The fundamental aim in surgical oncology is to address the contribution of the surgical intervention to tumour control together with assessments regarding the patient’s general condition and quality of life. The appropriate surgical approach for each patient is determined within the framework of clinical data and current guidelines.
What Does Surgical Oncology Address ?
Surgical oncology is a field that evaluates the role of surgical intervention in the diagnosis, staging and treatment processes of cancer. Within this scope, biopsy applications, the surgical removal of the tumour, lymph node dissection and, in some cases, reconstructive surgical procedures may be addressed.
Surgical oncology applications may generally be evaluated for the following purposes.
- Diagnostic purpose. Reaching a definitive diagnosis through biopsy and tissue sampling
- Curative purpose. The surgical removal of the tumour and surrounding tissues
- Staging purpose. Evaluating lymph node and surrounding tissue involvement
- Adjuvant. As part of combination treatment planned together with radiotherapy or chemotherapy
- Palliative. Managing situations such as obstruction, bleeding or compression caused by the tumour through surgical means
Which Diseases Does the Oncology Department Address ?
Surgical oncology covers a wide range of diseases, from digestive system cancers to gynaecological cancers and from brain tumours to head and neck cancers. In which disease and under which condition a surgical intervention is evaluated is determined in each case through individual clinical examination.
The main areas that may be evaluated within the scope of surgical oncology are as follows.
- Head and neck cancers. Thyroid, salivary gland, mouth and throat tumours
- Brain tumours. Primary brain tumours and central nervous system neoplasms
- Gynaecological cancers. Ovarian, uterine, cervical and vulvar cancers
- Gastrointestinal cancers. Colon, rectum, stomach, pancreas and liver tumours
- Cancers showing peritoneal spread. Cases evaluated within the scope of cytoreductive surgery and HIPEC treatment
This list is provided for general information purposes. Whether a surgical intervention is an option can only be determined through individual clinical assessment.
The Difference Between Medical Oncology and Surgical Oncology
While medical oncology covers systemic methods such as chemotherapy, immunotherapy and targeted drug treatments, surgical oncology addresses the operative approaches in which the tumour is physically intervened on. These two branches are not alternatives to one another; they are mostly components that complement each other.
For example, in breast cancer, shrinking the tumour with drug treatment before surgery (neoadjuvant), followed by surgery and then the application of radiotherapy, is a typical multidisciplinary approach based on the coordinated work of these three branches. The same applies to colorectal cancers, ovarian cancers and many other tumour types.
Which treatment method is used, in which order and in which combination is determined by the multidisciplinary team in line with the biological characteristics of the tumour, the patient’s general condition and clinical guidelines.
What Methods Are Used in Surgical Oncology ?
The methods applied in surgical oncology vary according to the type of disease and the purpose of the surgical intervention. The main surgical approaches are summarised below.
Head and Neck Surgery
Surgical assessments aimed at tumours in the head and neck region cover the thyroid, salivary gland, oral cavity and pharynx regions. Due to their anatomical complexity, such operations are among the interventions that require an experienced surgical team.
Brain Surgery
Surgical interventions aimed at central nervous system tumours are planned by taking into account the localisation and size of the tumour and its proximity to neurological structures. Brain surgery is one of the subspecialties within surgical oncology in which multidisciplinary coordination is required most intensively.
Gynaecological Oncological Surgery
This covers the surgical approaches applied in cancers of the female reproductive system organs such as the ovary, uterus, cervix and vulva. Assessment is carried out across a wide range, from staging surgery to cytoreductive operations.
Gastrointestinal Oncological Surgery
This covers the surgical approaches applied in cancers of the stomach, colon, rectum, pancreas, liver and bile ducts. This field includes operations that require comprehensive assessment both technically and in terms of multidisciplinary coordination.
Cytoreductive Surgery and HIPEC
Cytoreductive surgery aims to remove tumour tissues that have spread to the peritoneal surface in the most comprehensive way possible. HIPEC (hyperthermic intraperitoneal chemotherapy), in turn, is a combination approach in which a heated chemotherapeutic agent is applied within the abdomen following this surgery. Both methods are addressed only in patients deemed suitable and as a result of detailed multidisciplinary assessment.
In Which Situations Can Cancer Surgery Not Be Performed ?
Cancer surgery is not a method that can be applied in every patient and under every condition. Whether a surgical intervention can be evaluated is determined as a result of a comprehensive clinical examination. The following situations may be counted among the pictures in which surgery may not be applicable or may be postponed; however, each case must be addressed individually.
- The disease having reached an advanced stage and the tumour no longer being removable within a surgical margin
- The assessment that the patient’s general health condition and organ reserve cannot bear the surgical risk
- A resection within an acceptable margin not being possible due to the tumour’s proximity to critical anatomical structures
- The anticipation that applying systemic treatment (chemotherapy, immunotherapy) first may make the tumour more operable, in which case surgery is postponed, not cancelled
- The absence of the patient’s informed consent
The decision that surgery cannot be performed must always be based on the multidisciplinary assessment of the oncology team. The opinion of a single branch does not determine this decision on its own.
Frequently Asked Questions About Surgical Oncology
What is the difference between surgical oncology and general surgery? General surgery covers operative interventions across a wide range. Surgical oncology, on the other hand, is a specialised field applied particularly in patients diagnosed with cancer, keeping the biological behaviour of the tumour, surgical margin assessment and lymph node management at the forefront. Surgical decisions are taken in coordination with the oncology team.
Is chemotherapy or radiotherapy applied before cancer surgery? In some patients, systemic treatment (neoadjuvant chemotherapy or radiotherapy) is applied before surgery, aiming to shrink the tumour and make it more operable. This decision is determined according to the type and stage of the tumour and the multidisciplinary team assessment.
Is additional treatment required after surgical oncology? Adjuvant approaches such as radiotherapy, chemotherapy or targeted treatment after surgery may be planned in some situations. This assessment is made by the treatment team in line with the pathology results and surgical findings.
Does cancer surgery completely eliminate the tumour? Surgery aims at the physical removal of the tumour; however, since the treatment cannot be evaluated as a whole, a guarantee of outcome cannot be given. Surgical success depends on the type and stage of the tumour, the surgical margin and additional treatments. Each case is addressed individually.
Is there such a thing as inoperable cancer? Yes. The localisation and extent of the tumour or the patient’s general condition may, in some cases, make surgery impossible. However, this decision must always be based on a multidisciplinary team assessment; a definitive decision is not made with the opinion of a single branch. In some situations, shrinking the tumour first with drug treatment may make surgery possible afterwards.
What is HIPEC, and for whom is it evaluated? HIPEC (hyperthermic intraperitoneal chemotherapy) is a combination method involving the application of a heated chemotherapy solution within the abdomen following cytoreductive surgery. In certain cancer types that have spread to the peritoneal surface, it is addressed in patients deemed suitable as a result of multidisciplinary assessment. It may not be appropriate for every patient.
Which examinations are performed before surgical oncology? Imaging (CT, MR, PET-CT), biopsy and pathology assessment, blood tests and, where necessary, additional consultations are among the main steps completed before surgery. Which examinations are performed is determined according to the type of disease and the clinical picture.
Can a second opinion be obtained? Yes. Obtaining a second opinion before an important step such as a surgical decision is always possible. You can contact the clinic of Dr. Hasan Morcalı with your current findings to request an assessment.
Surgical Oncology Assessment at the Clinic of Dr. Hasan Morcalı
With over 20 years of clinical experience in the field of radiation oncology, Dr. Hasan Morcalı manages the coordination between surgical oncology, radiation oncology and medical oncology within a multidisciplinary framework.
The approach adopted at the clinic is based on a framework in which the clinical and individual characteristics of each patient are addressed separately and surgical decisions are taken in coordination with the relevant branches. Every stage of the process extending from diagnosis to treatment and monitoring is planned in line with current scientific guidelines.
The information on this page is for general information purposes and does not constitute a diagnosis or treatment recommendation. Consulting a physician for an assessment of your health condition is recommended.
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