Surgical Oncology

Overview

Cancer treatment has evolved tremendously over the years, integrating advanced techniques and collaborative care. While chemotherapy, radiation, and immunotherapy play vital roles, surgery remains one of the most effective and immediate methods to treat certain cancers.
This specialized branch of medicine — known as Surgical Oncology — focuses on using surgical procedures to diagnose, stage, and treat cancer, as well as manage related symptoms and complications.

Surgical oncologists are a crucial part of the multidisciplinary cancer care team, working alongside medical and radiation oncologists, pathologists, radiologists, and rehabilitation specialists to provide patients with comprehensive, individualized care.

What Is Surgical Oncology?

Surgical oncology is a field of cancer care dedicated to using surgery for cancer diagnosis and treatment. It involves procedures to remove tumors, stage cancer, or alleviate cancer-related symptoms. Depending on the case, surgery may be used as a standalone treatment or combined with other therapies such as chemotherapy, radiation therapy, or hormone therapy.

A patient’s eligibility for cancer surgery depends on several factors, including:

  • The type, size, and location of the tumor

  • The stage and grade of cancer

  • The patient’s overall health, age, and fitness level

  • The presence of coexisting medical conditions

Surgical oncologists not only perform the operations but also coordinate care before and after surgery — helping patients recover, manage side effects, and prepare for additional treatments if needed.

Goals of Surgical Oncology

Cancer surgery can serve several different purposes depending on the diagnosis and treatment plan. The main goals of surgical oncology include:

  1. Diagnosis (Biopsy or Diagnostic Surgery):
    To confirm whether a tumor is cancerous and identify its type and grade.

  2. Curative or Debulking Surgery:
    To remove a tumor completely or reduce its size significantly when full removal isn’t possible.

  3. Staging Surgery:
    To determine how far the cancer has spread and whether nearby organs or lymph nodes are affected.

  4. Preventive Surgery:
    To remove tissue that has a high risk of becoming cancerous, such as in hereditary cancers.

  5. Supportive Surgery:
    To assist other treatments — for example, placing an infusion port for chemotherapy.

  6. Reconstructive Surgery:
    To restore the appearance or function of an organ or body part after tumor removal.

  7. Palliative Surgery:
    To relieve symptoms like pain, pressure, or bleeding when cancer is advanced.

Types of Surgical Oncology Procedures

Surgical oncologists perform a wide range of procedures, from traditional open surgeries to modern minimally invasive approaches. The choice of method depends on the type of cancer, its stage, and the patient’s condition.

1. Open Surgery

Involves a large incision to directly access and remove the tumor along with surrounding healthy tissue (known as “margins”) to prevent recurrence.

2. Minimally Invasive Surgery

These procedures use smaller incisions, leading to less pain, faster recovery, and minimal scarring. Common minimally invasive techniques include:

  • Laparoscopy:
    A laparoscope (a thin tube with a camera) is inserted through a small incision to view internal organs. Surgical instruments are used through additional small incisions to remove tumors.

  • Laser Surgery:
    A focused beam of high-intensity light is used to destroy or remove cancerous tissue with precision.

  • Cryosurgery:
    Liquid nitrogen is applied to freeze and kill abnormal or cancerous cells.

  • Robotic Surgery:
    Similar to laparoscopy but performed using robotic instruments controlled by the surgeon through a computer console, allowing greater precision and flexibility.

In addition, other specialized procedures such as endoscopies, embolizations, Mohs surgery, and pleuroscopies may be performed by other specialists like dermatologists, pulmonologists, or interventional radiologists depending on the case.

When Is Surgery Used in Cancer Treatment?

Cancer surgery may be performed at different stages of treatment:

  • Before surgery (Neoadjuvant therapy):
    To shrink the tumor using chemotherapy or radiation so that it’s easier to remove surgically.

  • After surgery (Adjuvant therapy):
    To eliminate any remaining cancer cells and reduce the risk of recurrence.

A multidisciplinary team reviews every case to determine the right combination and timing of treatments for the best outcomes.

Common Side Effects of Surgical Oncology

Like any surgical procedure, cancer surgeries may cause temporary or long-term side effects. Common postoperative complications include:

  • Infection at the surgical site

  • Swelling and pain

  • Fatigue and weakness

  • Lymphedema (fluid buildup causing limb swelling)

  • Nausea or digestive disturbances

  • Scarring or changes in body appearance

To manage these effects, surgical oncologists work closely with rehabilitation specialists, nutritionists, and pain management experts to ensure a smoother recovery.

Cancers Commonly Treated Through Surgical Oncology

Surgical oncology plays a vital role in managing many types of cancers. Some commonly treated cancers include:

  • Breast cancer

  • Colorectal cancer

  • Lung and liver cancer

  • Pancreatic and stomach cancer

  • Gynecologic cancers (ovarian, uterine, cervical)

  • Head and neck cancers

  • Thyroid cancer

  • Kidney and prostate cancer

  • Bone and soft-tissue sarcomas

  • Brain and spinal tumors

  • Skin cancers and melanomas

  • Neuroendocrine and gallbladder cancers

Each cancer type requires a customized surgical plan, balancing complete tumor removal with preserving organ function and appearance.

Collaborative Care in Surgical Oncology

Surgical oncologists rarely work in isolation. They are part of a multidisciplinary cancer care team that may include:

  • Medical oncologists

  • Radiation oncologists

  • Pathologists and radiologists

  • Dietitians and nutritionists

  • Physiotherapists and rehabilitation experts

  • Pain management and palliative care specialists

Together, this team ensures that every patient receives comprehensive, personalized care addressing both the medical and emotional aspects of cancer treatment.

Advanced Surgical Recovery Program (ASURE)

At centers such as City of Hope, innovative programs like the Advanced Surgical Recovery Program (ASURE) are transforming patient recovery. The ASURE program is designed to help patients recover faster, reduce complications, and shorten hospital stays after surgery.

The ASURE program combines prehabilitation and post-surgical rehabilitation by preparing patients physically and mentally before surgery. The multidisciplinary team — including surgeons, anesthesiologists, nutritionists, behavioral therapists, and nurses — follows evidence-based protocols that enhance overall outcomes.

Key elements of ASURE include:

  • Optimized nutrition before and after surgery

  • Non-narcotic pain management strategies

  • Early mobility and physical activity within 24 hours of surgery

  • Psychological and emotional support throughout recovery

These enhanced recovery methods have been shown to lower fatigue, decrease the use of narcotics, and help patients return to daily activities more quickly.

Conclusion

Surgical oncology continues to be a cornerstone of cancer treatment, combining precision, skill, and compassion. From diagnosis to recovery, surgical oncologists play a vital role in removing tumors, managing symptoms, and improving patients’ quality of life.

With advancements like robotic surgery, minimally invasive techniques, and programs such as ASURE, patients today experience shorter hospital stays, fewer complications, and better long-term outcomes.

Ultimately, the goal of surgical oncology is not just to remove cancer — but to restore health, confidence, and hope.