What to expect from cancer surgery - questions to ask the surgeon

Surgery

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Surgery

Approximately 60% of cancer patients will have surgery. However, it can take several forms.

What to expect from cancer surgery

Some operations may involve endescopes, where an instrument is inserted through a hole made in the body. The endescope allows the surgeon the ’see’ inside the body and take a small amount of tissue for examination.

Some operations may involve a similarly small treatment. For example, the majority of bladder cancers only affect the bladder lining, and can be removed through a cytoscope (a tube passed into the bladder). The bladder can continue to work normally and even if the cancer returns, it may be possible to work on it again in this way.

Some operations, whilst requiring the surgeon to open up the body, may only be to take tissue for testing. For example, in cases of brain tumours - the surgeon may open up the skull, take some tissue from the tumour, and then use titanium screws to hold the skull back in place. At a later date, if there is a need for a full or second operation, the plate can be lifted.

Surgery in these examples is diagnostic. The surgeon uses his skills and, with the aid of pathology and histology reports, can make an accurate assessment of the problem.

It should be stressed that in the majority of these cases, the results will indicate that the problem is not malignant.

However, after taking samples for test, the problem may be deemed malignant, and the surgeon’s role will be crucial in establishing the stage and the grade of the cancer.


  • The stage defines how far the cancer has spread;

  • The grade, how aggressive the cancer is.

Both are measured on 0-4 scales.

Open quotesThe rogue cancer cells in the lymph nodes
                                                               may however be multiplyingClose quotes

A brain tumour is unlikely to have spread far because of the nature of the surrounding brain tissue, whereas a breast cancer could be just a small lump or could have ’metastasised’. Metastasis is the name given to the process by which malignant disease spreads to distant parts of the body, and to the secondary tumours resulting from this process. In the case of breast cancer it is possible that the body’s natural defence system will have ’picked up’ rogue cells and taken them as far as the lymph nodes in the armpits for examination. The body usually examines viruses and bacteria in this way and then makes a perfect-fit cloak to fit over them and neutralise them. The rogue cancer cells in the lymph nodes may however be multiplying.

If the tumour is confined to a single site and is whole, like a pea or a ball, it is said to be a solid tumour. This is ideal for surgery and the whole tumour may be removed effectively.

If the tumour has started to spread, the surgeon may also remove some of the surrounding tissue, and if it has moved to a lymph gland he may well remove that too.

Go to: manual lymphatic drainage and lymphoedema

These days, a surgeon would always prefer to confine his surgery to a localised removal e.g. breast lumps or bowel tumours, and even key hole surgery, rather than having to perform radical extended surgery. The former is ’clean’ and limited, causes less inflammation, less stress on the body and less release of growth hormone; and considerably improves the quality of the patient’s life.

If the cancer has spread, or there is a risk it may have done, surgery may well be followed by radiotherapy and/or chemotherapy. (We shall be looking at radiotherapy in detail in September.) Further surgery is also a possibility but is only needed in a small number of cases.

Open quotesBefore any operation your surgeon should
                                                    explain exactly what is to be doneClose quotes

Before any operation your surgeon should explain exactly what is to be done. You should feel free to ask the surgeon any and all questions, and he should be happy to answer them.

You may feel you want a second opinion. This will not upset the surgeon; they will feel that you are showing the proper interest and care for your condition. Try to obtain a second opinion from a hospital or training school outside the environment of your first surgeon. The local health authority can help, as can the cancer charities. You can even submit your file (including x-rays, scans and histology and pathology reports) to hospitals via the Internet. You have a legal right to your medical records, the surgeon should have them, or you may have to obtain them via your GR But if you do ask and receive them you must not be upset by the ’clinical’ nature of the reporting!

Talk over the diagnosis with a close friend or family member and, if you have more questions, ask them of the surgeon. Write them down, take a paper and pen and even a tape recorder.

The procedure before your operation will depend upon the type of cancer, its location and even the hospital. It is quite normal for you to be worried. Contact the relevant charity helpline and talk through your concerns; they may even suggest a local support group so you can talk with people who have already experienced similar operations.

Prepare yourself. The anaesthetic will have a negative effect on your immune system. Build yourself up in the preceding weeks. Each day take Zinc (25mgs), Vitamin E (400lU) and Vitamin C (2 gms, time release) to help the healing process, plus Fish oils (1000 mgs). Beta-carotene (6 mgs) and Selenium (100-200 mcgs) to boost your cancer defences and your general immune system. Antioxidants like curcumin and melatonin can help.  (Take some Vitamin E cream to rub in the scars after the operation to aid the healing process).

Open quotesTalk over the diagnosis with a close friend or family memberClose quotes

Hyperbaric Oxygen can help the healing process. And ashwagandha and frankincense can reduce inflammation in the body.

A good probiotic like Chris Woollams practitioner strength Probio8 Max will help boost your flattened microbiome.   

Go to: Probio8 Max and pancreatic enzymes 

You should also radically review your diet. You need to be eating a diet based on colourful vegetables and fruits, cutting down your toxins (alcohol, smoking, sugar, salt, caffeine, and saturated fat, while increasing your intake of good fats.

Go to: CANCERactive dietary guidelines for surgery 

Finally, remember one important fact. The surgeon will do his level best to cut out all the cancer from your body that he can safely do. But your diet, the products you use and your lifestyle may well have brought on the cancer in the first place. You were most probably doing something that made you ill in the first place; very few people are victims.

If you do not change your diet, the products you use and your habits and lifestyle other cells in your body may well turn cancerous, not merely because the original one had spread.

And next time the surgeon may not be able to save you. For a short while your life may be in his hands. But in the longer term, it’s in your own.

Some questions to ask your surgeon:

1:Please describe the operation in detail.

2:What are the risks during the operation?

3:Will the surgery cure the problem, or merely slow it down?

4:What does the surgeon consider to be success?

5:What are the short-term and long-term effects?

6:What treatment will be needed after surgery?

7:Will I need another operation?

8:What if my cancer comes back after surgery?

9:How often has the surgeon performed this particular operation before?
See our article - Prepare yourself well for cancer surgery

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