You might not be feeling well or you have noticed some growths on your body that are making you nervous. What kind of doctor do you need to find to get the proper diagnoses and treatment options needed to continue living a healthy long life?
Most hospitals have a division of surgical oncology that deals specifically with both the management and treatment of tumors. You need to understand that not all tumors are cancerous, but nonetheless, you need expert advise in treating any condition that involves abnormal growths.
When you go to such a division, an experienced physician can determine the status of your condition and form a treatment plan that would be best for you. It’s important to know that just because you go to a surgeon; it doesn’t mean that surgery is the only option.
Your physician will always start with the least invasive treatment options before considering more serious procedures. The doctor’s in the division of surgical oncology are very experienced in all phases of treatment and will do what’s needed to keep you healthy.
What experience do doctors in the division of surgical oncology need to have?
The simple answer is many years of intense education and training plus hours of practical experience. After 4 years of medical school and then a 2 to 4 year residency program, a prospective surgeon must then enter into an accredited fellowship program approved by the Society of Surgical Oncology.
After the fellowship has been successfully completed, he or she must complete a difficult board exam to be labeled as a board certified surgical oncologist.
It’s only after all of this that a surgeon has the opportunity to join a team in a reputable hospital’s division of surgical oncology. Only the cream of the crop is chosen, so you know you are receiving the best surgeon to manage and successfully treat your condition.
What to look for in a quality division of surgical oncology?
It’s good to look for a program that is accredited by the many surgical associations in the state it resides. Recognition is usually given for treatment excellence. A surgical oncology program is usually well connected with a vast hospital system and fully integrated with other complementary programs staffed by experts in the management and treatment of cancer.
Are the facilities up to your high expectations?
There’s more to treatment than just surgery. From the exam, tests, diagnoses, treatment plan and follow-up care, you need a surgical oncologist that can allow you the best doctors, support staff, facilities and programs to successfully treat your condition. You and your doctor want only the very best outcome and all these pieces need to be in place to provide that opportunity.
What’s the Use of Surgery?
Surgery is the oldest form of cancer treatment, and for many patients, portion of this curative plan comprises operation. The most significant part the consultation with the surgeon would be an entire history and physical examination.
Before surgical resection, diagnostic and staging studies must be carried out. This also enables the surgeon to determine whether the cancer is resectable (removable with surgery), also enables them to plan the surgical approach.
Because of advanced screening techniques, many patients have a disease that’s curable with surgery alone at diagnosis. In these situations, after surgery, the patient’s follow-up maintenance consists of close observation and/or radiology and lab tests.
The surgical oncologist would aim to take out cancer along with an area of healthy tissue surrounding it, also called a clear margin or clear excision, to stop the disease from recurring in that region (which can be called a local recurrence).
At times it isn’t feasible to remove an entire tumour, and a surgery called “debulking” can be done to eliminate as much of the tumor as possible and also to alleviate symptoms like pain, airway obstruction, or bleeding.
On the other hand, the participation of this surgical oncologist goes past what’s completed on the afternoon of surgery itself.
Included in the multidisciplinary care team, he or she supplies expert opinion regarding biopsy techniques, best image advice, the odds of attaining clear margins (particularly in borderline resectable instances), and also what role there’s, if any, for operative management of more complex disease.
Though chemotherapy and radiation therapy are used either pre- or post-operatively, a first surgery is critical as it isn’t apparent that chemotherapy or radiation may fix or compensate for the small operation. Excision of lymph nodes in the field of the tumor might be done in the time of surgery, based on the kind of cancer.
The advice about lymph node status (i.e. do they contain cancer cells or not?) Will help determine prognosis in addition to additional treatment options.
As an instance, if a patient has a small rectal cancer that’s believed to be node-negative pre-operatively, however, there’s nodal involvement found after surgery, this finding gives a less favorable prognosis than if most of the nodes were negative.
Furthermore, chemotherapy or radiation could be recommended for node-positive disease, but with node-negative illness along with a lack of additional risk factors, monitoring alone after surgery might be recommended.
The kinds of surgeries that are performed for cancers rely on the point and location of the tumor as well as the fitness of the individual for surgery, and will continue to evolve as surgical techniques advance. Your surgeon will discuss with one of the surgery that’s appropriate for your situation and the risks and benefits of the procedure.
A traditional case of the development of surgical procedure is the management of breast cancer. In 1890, Dr William S. Halsted pioneered the radical mastectomy, a surgery that removed the entire breast, all of draining nodes along with the pectoral muscles (the muscle at the chest just beneath the breast).
This is an extreme procedure that led to poor cosmetic outcomes and other long-term troubles. While this was successful against the cancer, other surgeons believed whether they could attain good oncologic results using a less comprehensive and disfiguring surgery.
Breast-conserving surgery was pioneered by Dr. Veronesi in Italy, who conducted quadrantectomy (eliminating a single quadrant of breast tissue) beginning in the 1970s, though it took years of follow-up to demonstrate that this significantly less extensive surgery was acceptable.
These days, breast surgeons tend to perform much smaller and much more cosmetically satisfying surgeries known as lumpectomies (which ought to be followed closely with breast radiation), while still maintaining excellent cancer management.
Furthermore, all girls used to get surgery to remove the lymph nodes from the underarm, called an axillary dissection.
The dissection left some girls with arm swelling, pain, or limited range of motion. Now, for a diagnostic staging of the axilla, sentinel lymph node dissection (removing just the first draining node) is completed. Axillary dissection is reserved for situations in which the sentinel node is positive for tumor, or even when a sentinel node can’t be found.
What about Reconstructive Surgery?
From time to time, after removal of the tumor, there’s a defect left behind this might be physically devastating or influence on function. To cure this, reconstructive methods are increasingly being used for specific cancers and are significant due to the effect on the individual’s wellbeing. Reconstruction can occur at precisely the same period that the tumor has been removed, (“immediate reconstruction”), or months to months afterwards, “delayed reconstruction.”
Every time a surgical oncologist works in combination with a plastic surgeon – for instance, a breast surgeon performing a mastectomy with immediate reconstruction achieved by the plastic surgeon – the combined surgical approach is called “oncoplastic surgery.”
In conclusion, Like radiation therapy, the exact facts of surgical technique are uttered by patient anatomy, tumor location, and cancer cell biology. Thus, there is not always one exact way of doing things. Experience and evidence continue to shape the field of surgical oncology.