Common types of surgery

There are hundreds of different types of surgery used to diagnose, stage and treat cancer. Some of the more common types are outlined below – some are minor and are more commonly called procedures, while others are much bigger operations.

Surgery to diagnose and stage cancer

For most cancers you will need further tests to make a diagnosis. These tests may involve a surgical procedure.

Biopsy

A biopsy is a procedure to remove abnormal tissue or a sample of cells from the affected area. A biopsy may be done under a local or general anaesthetic. It is sometimes done in the doctor’s rooms, but it may also be done at a radiology practice, in hospital, or as day surgery.

After the biopsy, a pathologist examines the sample under a microscope to see if it contains cancer cells. The initial results are usually available in a few days, though the full report can take up to 10 days.

A biopsy is often done using an ultrasound or CT scan to guide the needle to the correct place. Common types of biopsy used to diagnose and stage cancer include:

• fine needle aspiration – a thin needle is used to remove a sample of fluid and tissue from the tumour
• punch biopsy – a special tool is used to remove a circle of skin
• core biopsy – a hollow needle is inserted through the skin to remove a thin core of tissue
• incisional biopsy – part of the tumour is cut out
• excisional biopsy – the whole tumour is cut out, along with a narrow margin of healthy tissue
• surgical biopsy – the surgeon cuts into the body to remove all or part of the tumour; various surgical tools can be used depending on the part of the body affected
• endoscopic biopsy/endoscopy – a long, thin, flexible tube with a light and a camera is inserted into the body through a small cut or a natural opening such as the mouth. The doctor views images of the body on a TV or computer screen and takes a tissue sample. There are many types of endoscopy named after the part of the body affected, e.g. colonoscopy (colon), hysteroscopy (uterus), gastroscopy (stomach).

Staging surgery

Staging is the process of working out how large the cancer is and whether it has spread to other areas of the body. Some cancers are staged surgically. This means that the surgery to remove the cancer will help the doctor work out how far the tumour has spread throughout the body. All tissue and fluids removed during staging surgery are examined for cancer cells by a pathologist.

Knowing the stage of a cancer helps the doctor recommend the best treatment for you. Some cancers are also given a grade, which describes how abnormal the cancer cells are and how fast they are growing.

Sometimes diagnostic and staging surgery removes all of the cancer, and you don’t need further surgery or treatment. For specific information about staging a certain type of cancer, talk to your medical team or download our booklet on the type of cancer you have.

Surgery to treat cancer

The type of surgery used to treat cancer depends on the type of cancer, its location and stage, and your general health.

Some of the terms commonly used to describe surgery include:

• elective surgery – surgery that is necessary to treat a diagnosed illness, but is safe to be delayed; patients are placed on an elective surgery waiting list; most cancer surgery is elective surgery
• emergency surgery – life-saving surgery that has to happen as soon as possible to treat an acute illness, e.g. surgery to remove a tumour that is blocking the bowel
• marginal excision – a surgical procedure to remove cancerous tissue with a close or no margin
• wide local excision – a surgical procedure to remove cancerous tissue and some healthy tissue around it
• radical resection – a type of extensive surgery that aims to remove the diseased organ or tumour; may also remove the blood supply, lymph nodes and,  sometimes, attached structures
• lymphadenectomy (lymph node dissection) – removal of some or all lymph nodes from a part of the body
• inoperable – not able to be removed surgically; this may be because there is no lump of tissue that can be removed (as with blood cancers), or because it is not possible to safely remove all the cancerous tissue. Other treatments such as drug therapies or radiation therapy may be recommended.