Surgical Oncology (Cancer)

General Information:

Breast cancer is diagnosed when a tumor is found to be malignant (capable of invading surrounding tissues or other areas of the body). Breast cancer can be found in any area of the breast, but many begin in either the milk ducts or milk glands. It is important to realize that not all breast cancer manifests as a lump in the breast. Early diagnosis is key to effective treatment of most breast cancers.

Symptoms:

• Breast swelling (even without a distinct lump)
• Skin irritation, redness, or scaliness of breast or nipple
• Skin dimpling
• Breast or nipple pain
• Inverted nipple
• Nipple discharge

Surgical Treatment:

Depending on the type of breast cancer and its severity, a lumpectomy or mastectomy will be performed. A lumpectomy removes the breast cancer mass and some normal tissue surrounding the mass in order to ensure a clear margin. The nipple is not removed in most cases. If the cancer is larger or more diffuse, a mastectomy may be necessary. A mastectomy removes the entire breast. If a woman chooses to undergo breast reconstruction, the nipple and areola will be preserved, and reconstruction will be done after the mastectomy is completed.

Recovery Time:

A lumpectomy is generally done as an outpatient procedure. Mastectomy patients can expect to spend 1-2 days in the hospital following their surgery. Drain tubes are inserted at the mastectomy site to collect residual fluid. Normal activities can be resumed as incisions heal fully. Your doctor will determine whether chemotherapy or radiation is needed following your surgery.

General Information:

The esophagus is the long, hollow tube that moves food from your throat to your stomach. Esophageal cancer refers to malignant tumors on the wall of the esophagus. Risk factors for esophageal cancer include smoking, alcohol use, obesity, poor diet, and chronic acid reflux.

Symptoms:

• Difficulty swallowing
• Unexplained weight loss
• Chest pain, pressure, or burning
• Indigestion or heartburn getting worse
• Coughing or hoarseness

Surgical Treatment:

Very small tumors can be removed with an endoscopic procedure. Treatment for more advanced esophageal cancer involves the removal of part of the esophagus and possibly of the surrounding lymph nodes and upper part of the stomach. The remaining portion of esophagus and stomach are then reconnected.

Recovery Time:

Recovery time depends on the type of surgical intervention used. Your doctor will determine whether chemotherapy or radiation is needed following your surgery.

General Information:

The lungs are spongy organs in your chest that take in oxygen when you inhale and release carbon dioxide when you exhale. Lung cancer is the leading cause of cancer deaths in the United States. The risk of lung cancer is greatly increased among smokers.

Symptoms:

• New, persistent cough
• Changes in a chronic cough
• Coughing up blood
• Shortness of breath
• Chest pain
• Wheezing
• Hoarseness
• Unexplained weight loss
• Bone pain
• Headache

Surgical Treatment:

There are several different surgical procedures used to treat lung cancer. Your surgeon may choose to perform a wedge resection (remove a small section of the lung containing the tumor as well as some healthy tissue), a segmental resection (remove a larger part of the lung, but not an entire lobe), a lobectomy (remove an entire lobe of one lung), or pneumonectomy (remove an entire lung). Lung surgery can either be performed as an open surgery (a thoracotomy) or as a VATS procedure (video-assisted thoracic surgery). The latter is less invasive.

Recovery Time:

Expect a 5-7 night hospital stay for a thoracotomy and a 1-3 night hospital stay for a VATS procedure. Some time in the ICU may be required. Deep breathing exercises will be required to prevent pneumonia and infection. A chest tube will remain in place until the lung that was operated on has fully re-inflated. Your doctor will determine whether chemotherapy or radiation is needed following your surgery.

General Information:

Melanoma is considered the most serious form of skin cancer. It develops in the cells that produce melanin (pigment) in the skin. Exposure to UV radiation increases your risk of developing melanoma. Though melanoma often occurs in areas that have received the most sun exposure, it can also occur in hidden areas like soles of the feet, palms of the hand, and fingernail beds.

Symptoms:

• Change in an existing mole
• New growths on the skin

Warning signs for cancerous moles are

• Asymmetric shape
• Irregular border
• Changes in color
• Large diameter (more than ¼ inch)
• Evolving (change in size or shape or sudden itchiness or bleeding)

Surgical Treatment:

Early-stage melanoma is treated by surgical removal of the melanoma. In some cases, this can be done during the biopsy. If the melanoma is deeper, additional surgery may be needed to remove the cancer as well as a border of normal skin and tissue. If the melanoma has spread, surgery may needed to remove affected lymph nodes.

Recovery Time:

You should be able to resume normal activities immediately following the removal. Your doctor will determine whether chemotherapy or radiation is needed following your surgery.

General Information:

The pancreas is a gland located between your stomach and your spine. It produces essential hormones (including insulin) and digestive enzymes that help us process the food we eat. Tumors may occur in the pancreas or in the surrounding bile ducts.

Symptoms:

• Persistent pain in upper left or upper middle abdomen
• Pain worsens when lying flat on the back
• Pain worsens after eating or drinking
• Jaundice
• Fever
• Sweating
• Nausea
• Vomiting
• Unexplained weight loss

Surgical Treatment:

Treatment for pancreatic cancer involves the surgical removal of part or all of the pancreas. Commonly used procedures are the Whipple procedure (removes part of the pancreas, part of the small intestine, and the gallbladder) or a distal pancreatectomy, which can often be done laparoscopically.

Recovery Time:

You will need to stay in the hospital for several days following surgical treatment. Recovery time will vary depending on the patient and extent of surgical intervention, but it may take several weeks to resume work and normal activities. You may need insulin or other hormone or enzyme supplements after the surgery. You may also be placed on a special diet. Your doctor will determine whether chemotherapy or radiation is needed following your surgery.

General Information:

During cancer treatment, you may need chemotherapy, blood transfusions, antibiotics, or IV fluids. To make the delivery of these treatments easier, your doctor may decide to insert a medical device that will stay in place for the duration of your treatment. The catheter, or long tube, is placed under the skin and can be connected to a small plastic or metal disc called a port. The port and catheter are placed completely under the skin, though they may be visible as a small bump. Treatments are given by inserting a needle through the port under the skin.

Surgical Treatment:

There are several different types of catheters that may be inserted. Where the catheter is located and how it is inserted depends on the type. You will usually be given local anesthetic or conscious sedation when the catheter and port are placed.

Recovery Time:

Your doctor will instruct you in how to care for your catheter and port.

General Information:

The stomach is a muscular organ located under the ribs. It connects the esophagus and the small intestine. Stomach acids begin the digestive process and prepare fats, starches, and proteins for entry into the small bowel. Stomach cancers are most often found in the inner layers of the stomach lining.

Symptoms:

• Abdominal discomfort
• Black/bloody stools
• Vomiting after meals
• Vomiting of blood
• Weakness
• Fatigue
• Weight loss

Surgical Treatment:

Some stomach cancers can be treated with an endoscopy, in which the surgeon navigates the tube into the stomach and removes the tumor. In more advanced cases, a partial or full gastrectomy may be required. A partial gastrectomy removes part of the stomach, after which the remaining stomach is connected to the small intestine. In a full gastrectomy, the stomach is removed altogether, and the esophagus is connected directly to the small intestine.

Recovery Time:

After an endoscopy, you may experience bloating, cramping, or a sore throat. Patients who undergo a partial or full gastrectomy can live a normal life, though modifications may have to be made to diet and meal size. Recovery time for endoscopy and gastrectomy are dependent on the extent of the surgical intervention. Your doctor will determine whether chemotherapy or radiation is needed following your surgery.