SURGICAL ONCOLOGY
Surgical oncology is an important field of general surgery and has as its object the specialized surgical treatment of malignant tumors.
Cancer is a pathological process that affects the cells of an organ. These proliferate uncontrollably and form the tumor, which while initially located within the organ from which it emerges can then subsequently expand into tissues and infiltrate adjacent organs or give lymph node metastases or hematogenous metastases to distant organs.
There are different types of surgical treatment that can be applied to the oncology patient depending on the case:
- Radical surgical treatment
- Operation aimed at reducing the cancer cell population (debulging surgery)
- Surgical removal of metastases
- Palliative surgeries
- Restorative rehabilitation surgeries
- Preventive surgery (eg removal of the colon or breast in high-risk patients)
The surgeon should have the appropriate training, experience and be up to date with the latest oncology data. Good cooperation with oncologists and radiotherapists is required.
Surgical oncology is governed by certain rules:
- Tumor removal should be done en block, with gentle manipulations and radically (removal of adjacent tissues that are attached to the primary tumor)
- Extensive tumor removal with clear resection margins (R0 resection)
- Removal of the ipsilateral lymph nodes (lymph node cleansing)
The study of the human genome brought to light knowledge about the creation of cancer at the genetic level. Examples are the familial polyposis that has been shown to be due to the APC gene. If mutations in this gene occur, they will occur in the second or third decade of a colon cancer patient’s life. Also the hereditary predisposition for the development of breast cancer was found to be due to the BRCA2 gene. Thus, in these cases, preventive surgical removal of the corresponding organ (colon, breast) is recommended. We must emphasize, however, that it is not cancer that is inherited, but the hereditary predisposition for the development of cancer.