Tumor Removal Health Article

Definition

Tumor removal is a surgical procedure to remove an abnormal growth.

Purpose

A tumor can be either benign, like a wart, or malignant, in which case it is a cancer. Benign tumors are well

circumscribed and are generally easy to remove completely. In contrast, cancers pose some of the most difficult problems in all of surgery.

Currently 40% of all cancers are treated with surgery alone. In 55%, surgery is combined with other treatments—usually radiation therapy or chemotherapy.

The doctor needs to decide if surgery should be done at all. Because cancers spread (metastasize) to normal tissues, sometimes at the other end of the body, the ability of surgery to cure must be addressed at the outset. As long as the cancer is localized, the initial presumption is that cure should be attempted by removing it as soon as possible.

Non-curative surgery may make other treatments more effective. "Debulking" a cancer—making it smaller—is thought to assist radiation and chemotherapy to get to the remaining pieces of the cancer and be more effective.

Another important function surgery performs in cancer treatment is accurately assessing the nature and extent of the cancer. Most cancers cannot be adequately identified without a piece being placed under a microscope. This piece is obtained by surgery. Surgery is also the only way to determine exactly how far the tumor has spread. There are a few standard methods of comparing one cancer to another for the purposes of comparing treatments and estimating outcomes. These methods are called "staging." The most universal method is the TNM system.

• "T" stands for "tumor" and reflects the size of the tumor.
• "N" represents the spread of the cancer to lymph nodes, largely determined by those nodes removed at surgery that contain cancer cells. Since cancers spread mostly through the lymph system, this is a useful measure of their ability to disperse.
• "M" refers to the metastases, how far they are from the original cancer and how often they have multiplied.

Other methods of staging include Duke's method and similar systems, which add to the above criteria the degree of invasion of the cancer into the surrounding tissues.

Staging is particularly important with such lymphomas as Hodgkin's disease. These cancers may appear in many places in the lymphatic system. Because they are very radiosensitive, radiation treatment is often curative if all the cancer is irradiated. Therefore, it must all be located. Surgery is a common, usually essential, method of performing this staging. If the disease is too widespread, the staging procedure will dictate chemotherapy instead of radiation.