This page was reviewed under our medical and editorial policy by
Maurie Markman, MD, President, Medicine & Science
This page was updated on April 20, 2022.
Oncologists use a number of techniques to diagnose and treat cancer. Medical oncology often uses chemotherapy drugs to attack the cancer, while radiation oncology relies on various forms of radiation therapy. Hematology-oncology treats blood cancers. Dermatology, interventional pulmonology and other fields of medicine may also be involved in the process.
Surgical oncology is the field of cancer care that focuses on surgery to diagnose, stage and treat cancer, and to manage some cancer-related symptoms.
Whether a patient is a candidate for surgery depends on factors such as the type, size, location, grade and stage of the tumor. Other general health factors are also taken into account, such as the patient's age, physical fitness and any coexisting health conditions he or she may have.
Surgical oncologists at City of Hope work with a multidisciplinary team of physicians and clinicians to combine surgery with other therapies and procedures required by the patient’s comprehensive plan.
Our surgical oncologists take the time to discuss each patient's diagnosis and treatment options with him or her, addressing any questions or concerns. The surgical oncologists will work with the other team members—including nutritionists, rehabilitation therapists and naturopathic providers—to anticipate and manage side effects of surgery.Someone with or suspected of having cancer may undergo surgery for many reasons. Surgical oncology may be used to:
The two primary types of cancer surgery are open surgery and minimally invasive surgery.
In open surgery, the surgical oncologist makes a large incision, usually to remove all or part of a tumor and some of the surrounding healthy tissue (margins).
Minimally invasive surgical techniques may involve the techniques listed below.
Laparoscopy: A surgical oncologist makes a few small incisions and inserts a laparoscope—a thin tube with a tiny camera attached to it—into one of the incisions to capture an interior image, while inserting surgical tools into the other incisions to excise malignancies and surrounding tissue.
Laser surgery: The surgeon uses a narrow beam of high-intensity light to remove a tumor.
Cryosurgery: The surgeon uses liquid nitrogen to freeze and kill cancer cells.
Robotic surgery: This surgery is similar to a laparoscopic surgery. However, instead of manipulating surgical tools by hand, the surgeon uses a computer console to operate the robotic tools.
Other procedures, such as endoscopies, embolization, Mohs micrographic surgery and pleuroscopies, may be performed by non-surgeons, including dermatologists, radiation oncologists and interventional pulmonologists, depending on the procedure.
Non-surgical treatments may take place before surgery (neoadjuvant therapy) or after surgery (adjuvant therapy) to help prevent cancer growth, metastasis or recurrence. The treatments may include chemotherapy, radiation therapy or hormone therapy.
As with general surgery, complications may arise from surgical oncology procedures.
Some of the common side effects of cancer surgery include:
Some cancers that are commonly treated with surgical oncology include:
Cancer surgery is used to treat a wide range of cancers, depending on their location, size and stage. Members of the multidisciplinary teams at City of Hope discuss with the patient, and one another, the specific indications of a diagnosis and advise the patient on an individualized course of action tailored to his or her needs and treatment goals.
The Advanced Surgical Recovery Program (ASURE) at City of Hope is designed to help patients recover from surgery more quickly and with fewer complications. ASURE is intended to improve surgical outcomes and enhance the patient experience before, during and after surgery, while also reducing the length of a patient’s hospital stay.
The program is delivered by City of Hope multidisciplinary teams, which include surgeons, anesthesiologists, nutritionists, behavioral health therapists, nurses and other clinicians. They work collaboratively to implement evidenced-informed protocols, all under one roof. ASURE combines post-surgical rehabilitation with pre-habilitation, by preparing patients before surgery.
Typically, ASURE protocols involve nutrition, pain management with non-narcotic pain relievers and physical activity within 24 hours after surgery. The use of enhanced recovery methods like those used in ASURE has been shown to reduce fatigue, post-surgery complications and the amount of narcotics used in post-surgical care, while helping patients resume their everyday activities more quickly.