When is surgery used?

Surgery can be used to help diagnose some cancers. The surgeon may remove a small piece of tissue so it can be checked for cancer cells. This is called a biopsy. There are different ways of doing a biopsy. You can read more about this in our information on the type of cancer you have.

A pathologist is a doctor who looks at cells or body tissue to diagnose cancer. They look at the tissue sample under a microscope. If they find cancer cells, they can usually learn what type of cancer it is and the grade. This information helps the multidisciplinary team (MDT) plan the best treatment for you.

It can take a week or longer to get the results of a biopsy.

Surgery is the main treatment for many cancers. It may be used to try to cure the cancer. Sometimes it is the only treatment you need. But surgery can also be used with cancer treatments.

During surgery, the surgeon removes the cancer and an area of normal-looking tissue surrounding it. This is called the margin. A pathologist checks all the tissue. If there are any cancer cells left in the margin, your surgeon may advise that you have further surgery to remove more tissue. There are many different types of operation to remove cancer. This will depend on the type of cancer and where it is in the body.

During surgery, the surgeon may also remove some lymph nodes close to the cancer. Lymph nodes closest to the cancer are a common place for cancer cells to spread to. If they contain cancer cells, you usually need further treatment after surgery.

Depending on the type of cancer, some people might have a sentinel lymph node biopsy. This is a test to check the lymph nodes. The sentinel lymph node is the first node or nodes likely to be affected by the cancer. The surgeon removes a small number of lymph nodes close to the cancer, such as from the armpit (axillary) or groin (inguinal). They inject a blue dye or small amount of a harmless radioactive liquid to help them identify the sentinel nodes.

Reconstructive surgery is when surgery is used to:

• reconstruct a part of the body – for example, to create a new bladder after a person has had their bladder removed
• repair the skin – using a skin graft or skin flap after surgery for skin cancer
• restore the appearance of a part of the body – for example, breast reconstruction to create a new breast shape after surgery to remove a breast (mastectomy).

Reconstructive surgery is usually done by specialist surgeons or plastic surgeons. It may be done at the same time as removing the cancer, or at a later date.

Some people with a very high risk of developing breast or ovarian cancer may have risk-reducing surgery. This means removing healthy tissue – for example, the breasts or ovaries. This type of surgery is only offered if you have a very high cancer risk, usually because of your family history. This may be if you have inherited a cancer gene (mutation) for breast or ovarian cancer.

If you have an inherited gene mutation that causes bowel conditions such as familial adenomatous polyposis (FAP) and Lynch syndrome (LS), you have a high risk of bowel cancer. You might have surgery to the bowel to reduce your risk of getting bowel cancer.