For patients with “solid” (i.e. brain, breast, prostate, lung, esophageal, stomach, kidney, pancreatic, colon, bladder, liver, and muscle tumors), surgery may be the key to achieving a cure when the tumor has not spread outside the local area (i.e. Stage 1, 2, or 3 tumors). Note that surgery may be performed for Stage 4 tumors in certain cases, such as in kidney cancer, or in colon cancer with surgery of liver metastases.
Surgery certainly is a scary prospect too many cancer patients, the field has evolved substantially and continues to evolve to improve patient outcome and to shorten recovery time. For example, there is increasing use of minimally invasive surgery which can achieve the same outcome of tumor removal with quicker recovery times patients. Minimally invasive surgery can include laparoscopic surgery and robotic surgery.
Picking the “right” surgeon is very important to many patients. While much of medical oncology and radiation oncology follows standard protocols, there may be a greater degree of variance among surgeons in skill levels, comfort with minimally invasive techniques ( if those techniques are appropriate), and comfort with “riskier” patient who have multiple medical problems.
What should you ask when looking for in a surgeon?
- First, as with any physician, it is important that you are comfortable with your physician with respect to personality, age ( this will be a very individual decision for you as a patient), experience.
- How many of your particular case does the surgeon typically see in a month or year? Note that your surgeon does not need to be a patient “factory” and have done thousands of cases like your own to be proficient!
- Are minimally invasive techniques available for under consideration for your case? Note also that most patients are drawn in by the “sexiness” of robotic surgery, but in some cases the benefits are oversold to patients. Also note that younger surgeons are being trained in robotic surgery during their residency and/or fellowship and may actually be more comfortable than older surgeons (who may have taken a course to update them in robotic surgery) in robotic surgery.
- For surgeons at academic institutions, how much of the case will they do versus their fellows or residents?
For patients who wish to view more information on different surgical procedures, see the links below. As not to “gross” viewers out, the links below are to diagrammatic presentations or computer animations on various surgeries, and NOT to actual surgeries themselves (YouTube has plenty of actual surgeries on file if you want to see those)
- daVinci robotic surgical system: http://www.davincisurgery.com/davinci-surgery/davinci-surgical-system/
- Video explaining the Whipple procedure: http://www.youtube.com/watch?v=x4NJTNLq3xw
- Video showing an open colectomy: http://www.youtube.com/watch?v=mrMsb71ZJ1I&feature=related
- Video showing a laparascopic colectomy: http://www.youtube.com/watch?v=973G38dwxi8