Cancer Surgery

Treating Cancer with Surgery

Depending on the type and stage of cancer, surgery is common and often the first form of cancer treatment. The goal is usually to entirely remove the cancer itself. Surgery may be all that is required to cure the disease if cancer is diagnosed in its early stages and has not spread to other parts of the body. Often, however, surgery is part of a treatment plan that may also include chemotherapy, radiation therapy, hormone therapy and/or biological therapy.

It is also common in many types of cancer surgery to remove some of the lymph nodes in the area of the tumor. Lymph nodes are tiny glands located throughout the body that act as filters to help prevent the spread of infection. By examining tissue from these nodes, pathologists can help determine if the cancer has spread to other parts of the body.

Cancer surgeons at Swedish are part of a skilled team that includes anesthesiologists, surgical nurses and technicians. As the largest cancer program in the Pacific Northwest, the Swedish Cancer Institute (SCI) offers the latest surgical tools, technology and procedures available, including:

Minimally Invasive Robot-Assisted Surgery (da Vinci)

Swedish is among just a few in the Pacific Northwest to offer the robot-assisted daVinci® Surgical System. This innovative tool allows surgeons to perform some types of complex, minimally invasive procedures with greater precision while speeding patient recovery. Currently, da Vinci robotic technology is used to perform urologic, coloretal, thoracic, gynecological and cardiothoracic surgeries at Swedish.

Learn more about da Vinci and Lung Cancer
Learn more about da Vinci and Colorectal Cancer
Learn more about da Vinci and Prostate Cancer
Learn more about da Vinci and Cervical and Uterine Cancer

Breast Conserving Surgery

Surgery is often required to remove a breast tumor but in many cases, a mastectomy (surgically removing the whole breast) can be avoided. With breast-conserving surgical procedures, such as a lumpectomy, the breast tumor is removed while sparing as much of the breast as possible.

Sentinel-node Biopsy for Breast Cancer

For some women, the sentinel-node biopsy is another option for checking the lymph nodes for spread of the cancer. During this surgical procedure, which is less extensive than lymph-node dissection, only a few (usually 1 – 6) lymph nodes (known as the sentinel nodes) are removed and studied. The sentinel nodes are identified by a low dose radioactive tracer and a blue dye injected before surgery. The sentinel lymph nodes are the most likely lymph nodes to be affected by cancer and are a good indicator of whether the cancer has spread. A sentinel-node biopsy, however, may not be an option if a patient's tumor is large or if the lymph nodes are enlarged or known to be abnormal prior to surgery.

Learn more about Surgical Treatment Options for Breast Cancer

Minimally Invasive Transoral Laser Microsurgery (TLM) for Head and Neck Cancer

This new, minimally invasive technique originated in Europe and has revolutionized the surgical approach for head and neck cancers. Surgeons are able to remove head and neck tumors through the mouth, rather than cutting through the skin and muscle of the neck. For the patient, risk is greatly minimized and recovery of speaking, swallowing and breathing functions is faster than traditional, invasive surgical techniques.

Swedish Medical Center has pioneered this new approach in the Pacific Northwest to bring the best outcome possible to head and neck cancer patients. Our surgeons have access to the latest endoscopic instrumentation and bleeding-edge lasers, such as flexible carbon-dioxide lasers (OmniGuide^TM).

Learn more about Transoral Laser Microsurgery (TLM)

Minimally Invasive Video Assisted Thyroidectomy (MIVAT) for Neck Cancer

Head and neck surgeons at Swedish offer miminally invasive thyroid and parathyroid surgeries that allows patients to recover more quickly from traditional surgical techniques. In select patients, we are often capable of removing thyroid or parathyroid lesions through an incision on the neck that is less than an inch in length.  Traditionally, these incisions are three to four inches long, often altering an individual's self perception. Because scars in the neck can be very visible, minimizing these potential scars can improve the outcome of thyroidectomies and parathyroidectomies.

Learn more about Video Assisted Thyroidectomy (MIVAT) for Neck Cancer

Minimally Invasive Video Assisted Thoracic Surgery (VATS) Lobectomy for Lung Cancer

VATS is a surgical technique that accesses the lung through small incisions—versus the larger incisions required in conventional open surgery. In a VATS procedure, a tiny video camera is inserted through one of these smaller incisions, allowing surgeons to view the lung on a high-definition monitor and pinpoint the area that contains the tumor. Then, using special surgical staplers and clips, surgeons can go in and remove the diseased portion of the lung. Surgeons at Swedish Cancer Institute Thoracic Surgery introduced and pioneered the use of VATS in the Pacific Northwest in 1997.

Learn about Surgical Treatment Options for Lung Cancer

Diagnosing and Staging Cancer

Surgery may be used as part of the diagnosis process to obtain a biopsy—a study on a small sample of tumor tissue. Sometimes, if a tumor is found to be malignant (cancerous), it will be removed during the same operation.

Surgery may also be used to determine the stage, or extent, of the cancer. Staging establishes if the cancer has grown only within its area of origin, or if it has spread to other areas. Knowing the cancer stage is important for creating the most appropriate treatment plan.

Cancer Risk Assessment & Preventive Procedures

The SCI's Hereditary Cancer Clinic focuses on patients and families at risk for hereditary cancers including—but not limited to—breast, ovarian and colon cancers. The results of genetic testing can significantly influence a patient’s treatment plan, as well as indicate appropriate screening tests and medical procedures for relatives who may be at risk of cancer. Genetic testing results and consultations with SCI's experts may lead a patient to consider preventive procedures, such as:

• Prophylatic Mastectomy: Surgically removing one or both breasts may prevent or reduce risk of developing hereditary breast cancer when there is no sign of breast cancer.
• Salpingo-Oophorectomy (RRSO): Surgically removing the ovaries and fallopian tubes to prevent or reduce the risk of developing hereditary breast cancer when there is no sign of ovarian cancer.

Learn more about Genetic Testing
Learn more about Salpingo-Oophorectomy (RRSO) (PDF)

Reconstructive Surgery

According to the National Cancer Institute, reconstructive surgery is "surgery that is done to reshape or rebuild (reconstruct) a part of the body changed by previous surgery." For example, a woman may consider reconstructive breast surgery after a mastectomy. In the video below, Plastic Surgeon, Dr. Wandra Miles explains what to expect with breast reconstruction.

Microvascular Surgical Reconstructive Surgery for Head and Neck Cancer

Cancers originating in the head and neck region often requires complex extirpative surgeries that lead to massive anatomical defects. These defects not only impact a patient’s self-esteem from a cosmetic standpoint, but they also typically severely alter the patient’s ability to swallow, speak, and breathe. In the past, reconstructive options were limited, and suboptimal cosmetic and functional results were “expected” side-effects of the treatment of head and neck cancers.

Microvascular surgical reconstructive technique (free flaps) is now widely accepted as the method of choice to reconstruct and rehabilitate these patients. For example, when a patient has cancer of the tongue and jaw, it is often necessary to remove the entire tongue and jaw. We now are able to reconstruct the jaw bone and tongue utilizing autogratfs from the patient, such as the fibula (leg bone) or the skin of the thigh or forearm to reconstruct both the jaw bone and tongue.

Learn more about Microvascular Surgical Reconstructive Surgery for Head and Neck Cancer