Types of surgery

Staging surgery

Staging is the process of working out how large the cancer is and whether it has spread to other areas of the body. Knowing the stage of a cancer helps your medical team work out the likely outcome of the disease (prognosis) and recommend the best treatment for you.

Most of the time staging is done before surgery using imaging scans such as CT, PET–CT or MRI, and a needle biopsy. Sometimes, the stage is revised after surgery. This means that the surgery to remove the cancer will help the medical team work out how far the tumour has spread throughout the body. All tissue and fluids removed during surgery are examined for cancer cells by a pathologist.

Having a biopsy

Before surgery to treat cancer, you may have a medical procedure called a biopsy. Needle biopsies are commonly used to remove a small sample of cells or tissue from the area of concern. If the cancer can’t be diagnosed from a tissue sample, you may have surgery to remove the mass so it can be checked for signs of cancer. The biopsy results are used to diagnose and stage cancer.

General information

Where you have it

It may be done in the doctor’s rooms, at a radiology practice, in hospital, or as day surgery. It is often done using an ultrasound or CT scan to guide the needle to the correct place.

Before the biopsy

You will usually have a local anaesthetic to numb the area. In some cases you may need sedation or a general anaesthetic, which puts you to sleep.

After the biopsy

A pathologist examines the sample under a microscope to see if it contains cancer cells. The initial results are usually available in a few days, though the full report can take up to 10 days.

Common ways of taking biopsies

Fine needle aspiration – A thin needle is used to remove a sample of fluid or cells from the tumour.

Punch biopsy – A special tool is used to remove a circle of tissue.

Core biopsy – A hollow needle is inserted through the skin to remove a thin piece of tissue (a core).

Surgical biopsy – The surgeon cuts into the body to remove all or part of a tumour. It may be called an excision biopsy (removes the whole tumour) or incision biopsy (removes part of the tumour).

Endoscopic biopsy – A flexible tube with a light and camera (endoscope) is inserted into the body through a natural opening (such as the mouth) or a small cut. This lets the doctor see inside the body and take a tissue sample. Endoscopies are named after the part of the body affected, e.g. colonoscopy (colon), gastroscopy (stomach).

Surgery to treat cancer

Some terms commonly used to describe cancer surgery include:

• emergency surgery – life-saving surgery that has to happen as soon as possible to treat an acute illness
• wide local excision – a surgical procedure to remove cancerous tissue and some healthy tissue around it
• radical excision or resection – surgery that aims to remove the diseased organ or tumour; may also remove the blood supply, lymph nodes and, sometimes, attached structures
• lymphadenectomy (lymph node dissection) – removal of some or all lymph nodes from the area near the cancer
• inoperable – not able to be removed surgically; this may be because there is no lump of tissue that can be removed (as with blood cancers), or because it is not possible to safely remove all the cancerous tissue. Other cancer treatments are usually recommended instead.  

How long should I have to wait before cancer surgery?

It’s common to have to wait for surgery. How long you have to wait depends on the type of cancer, its stage, the surgery you are having, and the hospital’s schedule.

The waiting list is organised by how urgently people need surgery. This ensures that people are treated in turn but without waiting for periods of time that would be harmful.

Although most cancer surgery is elective surgery, it usually falls into the most urgent category, which means it is recommended to take place within 30 days of you and your surgeon agreeing on the procedure.

The recommended time frames for treatment to start are set out in the Guides to Best Cancer Care.

Waiting for surgery to begin can be a stressful time – if you are anxious or concerned, speak to your surgeon or call Cancer Connect on 13 11 20.