For many patients, surgery can offer the best chance for success. Surgical options are considered only after careful, individual assessment of your overall health. You and your physician will discuss possible options and together decide the best option for you. The surgical team will pursue the safest, most effective procedures.

• Breast surgery
• Colorectal surgery
• General surgery
• Laparoscopic surgery
• Stent placement
• Hyperthermic intraperitoneal chemotherapy

Breast surgery

Breast cancer surgery removes the cancerous tissue, and involves either partial or complete removal of the breast, including:

• Lumpectomy is the most common form of breast surgery, in which only part of the breast is removed. The surgeon removes only the portion of the breast that contains the tumor and some of the healthy tissue that surrounds it. In many cases, the surgery is followed by several weeks of radiation therapy to remove any remaining cancer cells.
• Mastectomy removes all or part of the breast and possible nearby structures. Surgeons only elect this option when lumpectomy is insufficient to treat the cancer. As with lumpectomy, surgery may also be followed by additional therapies to remove remaining cancer cells.

Colorectal surgery

Scripps Cancer Center surgeons most often use minimally invasive, laparoscopic surgery whenever possible to treat colorectal cancer as well as other cancers. Minimally invasive procedures offer patients:

• Smaller incisions
• Reduced post-operative pain
• Shorter hospital stay
• Faster recovery

Types of colorectal cancer surgeries offered using minimally invasive procedures include:

• Colectomy (large bowel resection)
• Polypectomy and local excision, in which polyps may be removed using a colonoscope or may be performed by inserting instruments through the anus
• Local transanal resection, which like local excision may be performed through the anus, involves removing the invasive cancer as well as some surrounding normal rectal tissue

When laparoscopic options are not available, surgeons may perform traditional surgical procedures such as:

• Colectomy or large-bowel resection may be performed through an incision in the abdomen if a laparoscopic-assisted approach is not possible
• Low anterior resection, in which the surgeon removes the cancer, lymph nodes and some surrounding tissue of the rectum
• Abdominoperineal (AP) resection, in which the anus and surrounding tissue is removed
• Pelvic exenteration is used when the cancer has spread to surrounding organs, and involves removal of the anus and any affected nearby organs such as the bladder, prostate (in men) or uterus (in women)

General surgery

When minimally invasive procedures are not appropriate, open surgery may be necessary to remove or reduce the cancerous tissue. Surgeons often combine open surgery with other treatments such as radiation and chemotherapy, to maximize results and decrease metastatis.

Laparoscopic surgery

Laparoscopic surgery is a minimally invasive procedure in which the surgeon can see inside the body through small incisions with the aid of a lighted scope attached to a video camera (laparoscope). Plastic tubes are inserted through these incisions and the laparoscope and several small instruments are then introduced through the tubes. The laparoscope transmits the image of inside the body allowing the surgeon to perform the procedure. This procedure is often used in abdominal surgeries including gall bladder, (cholecystectomy), kidneys (nephrectomy), colon and common bile duct.

Stent placement

Stents may be used to treat blockages associate with cancer, such as a bowel obstruction or an obstruction caused by colorectal cancer. During the procedure, a tiny tube known as a stent is placed to prop open an obstruction in the affected area to allow normal functioning prevent future obstruction.

Hyperthermic intraperitoneal chemotherapy (HIPEC)

Hyperthermic intraperitoneal chemotherapy (HIPEC) is used in specific types of abdominal cancer and is performed in the operating room immediately following surgery. HIPEC delivers heated chemotherapy directly into the abdominal cavity, where it can penetrate diseased tissue directly and eliminate remaining cancer cells that are too small to be seen. This combination therapy is effective in slowing or preventing recurrence of the disease and can add quality months, or even years, to your life.