Diagnostic Surgery

There are many ways to detect or confirm a suspicion of the presence of a cancer. Microscopic examination of biopsy samples is the ideal way that a positive diagnosis of cancer can be made. This procedure involves physically removing all or part (tissue, cells, or fluid) of a suspected tumor and examining this material under a microscope. The purpose of a biopsy is to identify the histologic type of cancer and possibly stage of disease.

Diagnostic surgery is used to get a tissue sample to identify your specific cancer and make a diagnosis. The diagnosis of cancer often can be confirmed only by looking at the cells under a microscope. Several surgical techniques can be used to obtain a sample. These are surgical biopsies.

Biopsy
The biopsy technique varies according to the organ concerned and the type of cancer. Several quality criteria should be respected.
The biopsy
·    uses an instrument which does not cause any crush nor coagulation of the sampled tissue (cold lancet, biopsy forceps),
·    should be pertinent and should represent the whole tumour,
·    suould avoid haemorrhaging, necrotic or infected zones,
·    should concern junction zones between healthy tissue and tumour (for instance the implantation foot of polyp tumours),
·    Should avoid any bleeding or abscess which would slow down further treatment,

Impact of long waiting lists for diagnostic surgery, x-rays, on patient referrals
National and provincial surveys report lengthy delays in access to diagnostic imaging and surgeries for cancer diagnosis.  When this results in delays to referral to specialist oncology consultation, there can be a significant, negative impact on the emotional well-being of patients, the initiation of cancer therapy and on cancer control outcomes.

The Board of Directors of the Canadian Association of Radiation Oncologists supports the mandate of the Canadian Strategy for Cancer Control to suggest national strategies for cancer prevention, diagnosis and treatment.  CARO will work within this and other initiatives to identify and correct the gaps in the current system and to improve access to cancer diagnosis and treatment.

Other Surgery
Palliative surgery is used to treat complications of advanced disease. It is not intended to cure the cancer. It can also be used to correct a problem that is causing discomfort or disability. This may require surgery for effective relief. Palliative surgery may also be used to treat pain when it is hard to control by other means.

Supportive surgery is used to help with other types of treatment. For example, a vascular access device such as a catheter port can be placed into a vein to help deliver chemotherapy treatments reducing the number of needle sticks needed.
Restorative (or reconstructive) surgery is used to restore a person’s appearance or the function of an organ or body part after primary surgery. Examples include the use of tissue flaps, bone grafts, or prosthetic (metal or plastic) materials after surgery for oral cavity cancers.
Debulking (or cytoreductive) surgery is done in some cases when removing a tumor entirely would cause too much damage to an organ or surrounding areas. In these cases, the doctor may remove as much of the tumor as possible and then try to treat what’s left with radiation therapy or chemotherapy.