Surgical oncology is the branch of

surgery Surgery is a medical specialty that uses manual and instrumental techniques to diagnose or treat pathological conditions (e.g., trauma, disease, injury, malignancy), to alter bodily functions (e.g., malabsorption created by bariatric surgery s ...

applied to

oncology Oncology is a branch of medicine that deals with the study, treatment, diagnosis, and prevention of cancer. A medical professional who practices oncology is an ''oncologist''. The name's Etymology, etymological origin is the Greek word ὄγ ...

; it focuses on the surgical management of

tumors A neoplasm () is a type of abnormal and excessive growth of tissue. The process that occurs to form or produce a neoplasm is called neoplasia. The growth of a neoplasm is uncoordinated with that of the normal surrounding tissue, and persists ...

, especially

cancer Cancer is a group of diseases involving Cell growth#Disorders, abnormal cell growth with the potential to Invasion (cancer), invade or Metastasis, spread to other parts of the body. These contrast with benign tumors, which do not spread. Po ...

ous tumors. As one of several modalities in the management of cancer, the specialty of surgical oncology has evolved in steps similar to medical oncology (

pharmacotherapy Pharmacotherapy, also known as pharmacological therapy or drug therapy, is defined as medical treatment that utilizes one or more pharmaceutical drugs to improve ongoing symptoms (symptomatic relief), treat the underlying condition, or act as a p ...

for cancer), which grew out of

hematology Hematology (American and British English spelling differences#ae and oe, spelled haematology in British English) is the branch of medicine concerned with the study of the cause, prognosis, treatment, and prevention of diseases related to bloo ...

, and

radiation oncology Radiation therapy or radiotherapy (RT, RTx, or XRT) is a treatment using ionizing radiation, generally provided as part of cancer therapy to either kill or control the growth of malignant cells. It is normally delivered by a linear particle a ...

, which grew out of

radiology Radiology ( ) is the medical specialty that uses medical imaging to diagnose diseases and guide treatment within the bodies of humans and other animals. It began with radiography (which is why its name has a root referring to radiation), but tod ...

. The Ewing Society—known today as the Society of Surgical Oncology—was started by surgeons interested in promoting the field of oncology. In 2011, the American Board of Surgery ratified Complex General Surgical Oncology via a specialty Board certification. The field was expected to continue expanding via the proliferation of cancer centers, as well as advanced minimally invasive techniques, palliative surgery, and neo-adjuvant treatments.

Debate

Whether surgical oncology qualifies as a distinct medical specialty remains a topic of heated debate. Today, many agree that it is impractical for any single surgeon to be proficient in managing all types of malignant diseases. There are currently 19 surgical oncology fellowship training programs in the United States that have been approved by the Society of Surgical Oncology and this number is expect to grow. Although many general surgeons treat patients with malignant neoplasms, the term 'surgical oncologist' is typically reserved for surgeons who have completed approved fellowship training programs. However, this is a matter of semantics, as many surgeons who are thoroughly involved in treating cancer patients may consider themselves to be surgical oncologists. Most often, ''surgical oncologist'' refers to a general surgical oncologist (a subspecialty of

general surgery General surgery is a Surgical specialties, surgical specialty that focuses on alimentary canal and Abdomen, abdominal contents including the esophagus, stomach, small intestine, large intestine, liver, pancreas, gallbladder, Appendix (anatomy ...

), but thoracic surgical oncologists, gynecologic oncologists and so forth can all be considered surgeons who specialize in treating cancer patients.

Training

The importance of training surgeons who subspecialize in cancer surgery is supported by

clinical trials Clinical trials are prospective biomedical or behavioral research studies on human subject research, human participants designed to answer specific questions about biomedical or behavioral interventions, including new treatments (such as novel v ...

showing that surgical oncology outcomes are positively correlated with surgeon volume. In other words, surgeons who treat more

cases tend to become more proficient, and their patients often experience improved survival rates. This is another controversial point, but it is generally accepted—even as common sense—that a surgeon who performs a given operation more often, will achieve superior results when compared with a surgeon who rarely performs the same procedure. This is particularly true of complex cancer resections such as, Breast Cancer Surgery, pancreaticoduodenectomy (Whipple procedure) for pancreatic cancer, and gastrectomy with extended (D2) lymphadenectomy for gastric cancer. In the United States and Canada, fellowship trained surgical oncologists have among the longest training periods of any physicians/surgeons. In some areas like Breast Diseases and

Breast Cancer Breast cancer is a cancer that develops from breast tissue. Signs of breast cancer may include a Breast lump, lump in the breast, a change in breast shape, dimpling of the skin, Milk-rejection sign, milk rejection, fluid coming from the nipp ...

there we know as Breast Surgeon the specialist that only works with patients with breast diseases and

breast cancer Breast cancer is a cancer that develops from breast tissue. Signs of breast cancer may include a Breast lump, lump in the breast, a change in breast shape, dimpling of the skin, Milk-rejection sign, milk rejection, fluid coming from the nipp ...

. A training period (clinical and research) of 6 to 8 years is typical and 8–10 years is not uncommon.

Surgical oncology types and forms

These are the most common types and forms of oncological surgery: * surgery to diagnose cancer * surgery to stage cancer * curative surgery :* radical surgery * surgery to debulk cancer * palliative surgery * supportive surgery *

reconstructive surgery Reconstructive surgery is surgery performed to restore normal appearance and function to body parts malformed by a disease or medical condition. Description Reconstructive surgery is a term with training, clinical, and reimbursement implicat ...

* preventive (prophylactic) surgery.

Surgical oncology techniques

Newer surgical techniques are less invasive, use different types of surgical instruments, and lead to less pain and shorter recovery times. The most effective surgical oncology techniques are: *

cryosurgery Cryosurgery (with ''cryo'' from the Ancient Greek ) is the use of extreme cold in surgery to destroy abnormal or diseased tissue; thus, it is the surgical application of cryoablation. Cryosurgery has been historically used to treat a number o ...

* electrosurgery * laparoscopic surgery *

laser surgery Laser surgery is a type of surgery that cuts tissue using a laser in contrast to using a scalpel. Soft-tissue laser surgery is used in a variety of applications in humans ( general surgery, neurosurgery, ENT, dentistry, orthodontics, and ...

* mohs surgery * radiofrequency ablation * robotic surgery and other forms of surgery. * thoracoscopic surgery

Books

One of the first text books dedicated to surgical oncology was written by the American-Irish surgeon, Theodore O'Connell in 1981. Many publications in surgical oncology are also appearing. The majority are large reference textbooks that seemingly combine specialties that are not generally practiced by a single practitioner but cover the academic subject. A number of practical handbooks such as "surgical oncology" in the well read Oxford Handbooks series, have recently been published, perhaps alluding to the evolving practicality of this emerging discipline.

References

External links

European Society of Surgical OncologySociety of Surgical Oncology
{{Authority control Surgical specialties