talked again to the urologist and met with a radiation oncologist. I ended up having the radiation seeds implanted—I think I made the right choice for me.”
—Ken, age 70, prostate cancer survivor
Just as there are many different cancers, there are different ways that cancer can be treated. Most cancer treatments can be categorized into three main types—surgery, radiation therapy, and systemic therapy (including chemotherapy). In this chapter, we will touch the surface on information about these treatments, as well as discuss complementary and alternative medicine and clinical trials. An overview will be provided of some of the common terms that you may encounter when discussing cancer treatments with your healthcare team. We will be staying general with our information since each situation is unique, and treatment decisions should be made in conjunction with your treatment team after understanding all the particulars about your cancer and your general health profile.
Surgery
Surgery is used to diagnose cancer, to learn more about the cancer, as well as to treat cancers. Different types of surgery are used depending on the type of cancer, where it is located, and the goals of the surgery.
Special Surgical Techniques
Surgery can be performed in a traditional “open” format as you see on shows such as Grey’s Anatomy, with an open incision and use of a scalpel. However, there are also other types of surgery commonly used.
Laparoscopic Surgery
With this type of surgery, a laparoscope (a thin, lighted tube) is used to see inside the body. The laparoscope, along with other surgical instruments that are also attached to thin tubes, is inserted into the body through several small incisions or portholes. The instruments are manipulated by the surgeon who is watching a monitor so that she/he can see what is happening in the body.
These images are projected to the monitor from a tiny camera at the end of one of the tubes. The use of portholes instead of a large incision may mean a faster recovery and fewer complications.
Robotic Surgery
Like laparoscopic surgery, robotic surgery is performed through several small incisions or portholes. However, with robotic surgery, the surgeon sits away from the operating table at a special console and sees a three-dimensional image of the area being operated on. The surgeon uses hand controls that tell the robot how to manipulate the instruments. The “arm and wrist” of the robot mimics the surgeon’s movements, while the surgeon’s hands control the movement and placement of the instruments.
Laser Therapy
With laser therapy treatment, high-intensity light is used to treat cancer. Lasers can be used to shrink or destroy tumors or pre-cancerous growths. Lasers are more commonly used to treat superficial cancers (cancer on the surface of the body or lining of internal organs).
Cryotherapy
Cryotherapy treatment uses extreme cold, usually using liquid nitrogen or argon gas, to kill cancer cells. For tumors on the outside of the body, such as some skin lesions, the liquid nitrogen is applied directly onto the area using a cotton swab or spraying device. If the tumor is inside the body, the procedure is done using guidance from ultrasound or magnetic resonance imaging (MRI). A probe is inserted through the skin to the tumor. When the probe comes into contact with the tumor, the liquid nitrogen or argon gas circulating through the probe freezes the tumor to kill the abnormal cells.
Embolization
The embolization procedure is used to cut off the blood supply to a tumor. The procedure may be performed as part of a surgery, but often it is done by an interventional radiologist who uses X-ray guidance to insert a catheter into a blood vessel and then threads it to the blood vessel leading to a tumor. Special substances that clot and form a blockage are then injected, shutting down the blood supply to the tumor.
Radiofrequency Ablation
Radiofrequency ablation (RFA) uses heat created by radio waves to kill cancer cells. The procedure is done using ultrasound, CT scan, or MRI guidance to insert a probe that goes through the skin into the tumor. High-frequency electrical currents flow through the probe and heat up the tumor to kill the abnormal cells.
Mohs Surgery
Mohs surgery involves removing small sections of the affected skin, one layer at a time. After each layer is removed, the tissue is looked at under a microscope, checking for abnormal cells. If abnormal cells are seen, the next layer is removed and examined. The process continues until reaching a layer of tissue that shows no evidence of cancer. It is most commonly used to treat skin cancers where tissue sparing is important, such as on the eyelid, lip, and nose.
Questions to Ask Your Healthcare Team about Surgery
What type of surgery is recommended?
Can you describe the procedure?
How will I look after surgery?
Will I be hospitalized after the surgery? If so, how long?
How will pain be managed?
What are the potential side effects?
