The Role of Surgery in Advanced-Stage Cancer

Introduction

Cancer is one of the biggest challenges in modern medicine, and treatments applied in the early stages of the disease are generally more successful. However, when cancer reaches advanced stages, the treatment process becomes more complex and controlling the disease can be difficult. At this point, surgery plays a critical role in both increasing survival rates and improving quality of life.

This article will examine the role of surgery in advanced-stage cancer, its advantages, limitations, and future perspectives in detail.

What is Advanced-Stage Cancer?

The stages of cancer are determined by the degree of tumor spread and its effect on the body. Cancer is generally classified into four main stages:

• Stage 1: The tumor is localized and has not yet spread.

• Stage 2: The tumor is larger and has begun to spread to nearby lymph nodes.

• Stage 3: Cancer has spread further to nearby organs and lymph nodes.

• Stage 4: Cancer has metastasized to distant organs (liver, lungs, brain, etc.).

Advanced-stage cancer is generally considered Stage 3 and Stage 4, and treatment strategies are determined based on the progression of the disease.

Treatment Methods for Advanced-Stage Cancer

The treatment for advanced-stage cancer aims to control the disease and improve the patient's quality of life. These treatments include:

• Surgery

• Chemotherapy

• Radiotherapy

• Targeted Therapies (immunotherapy, biological therapies)

• Palliative Care

While surgery provides a complete clearance of cancer in early stages, it can be applied for different purposes in advanced stages.

The Goals of Surgery in Advanced-Stage Cancer

1. Reducing Tumor Burden (Debulking Surgery) Even if it's not possible to remove the entire tumor, removing a large portion can make chemotherapy and radiotherapy more effective.

2. Improving Quality of Life Surgical intervention can be performed to alleviate symptoms caused by cancer, such as pain, bowel obstruction, and bleeding.

3. Surgical Removal of Metastatic Foci In some cases, cancer that has spread to organs like the liver or lungs can be surgically removed.

4. Palliative Surgery Even without providing a complete cure, surgical options can be considered to increase the patient's comfort.

Surgical Options in Advanced-Stage Cancer

1. Surgeries to Relieve Bowel Obstruction In advanced-stage colorectal cancer, a bowel obstruction can occur, preventing the patient from eating. In this case, surgery can be performed to relieve the blockage.

2. Surgeries for Metastases In cancers that have spread to organs like the liver or lungs, removing the tumors in these areas can prolong the patient's life.

3. Ostomy (Colostomy or Ileostomy) to Ensure Bowel Transit A stoma can be created to regulate and relieve the patient's bowel movements.

4. Surgeries for Bone and Spinal Metastases In cancers that have spread to the spine or bones, the tumor can press on the area, causing pain and limited movement. In such situations, surgery can restore the patient's mobility.

Limitations of Surgery

Although surgery can be life-saving in advanced-stage cancer, it has some limitations:

• Not suitable for all patients: Patients with extensive spread may not benefit from surgery.

• Can be a risky procedure: The risks of general anesthesia and surgery can be dangerous for elderly or frail patients.

• A complete cure is not guaranteed: Surgery is usually performed as a supportive treatment.

Conclusion

In advanced-stage cancer, while surgery may not be able to completely cure the disease, it is of great importance in relieving symptoms, extending life, and increasing the patient's comfort. With the right patient selection and a multidisciplinary approach, surgery can be a promising treatment option even in advanced-stage cancer.