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Surgery

ACC SurgerySurgery is the most commonly used techniques to treat cancer in companion animals. The best chance to achieve complete surgical removal of cancer is during the first surgical procedure and is often best performed by a surgeon with experience in surgical oncology. Surgeons do not act in isolation and ideally are part of a comprehensive team of medical oncologists, pathologists, radiologists, criticalists, and certified veterinary technicians. Many surgeries will benefit from knowledge of tumor type, associated prognosis, and possible advanced diagnostic imaging such as MRI, CT, and U/S to define tumor extent and resectability. Surgery can also include specialized surgical techniques such as thoracoscopy, laparoscopy, endoscopy, and other interventional procedures such as palliative stenting.

Amputation is a common procedure for the treatment of many cancers. We recognize this can be a scary option to consider. We have put together two videos, one each for dogs with a front limb and a rear limb amputation, and an interview with the owners, to help you understand the process and answer your questions.

What is the goal of surgical oncology?
The goal of surgery is to control or eliminate the local cancer in an attempt to improve the quality of the patient’s life. Successful surgical removal of localized cancer cures more cancer patients than any other form of treatment. A cure is not always possible and one of the most difficult decisions in surgical oncology is the decision not to perform surgery.

Is there a surgeon that specializes in oncology?
A surgical oncologist is often board certified by the American College of Veterinary Surgery that has advanced training and current knowledge of tumor biology and, importantly, the role of surgery in the multimodality treatment of cancer.

What are the common reasons for surgery?
The most common indications for surgery are to get a diagnosis (surgical biopsy), cure the cancer patient, pain relief or improved function, palliative surgery (marginal resection also known as de-bulking surgery) and incomplete removal to enhance success with combined treatments.

What is surgery for diagnosis?
Commonly referred to as a biopsy, this is one of the most important steps in management of the cancer patient. In this surgery, a section of tumor is removed to be analyzed under a microscope by a pathologist in order to establish a diagnosis. This analysis frequently occurs within two business days of surgery. Information about tumor grade can be obtained from larger biopsy samples that may influence the type of surgery recommended.

What is surgery for cure?
This generally refers to the first surgery performed to remove the tumor with complete margins. This is often confirmed by a pathology report that offers microscopic (histological) evidence that the tumor was removed and encased by normal healthy tissue and that no cancer was left behind. Local control achieved by surgery may require other treatments such as chemotherapy to result in prolonged survival.

What is palliative surgery?
Palliative surgery is a surgery that attempts to improve the quality of the patient’s life (pain relief or improved function or esthetics) but not necessarily lengthen the patient’s life. Examples of palliative surgery would be removal of a mass that is bleeding or infected or amputation of a limb for pain relief after a pathologic bone fracture.

What is de-bulking surgery?
Debulking surgery, otherwise known as marginal resection, is incomplete removal of a tumor to enhance the efficacy of other treatment modalities such as cryotherapy, chemotherapy, or radiation therapy.

If you are interested in other current cancer treatment options; please refer to chemotherapy and radiation therapy. The ACC offers additional information as Client Handouts that can be obtained on site or via mail if requested.