Surgical oncology
Encyclopedia
Surgical oncology is the branch of surgery
which focuses on the surgical management of cancer
.
The specialty of surgical oncology has evolved in steps similar to medical oncology, which grew out of hematology
, and radiation oncology, which grew out of radiology
. The Ewing Society known today as the Society of Surgical Oncology was started by surgeons interested in promoting the field of oncology. Though it has not been ratified by a specialty Board certification, the area of expertise is coming to its own by the success of combined treatment with chemotherapy, radiation, and targeted biologic treatments. The proliferation of cancer centers will continue to popularize the field, as will developments in minimally invasive techniques, palliative surgery, and neo-adjuvant treatments.
Most often, surgical oncologist refers to a general surgical oncologist (cf. General Surgery
), but thoracic surgical oncologists, gynecologic oncologists and so forth can all be considered surgeons who specialize in treating cancer patients.
cases a surgeon treats, the more proficient he becomes, and his or her patients experience improved survival rates as a result. 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 cancer resections such as pancreaticoduodenectomy
(Whipple procedure) for pancreatic cancer, and gastrectomy
with extended (D2) lymphadenectomy
for gastric cancer.
Surgery
Surgery is an ancient medical specialty that uses operative manual and instrumental techniques on a patient to investigate and/or treat a pathological condition such as disease or injury, or to help improve bodily function or appearance.An act of performing surgery may be called a surgical...
which focuses on the surgical management of cancer
Cancer
Cancer , known medically as a malignant neoplasm, is a large group of different diseases, all involving unregulated cell growth. In cancer, cells divide and grow uncontrollably, forming malignant tumors, and invade nearby parts of the body. The cancer may also spread to more distant parts of the...
.
The specialty of surgical oncology has evolved in steps similar to medical oncology, which grew out of hematology
Hematology
Hematology, also spelled haematology , is the branch of biology physiology, internal medicine, pathology, clinical laboratory work, and pediatrics that is concerned with the study of blood, the blood-forming organs, and blood diseases...
, and radiation oncology, which grew out of radiology
Radiology
Radiology is a medical specialty that employs the use of imaging to both diagnose and treat disease visualized within the human body. Radiologists use an array of imaging technologies to diagnose or treat diseases...
. The Ewing Society known today as the Society of Surgical Oncology was started by surgeons interested in promoting the field of oncology. Though it has not been ratified by a specialty Board certification, the area of expertise is coming to its own by the success of combined treatment with chemotherapy, radiation, and targeted biologic treatments. The proliferation of cancer centers will continue to popularize the field, as will developments in minimally invasive techniques, palliative surgery, and neo-adjuvant treatments.
Debate
Whether surgical oncology constitutes a medical specialty per se is the topic of a heated debate. Today, some would agree that it is simply impossible for any one surgeon to be competent in the surgical management of all malignant disease. However, there are currently 19 surgical oncology fellowship training programs in the United States that have been approved by the Society of Surgical Oncology. While many general surgeons are actively involved in treating patients with malignant neoplasms, the designation of "surgical oncologist" is generally reserved for those surgeons who have completed one of the approved fellowship 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 (cf. General Surgery
General surgery
General surgery, despite its name, is a surgical specialty that focuses on abdominal organs, e.g., intestines including esophagus, stomach, small bowel, colon, liver, pancreas, gallbladder and bile ducts, and often the thyroid gland . They also deal with diseases involving the skin, breast, soft...
), 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 sub-specialize in cancer surgery lies in evidence, supported by a number of clinical trials, that outcomes in surgical cancer care are positively associated to surgeon volume -- i.e. the more cancerCancer
Cancer , known medically as a malignant neoplasm, is a large group of different diseases, all involving unregulated cell growth. In cancer, cells divide and grow uncontrollably, forming malignant tumors, and invade nearby parts of the body. The cancer may also spread to more distant parts of the...
cases a surgeon treats, the more proficient he becomes, and his or her patients experience improved survival rates as a result. 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 cancer resections such as pancreaticoduodenectomy
Pancreaticoduodenectomy
A pancreaticoduodenectomy, pancreatoduodenectomy, Whipple procedure, or Kausch-Whipple procedure, is a major surgical operation involving the pancreas, duodenum, and other organs...
(Whipple procedure) for pancreatic cancer, and gastrectomy
Gastrectomy
A gastrectomy is a partial or full surgical removal of the stomach.-Indications:Gastrectomies are performed to treat cancer and perforations of the stomach wall....
with extended (D2) lymphadenectomy
Lymphadenectomy
Lymphadenectomy consists of the surgical removal of one or more groups of lymph nodes. It is almost always performed as part of the surgical management of cancer....
for gastric cancer.
Books
A large number of publications in surgical oncology are also appearing. The majority are large reference textbooks that seemingly combine specialtiies that are not generally practiced by a single practitioner but cover the academic subject. A number of practical handbooks such as "surgical oncology" http://ukcatalogue.oup.com/product/9780199237098.do in the well read Oxford Handbooks series, have recently been published, perhaps alluding to the evolving practicality of this emerging discipline.External links
- European Society of Surgical Oncology
- Society of Surgical Oncology
- Nature Clinical Practice Oncology
- Cancer Management Handbook: Principles of Surgical Oncology
- http://ukcatalogue.oup.com/product/9780199237098.do Oxford Handbook of Surgical Oncology
- Surgical Oncology
- The Lancet Oncology
- Annals of Surgical Oncology