Unlike other cancer treatments where your doctor tries to shrink a tumor, surgery is the physical act of removing a tumor. A surgeon uses a specific procedure based on the type of tumor you have to complete the surgery.

Your doctor also may recommend chemotherapy, radiation therapy and immunotherapy before or after your surgery.

“Multidisciplinary care for cancer is mandatory for many types of cancers,” said Dr. Jessica Wernberg, surgical oncologist with Marshfield Clinic Health System.

There are four things you should know about surgically removing a tumor before you agree to have surgery.

1. Not all tumors require surgery

Doctors treat some tumors with chemotherapy and/or radiation instead of removing it with a surgery.

Most tumors that require surgery are either solid organ tumors or soft tissue tumors.

Soft tissue tumors include breast cancer and sarcoma, which is a connective tissue cancer. For solid organ tumors, your surgeon needs to remove the part of the organ with the solid tumor in it.

Some organs with solid organ tumors are completely removed including the esophagus, kidney, uterus, ovaries, stomach, colon and appendix.

In other situations, your surgeon only removes the diseased portion of an organ containing a tumor.

For cancers that affect the digestive system such as the colon or esophagus, the surgeon has to reconnect those organs so your normal digestive processes continue.

2. Surgery requires some prep work

Before surgery, your surgeon works with you to assess the risks of your surgery.

They determine if you have any significant health concerns such as smoking, diabetes or heart disease, which impact the risks of surgery.

A surgeon’s job is to look at the patient, the tumor and really balance the risks of the operation with the benefits. With cancer, the benefits are very obvious, but sometimes the risks are very high,” Wernberg said. “Every operation is different even for the same cancer because every person is different.”

Your surgeon meets with you to talk about your surgery and the risks. Wernberg also recommends that a loved one come with you to these appointments to help you recall the conversation.

She also suggests you ask many questions during this meeting so you are comfortable with moving through the process. Patient navigators can help with this as well.

3. Course of treatments can change

Depending on the type of tumor you have and other factors, your treatment could include chemotherapy, radiation therapy or surgery in any order.

Sometimes your team recommends you remove the tumor first so they can complete a biopsy of the tumor. This helps determine the course of chemotherapy and radiation therapy treatments.

Other times outcomes improve by doing chemotherapy or radiation therapy before a surgery.

4. Managing the risks of surgery

Wernberg admits that anything can happen during surgery. That is why it is important to meet with your surgeon so you understand the risks and make an informed medical decision.

“Surgery is part of the curative intent. We understand there are inherent risks with every surgery,” Wernberg said.

Common risks include:

• Blood clots
• Bleeding
• Infections
• Leaks from organ connections
• Pneumonia

Advancements such as robotic surgery and outpatient procedures, have minimized complications.

Robotic surgery minimizes big incision complications so patients can go home sooner. Many procedures used to require intensive care, but more procedures are improving and becoming outpatient procedures so patients can leave that day.

In order to reduce risks and complications, Wernberg also recommends getting in better shape before a surgery.

“If somebody can be active before surgery, they are more likely to recover faster with fewer complications after surgery,” Wernberg said.

For more information about removing tumors with surgery, talk to your doctor.

Concern for eyes leads patient to cancer diagnosis that required surgery

Lois TeStrake, a long-time resident of Marshfield, Wisconsin has a passion for life and helping the people around her. A question of concern from a stranger helped her discover she had pancreatic cancer.

TeStrake was enjoying a normal day as she was working in a local clothing store. After helping one customer, she received a surprising question. “Is there something wrong? Your eyes are looking yellow.” That customer was Dr. Wernberg, surgical oncologist at Marshfield Clinic Health System. This concern prompted TeStrake to call Dr. Wernberg’s office for further testing.

Initially her care team had thought TeStrake had plugged bile ducts that were causing her jaundice, and she was scheduled for surgery. Then they discovered she had stage two pancreatic cancer. Dr. Wernberg and Chady Leon, M.D., hematology-oncology specialist, brought together a multi-disciplinary team of specialists from surgery, gastroenterology, oncology and radiation oncology to discuss her care and created a treatment plan.

Watch how Dr. Wernberg’s concern made a difference for TeStrake.

For questions about cancer care, talk to a Marshfield Clinic Health System provider.

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