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  • It is essential that surgical oncology be present from the moment a patient is diagnosed, since the surgical approach is crucial to the curing process of a cancer patient
  • Dr. Santiago Gonzalez Moreno, medical director at MD Anderson Cancer Center Madrid, emphasizes the importance of experience and training as decisive factors in achieving a surgical approach of excellence
  • Finding less invasive approaches, such as laparoscopy or robotic surgery, and being able to perform more conservative surgery are two of the great milestones of surgical oncology in recent years

 

On the occasion of World Cancer Day, on Monday, February 4, Dr. Santiago Gonzalez Moreno, medical director and head of the Surgical Oncology Service at MD Anderson Madrid, wanted to emphasize the importance of surgical oncology as a fundamental part of the treatment plan of a patient with cancer from the outset. "From the very first consultation, it is very important that the surgical oncologist assess, as part of a multidisciplinary committee together with the medical oncologist and other specialists, the patient's situation, the extent of the tumor, its effects….".

Thanks to their participation and the pooling of the experience of all the professionals on a multidisciplinary committee, all the treatment options available (surgery, radiosurgery, chemotherapy, radiotherapy, immunotherapy, targeted therapies...) and the combinations of these can be looked at and analyzed to find for the best approach for each patient. There is a wide range of treatments, among which the contribution of surgical oncology stands out in terms of survival and even the chances of a cure for the cancer.

Regarding surgical intervention, this must be done by professionals with ample knowledge and experience in the treatment of cancer. "We really only have one attempt at surgery; if it does not go well and we do not perform surgery correctly, guided by surgical oncologists who are experts in the treatment of cancer, it can have a significant impact on the future of the patient", explains Dr. Gonzalez Moreno, who notes that MD Anderson Madrid maintains close contact with MD Anderson Houston, precisely with the aim of training in surgical and medical oncology of excellence.

For that reason, a second opinion in surgical oncology is as or more important than a second opinion in medical oncology, as an inappropriate surgical intervention cannot be reversed, neither with subsequent surgery nor with chemotherapy or radiotherapy treatments. "If the surgery is not carried out by an expert surgical oncologist, we are missing an opportunity", insists the expert.

Furthermore, of course, pharmacological treatments can help and complement the result of surgical intervention prior to or after surgery, either with treatments beforehand that help reduce the size of the tumor or with subsequent treatments that help prevent relapse or prevent the disease spreading. Likewise, pharmacological treatments are fundamental in patients with tumors in which surgery is not indicated, either due to the patient's age or health, or due to the characteristics of the tumor itself. A task that, while vital, "can never replace surgical treatment,” says Dr. Gonzalez Moreno.

Advances in surgical oncology

In recent years, not only pharmacological treatments have advanced dramatically. In surgical oncology, points out the head of Surgical Oncology at MD Anderson Madrid, "progress has been made towards less invasiveness while maintaining the radicality of the treatments and the possibility of preserving certain structures". As an example, Dr. Gonzalez Moreno points to laparoscopy and robotic surgery as an important novelty in that they are less invasive approaches that allow, in cases where indicated, the same results as those obtained with open surgery, but with smaller incisions. "This immediately contributes to more rapid initial recovery of patients”.

Regarding the conservation of structures, Dr. Gonzalez Moreno gives the example of the sentinel lymph node in tumors like breast cancer. "We have devised techniques that allow us to locate one or several lymph nodes where the tumor spreads to first, so, if these are not affected, we can avoid the removal of the lymph nodes from the axilla and save the breast cancer patient future problems," says the doctor, who notes that the number of mastectomies has also been reduced. Another example is rectal surgery, where it is no longer necessary to remove the anus.

A whole series of advances that have further improved the surgical approach to cancer, a treatment without which, reiterates Dr. Gonzalez Moreno, "cancer patients would not have the chances of survival or the chances of a cure that they have with surgery"