Children's Cancer

Surgery is one of the main treatments for children's cancer. Your child might have surgery for a range of reasons, including:

• Diagnosis and staging – to help diagnose a tumour, or see how big it is and whether it has spread
• First-line treatment – to remove the entire tumour
• Combination treatment – to remove as much of the tumour as possible before starting another treatment or to remove any remaining cancer after other treatments
• Palliative treatment – to relieve the symptoms of a tumour, especially if it is causing pain.

Doctors will only perform surgery for cancers that involve a lump or tumour. Doctors don’t use surgery for blood cancers, such as leukaemia.

However, a child with any type of cancer, including blood cancer, might have surgery to insert a central line. A central line is also called a venous access device, central venous catheter or portacath. Doctors usually put central lines into a large blood vessel in the chest or upper arm. The device is a small plastic tube that either sticks out of the body or sits just under the skin. It allows medicines, including chemotherapy, to be given intravenously. It can also be used to take blood samples for testing.

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Types of surgery

Surgery to remove a tumour usually involves making a large incision the skin. The doctor will remove as much of the tumour as possible. Your child will need to stay in hospital for this type of surgery.

Minimally invasive surgery (also called keyhole surgery) can be used to help make a diagnosis and for treatment. Recovery times are usually shorter than for surgery that requires large cuts, and there is often less pain.

Minimally invasive surgery can only be done in certain parts of the body. The procedure involves making small cuts in the body and inserting plastic or metal tubes called ports. A video camera and instruments can be inserted into the body via the ports so the doctor can see and operate on the tumour and the surrounding tissue. The doctor may use special cauterising devices that can cut out all or part of the cancer.

This type of surgery is called a:

• Laparoscopy when it is done in the abdomen (belly), and a
• Mediastinoscopy or thorascopy when it is done in the chest.

Another type of surgery, called an endoscopy, uses a tube inserted through a natural body opening such as the mouth, rather than making a cut.

Side effects of surgery

Surgery is almost always done under general anaesthetic so that your child sleeps through it. All childhood cancer centres have specialised teams who make sure your child is comfortable and in minimal pain.

Potential side effects of surgery depend on the type of surgery and how complex the procedure is. During the surgery, potential complications can include:

• Bleeding
• Infection
• Damage to other organs or tissues
• Reactions to medicines used during surgery, such as anaesthetics.

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