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 such as chemotherapy or radiation therapy, or to remove any remaining cancer after chemotherapy or radiation therapy
- palliative surgery – to relieve the symptoms of a tumour, especially if it is causing pain.
These types of surgery are only done for cancers that involve a growth or tumour – they are not used 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 (also called a venous access device, central venous catheter or portacath) into a large blood vessel, usually in their chest or upper arm. This 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, and can also be used to take blood samples for testing.
Types of surgery
Surgery to remove a tumour usually involves making large incisions (cuts). 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, as well as for treatment. Recovery times are usually shorter than for surgery that requires large incisions, 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 a tube. The tube contains a video camera that lets the doctor see the tumour and the surrounding tissue, and a special device 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 the procedure. 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, damage to other organs or tissues, and reactions to drugs used during surgery, such as anaesthetics.