The role of surgeons in cancer management

The incidence of cancer continues to rise in western countries, although slower than in previous decades. In the UK 24% of all deaths are caused by cancer. The role of surgery in cancer management has expanded over the last few decades to include screening, prevention, diagnosis and staging, reconstruction and palliation.In UK, the breast, bowel and cervical national screening programmes rely on surgeons to perform invasive diagnostic procedures.Genetic testing enables identification of carriers of pathological genetic mutations who are at high risk of developing cancer and might benefit from ‘risk-reducing’ surgery.Advances in surgical technology have led to a variety of new techniques being available to surgeons and cancer patients for diagnostic and therapeutic purposes, including vacuum-assisted devices, photodynamic therapy, radio frequency ablation, cryosurgery and microwave ablation.Oncological surgical procedures often result in disfigurement, mutilation or functional loss, and restorative surgery has become an integral part in the management of cancer patients with the ultimate aim of improving their quality of life. In incurable cancer patients, palliative surgery can be justified to reduce the severity of symptoms and improve the quality of life, where conservative strategies or less invasive interventions have failed or are not appropriate.