Do All Tumours Really Require Surgery?

When a tumour is diagnosed, one of the first questions patients often ask is whether surgery is necessary. The answer is not always straightforward. Tumours vary widely in their behaviour. While some are benign and slow-growing, others are malignant and require timely intervention.

This is where surgical oncology plays an important role. Beyond performing operations, surgical oncology focuses on careful assessment and planning to determine whether surgery is needed, when it should be performed and how it fits into an overall treatment strategy. Through a structured and individualised approach, patients can receive care that is appropriate, effective and tailored to their specific condition.

The Role of Surgical Oncology In Cancer and Tumour Treatment

A surgical oncologist is involved in the entire cancer care journey, from the initial diagnosis to long-term follow-up. Surgical oncologists perform several key functions such as:

Assessment and Planning

Treatment in surgical oncology begins with a thorough assessment. This often involves performing imaging studies, laboratory tests and biopsies to confirm the diagnosis and understand the specific genetic makeup of the tumour. Once the nature of the tumour is confirmed, the surgical oncologist collaborates with a multidisciplinary team to design a personalised treatment plan.

Tumour Removal and Staging

When surgery is deemed necessary, the surgical oncologist performs a procedure to remove the tumour, along with a rim of healthy tissue, to ensure no cancer cells are left behind. During this process, staging is often carried out. This may involve removing nearby lymph nodes to check if the cancer has spread.

Preparing for Adjunct Therapies

Surgical oncology also plays a role in other treatments. For instance, a surgeon performs 'debulking' surgery to remove as much of a tumour as possible. This makes follow-up therapies like radiation or chemotherapy more effective. Additionally, they may perform minor procedures to assist with treatment, such as inserting infusion ports for easier delivery of chemotherapy drugs.

When Is Surgery Needed for a Tumour?

The decision to operate depends on several specific factors that your oncologist will evaluate carefully. Surgery is necessary only when the tumour poses a risk to your health or quality of life.

Common situations where surgery may be advised include:

• Large or Rapidly Growing Tumours: Tumours that increase in size quickly or become difficult to control with treatments such as medication or radiation.
• Tumours Affecting Critical Locations: When a tumour is located near or within vital structures and interferes with normal organ function.
• Confirmed or Suspected Malignancy: When a tumour is cancerous, or when a previously benign tumour shows signs of malignant change.
• Symptoms Caused by Pressure or Obstruction: When benign tumours cause significant problems as they press on nerves, blood vessels or organs, leading to pain, blockage or functional impairment.
• Tumour Recurrence After Treatment: If a tumour returns following earlier treatment.

Can Tumours Be Treated Without Surgery?

In many cases, non-surgical options are effective either as a standalone treatment or in combination with surgery. For some slow-growing, benign or early-stage tumours, doctors may recommend active surveillance (also known as watchful waiting). This involves regular monitoring to ensure the tumour is stable. Additionally, medication may be used to shrink tumours or manage symptoms.

For malignant tumours or cancers that have spread (metastasised), surgery may not always be feasible. Thus, oncologists may consider other alternatives including:

• Radiation Therapy: High-energy beams are used to damage cancer cells and prevent them from dividing, which can cause the tumour to shrink or stop growing.
• Chemotherapy: Medications travel through the bloodstream to target rapidly dividing cells throughout the body, making this approach useful when cancer has spread beyond a single area.
• Immunotherapy: This approach works by strengthening the body’s immune response, helping it recognise and attack cancer cells more effectively.
• Targeted Therapy: Rather than affecting all fast-growing cells, targeted treatments focus on specific genetic or molecular features that allow cancer cells to grow and spread.

Guiding You Through Tumour Treatment at Dennis Lim Surgery

Facing a tumour diagnosis can raise many questions, particularly about whether surgery is necessary. It can be reassuring to know that not all tumours require an operation and that treatment decisions are made carefully based on your specific condition.

At Dennis Lim Surgery, the focus is on helping patients understand their diagnosis and the options available to them. With careful assessment and clear communication, patients are assessed by Dr Dennis Lim, who has been trained under a fellowship programme at the Memorial Sloan Kettering Cancer Centre.  Arrange a consultation with us for an accurate assessment and a discussion of the treatments appropriate for your condition.

Our Oncology Surgeon

Dr Dennis T H Lim
Head and Neck General Surgeon
MBBS (Singapore), M.Med (Surgery), FRCS (Edinburgh), FRCS (Glasgow), FAMS (Surgery)

Dr Dennis Lim is a specialist in head and neck surgical oncology, with particular expertise in tumour surgery. Trained at the Memorial Sloan-Kettering Cancer Center, New York, Dr Lim previously served as senior consultant surgical oncologist at the National Cancer Centre and Singapore General Hospital. He now runs a private practice, offering personalised, multidisciplinary care and employing advanced surgical techniques to achieve optimal outcomes for patients with head, neck and skin tumours.