When Should You See a Surgical Oncologist?

When faced with a possible cancer diagnosis, many people are unsure which specialists they may need to see. Cancer care usually involves a team of professionals, each contributing to different stages of diagnosis and treatment. Surgical oncologists specialise in the use of surgery to diagnose, stage, and manage cancer, often working alongside other experts as part of a multidisciplinary team. Understanding when it may be appropriate to see a surgical oncologist can give you a clearer picture of your options and help you take an active role in planning your care.

When to Consult a Surgical Oncologist

Knowing when to see a surgical oncologist involves recognising specific situations where surgical expertise is essential. Here are some of the most common scenarios where consulting a surgical oncologist is highly recommended:

• Diagnosis of a Solid Tumour

  If you have been diagnosed with—or are suspected of having—a solid tumour, a surgical oncologist can assess the condition and determine whether surgery is needed. Their expertise ensures accurate tumour removal and staging, which are essential for guiding further cancer treatment.

• Need for a Biopsy

  When a biopsy is required to confirm or stage cancer, surgical oncologists can perform the procedure with precision. Accurate biopsy results are essential for developing an effective treatment plan.

• Surgical Tumour Removal

  Patients who require curative surgery to remove a localised tumour—or debulking surgery to reduce tumour size—benefit from the expertise of surgical oncologists. These professionals are trained to carry out complex procedures that can improve clinical outcomes.

• High Cancer Risk

  Individuals with a genetic predisposition or strong family history of cancer may benefit from consulting a surgical oncologist for preventive procedures, such as prophylactic mastectomy. These measures can help reduce cancer risk and enable early intervention.

• Palliative Surgery Needs

  Even when cancer cannot be cured, surgical oncologists can perform palliative surgeries to relieve symptoms like pain, bleeding or obstruction, improving the patient’s comfort and quality of life.

• Coordinated Cancer Care

  Surgical oncologists play a vital role in multidisciplinary care teams, working alongside medical and radiation oncologists to ensure a comprehensive and well-coordinated treatment plan.

• Referral by Other Doctors

  Many patients are referred by primary care physicians or specialists to surgical oncologists for surgical evaluation and treatment planning. A timely referral ensures proper assessment and access to the most effective care.

Types of Cancers Commonly Treated Surgically

Surgical oncologists handle a variety of cancers where removing the tumour may be an important part of treatment. Common cancers that are often treated with surgery include:

• Breast Cancer: Surgical treatment typically includes lumpectomy or mastectomy to remove cancerous tissue. Surgery is often combined with chemotherapy or radiation to improve outcomes and reduce recurrence risk.
• Colon and Rectal Cancer: Surgical removal of part or all of the colon or rectum is a standard approach, often using minimally invasive techniques. The procedure removes the tumour and affected lymph nodes to limit the spread of disease.
• Thyroid and Parathyroid Tumours: Thyroid surgery removes cancerous nodules, while parathyroid surgery addresses hyperactive glands that may be tumour-related. Precision is important to minimise complications and preserve gland function.
• Liver, Pancreatic and Stomach Cancers: Complex surgeries like hepatectomy, Whipple procedure and gastrectomy are performed to remove tumours while preserving organ function. These operations require specialised skill to optimise cancer control and patient recovery.
• Skin Cancers (e.g. Melanoma): For skin cancers like melanoma, a wide excision removes the lesion and margins to ensure complete removal. Precise surgeries such as Mohs surgery minimise healthy tissue removal while ensuring complete tumour excision.
• Sarcomas and Other Soft Tissue Tumours: Wide excision with clear margins is generally required, sometimes followed by reconstructive surgery. Additional treatments, such as chemotherapy or radiation, may be used as part of ongoing management.

Signs That Surgery May Be Needed

Not all cancers require surgery, but in many cases, it is a crucial step for diagnosis, treatment or preventing further complications. The following signs and circumstances may indicate that surgical intervention should be considered:

• Tumour Causing Pain or Compression: Surgery may be needed if a tumour is causing significant pain or compressing vital organs, nerves or blood vessels. Removing or reducing the tumour can alleviate symptoms and improve quality of life.
• Recurrent or Non-Responsive Tumour Despite Other Treatments: When cancer tumours persist, grow back or do not respond to chemotherapy or radiation, surgical removal might be necessary to control the disease. Surgery can provide another chance for remission or symptom relief.
• Visible Lump or Mass That’s Growing: A lump or mass that is visibly enlarging or changing in character should be evaluated surgically. Surgery helps confirm the diagnosis through biopsy and can remove the mass before it spreads further.
• Imaging Shows Localised Cancer That Can Be Removed: When diagnostic imaging shows cancer confined to a specific location, surgery is often the best option to remove the tumour completely. This localised approach may prevent cancer progression and improve long-term survival.

Our Oncology Surgeon

Dr Dennis T H Lim

Head and Neck General Surgeon
MBBS, M.Med (Surg), FRCS (Edin), FRCS (Glas), FAMS

Dr Dennis T H Lim is a specialist in head and neck surgical oncology, with expertise in cancers of the thyroid, parotid gland, head and neck, and melanoma. 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, providing personalised, multidisciplinary care using advanced surgical techniques to optimise outcomes for patients with head and neck cancers.