Prof. Dr. Metin Çakmakçi, surgeon at Anadolu Medical Centre
Four different methods are applied when treating cancer: surgical intervention, chemotherapy, radiation therapy, and biotherapy, whereas various combinations of these methods are used. The most radical and most successful approach is surgery – it is effective in the early stage of the disease for removing the primary tumour.
Surgery is a local treatment. Many cancer types, including gastric cancer, kidney cancer, and brain cancer form tumours. The role of the surgery is to remove the tumour so formed and the tissues associated with it. Depending on the tumour type, location and stage surgery may be applied as an independent therapy. For instance, surgery may be applied independently, and yet efficiently to treat initial stage of breast cancer.
Moreover, medicamental or radiation therapy may be applied in addition to this procedure. Of course, the sequence of the different methods may vary. The tumour (and sometimes the metastasis) may be removed surgically, but surgery is not applicable if cancer is spread in various areas of the body. If metastases are too many, surgery proves to be useless. If the tumour has spread all over the body, even if the main tumour is removed, the patient’s status will not improve. That is why surgery is not applicable in all cases and suggests options.
A therapy aimed at the whole body, such as chemotherapy, should be applied for the systemic destruction of cells which have probably migrated to other organs of the body. Radiotherapy is a local treatment – not the whole body is irradiated but only particular areas where there is a probability of forming cancer cells. We should not ignore the fact that not every cancer forms a tumorous tissue. Blood cancer (leukaemia), for instance, does not cause the formation of a tumorous mass and the surgical therapeutic method is inapplicable.
The use of the surgical method at a later stage of the disease is usually ineffective. In late stages it may be useful to solve the current problem only. For instance, when the large intestine cancer forms metastases in the brain and the liver, the removal of the tumour does not affect the prolongation of patient’s life. However, when intestines are blocked, even if the tumour itself cannot be removed, a passage in the intestine may be opened at least.
Age is not a factor to be considered when choosing the surgical method. The factor that matters in such cases is the condition of the tumour. It is necessary, of course, the patient to be in a state, which allows anaesthesia and surgery.