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The evolution of cancer surgery and future perspectives
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The evolution of cancer surgery and future perspectives
The evolution of cancer surgery and future perspectives
Journal Article

The evolution of cancer surgery and future perspectives

2015
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Overview
Surgery is the oldest oncological discipline and remains the cornerstone of treatment for most patients with cancer. However, the way surgery is used to treat cancer has evolved and outcomes continue to improve as a result of greater biological understanding, relentless technical innovation and a paradigm shift towards multimodal treatment. In this Perspectives, the authors discuss the developments in cancer surgery that have occurred over time and provide an overview of the key uses of surgery in the current era of multidisciplinary cancer care. Surgery is the oldest oncological discipline, dating back thousands of years. Prior to the advent of anaesthesia and antisepsis 150 years ago, only the brave, desperate, or ill-advised patient underwent surgery because cure rates were low, and morbidity and mortality high. However, since then, cancer surgery has flourished, driven by relentless technical innovation and research. Historically, the mantra of the cancer surgeon was that increasingly radical surgery would enhance cure rates. The past 50 years have seen a paradigm shift, with the realization that multimodal therapy, technological advances, and minimally invasive techniques can reduce the need for, or the detrimental effects of, radical surgery. Preservation of form, function, and quality of life, without compromising survival, is the new mantra. Today's surgeons, no longer the uneducated technicians of history, are highly trained medical professionals and together with oncologists, radiologists, scientists, anaesthetists and nurses, have made cancer surgeries routine, safe, and highly effective. This article will review the major advances that have underpinned this evolution.