Deciding on surgery
The topic of whether cancer surgery does more harm than good is a valid issue. Surgery can be a curative treatment by itself or with other treatments such as chemotherapy or radiation. However, in addition to promoting a cure and healing, surgery can also create conditions that may increase your risk of metastasis.1Tohme S, Simmons RL, Tsung A. Surgery for cancer: a trigger for metastases. Cancer Research. 2017 Apr 1;77(7):1548-1552.
Inflammation is one such condition. It is a normal response to tissue being cut and is necessary in the process of healing wounds. However, evidence suggests that inflammation related to tissue trauma from surgery can also inhibit your natural immune response against cancer, leading to cancer growth and spread. The type of anesthesia used and other factors can also impact your anticancer immune response. Surgery is somewhat literally a classic “double-edged sword”, with the potential for both good and harm. Your decision to undergo surgery needs a full, open discussion with your oncology team about both benefits and risks.
Consider an analogy: You’re at home on a cold, snowy day, and suddenly you realize your house is on fire. If you stay in the house, the fire may kill you. If you go outside, you may develop pneumonia, and that may kill you down the road.
The cancer in your body is like the fire. It might kill you pretty quickly if you do nothing, but that depends on how big the cancer (fire) is, how quickly it’s spreading, whether you’ve fireproofed your home, whether you have a fire extinguisher, and more.
The threat of cancer spread or metastasis from surgery is like the risk of pneumonia. It’s a risk, but not a sure thing. And you may be able to take action to reduce that risk. Grabbing some warm clothes or contacting a neighbor could dramatically reduce your risk of pneumonia. Some surgical techniques and options can similarly reduce your risk of cancer spread related to surgery.
This handbook discusses factors that can contribute to inflammation and immune dysfunction, and also measures that you and your surgical team can take to reduce the risk of cancer spread related to surgery. Options are available to reduce the risks of poor cancer outcomes posed by the anesthetic, blood transfusion, low body temperature (hypothermia), and complications after surgery.2Tohme S, Simmons RL, Tsung A. Surgery for cancer: a trigger for metastases. Cancer Research. 2017 Apr 1;77(7):1548-1552.
Before deciding whether surgery is your best option, you need to discuss questions such as these with your oncology team and get clear answers:
- What will likely happen if I don’t have surgery?
- What can I do to prepare myself to improve my immune function and reduce inflammation? (also see Preparing for surgery ›)
- How long can I take to bolster myself before surgery?
- What will the surgery team do to reduce inflammation and minimize the risk of cancer spread?
- What can I do after surgery to reduce my risks of cancer spread and metastasis? (also see In remission ›)
A health professional who is trained in integrative approaches may have more tools to help you reduce inflammation, improve immune function, and improve your resilience before and after surgery. If your team doesn’t include someone with this expertise, consider adding an integrative oncologist, naturopathic oncologist, or functional medicine physician to your team if possible.
Consider taking this handbook with you to refer to during your discussion.