Many children with cancer will have surgery during their treatment. Surgery is used to biopsy a suspicious mass or lump at diagnosis, stage a disease, insert a central line, remove and / or debulk (reduce the size of) a tumour. Surgery may be an important part of the treatment for children with solid tumours or brain tumours. The general surgeon, orthopaedic surgeon or neurosurgeon may be part of the team providing the care.

Resection of a primary tumour

The surgical removal of the primary tumour may happen before or after chemotherapy. In a few cases complete resection (removal) of the tumour may be the only treatment needed, however most children will require additional chemotherapy and / or radiotherapy. Resection of a primary tumour involves major surgery being performed under a general anaesthetic. The exact nature of the surgery will be explained by the surgical team. The surgeon will remove the affected organ or all of the tumour and some of the normal-looking tissue next to it.

Debulking a tumour

Sometimes a tumour is too large to be removed safely. Debulking the mass (removing as much as possible without removing it entirely) can be beneficial (It may make the child more comfortable, particularly if the mass is large). Chemotherapy and radiotherapy may then be more effective on a smaller tumour.

Second look procedures

Some children with solid tumours and brain tumours may have a second look procedure 3 - 6 months after the initial debulking. Treatment - radiotherapy and / or chemotherapy - may have shrunk the tumour and it may now be easier to remove surgically. Or, the surgeon may check the area for recurrence and may biopsy the surrounding tissue.

Amputation and enucleation

For some children with retinoblastoma and sarcoma, surgery includes the removal of all or a portion of a body part. Advances in childhood cancer treatment mean that amputation and enucleation (removal of the eye) are needed less often. Surgery for bone tumours can often be complex, involving bone grafts and limb salvage.