Surgical Oncology

A patient rarely sees a surgical oncologist first. A general practitioner or another specialist usually finds a suspicious lump, an abnormal imaging result or a positive biopsy first. A referral is then made. It is time to see a surgeon specialising in oncology when a solid tumour diagnosis has been made or is strongly suspected, and removing it appears to be a primary treatment option.

A cancer that's not responding to other treatments like chemotherapy or radiation and surgical removal is still an option, is recommended a consultation. After a cancer has been removed and pathology reports show concerning features, such as positive margins like cancer cells at the edge of the removed tissue, patients would qualify for surgical oncology. A discussion about risk-reducing surgery is a proactive step that should be taken by individuals with a strong family history or known genetic mutations like BRCA1/2.

Diagnosis begins much before surgery is planned. Firstly, a surgical oncologist reviews all existing data. This is mainly imaging scans like CT, MRI or PET-CT to locate the tumour and see if it has spread. Pathology reports from needle or endoscopic biopsies are used to confirm the type of cancer.

Focusing on the area in question, the surgeon then performs a thorough physical examination. In a patient with a possible gastrointestinal cancer, for example, this includes feeling the abdomen for masses or enlarged lymph nodes. A detailed review of the patient's overall health is essential. The surgeon assesses heart, lung and kidney function as well. This ensures the patient can safely undergo anaesthesia and the stress of a major operation.

The surgeon might perform a diagnostic surgical procedure for some cancers, like an indeterminate thyroid nodule or a suspicious ovarian cyst. This could be a laparoscopic look inside the abdomen or a direct excisional biopsy of a lymph node. Either way, the goal is to remove the entire suspicious area for a definitive diagnosis in one step.

• Breast cancer: Mastectomies, breast-conserving surgery and sentinel lymph node biopsies.
• Gastrointestinal cancers: Surgery for colon, rectal, stomach, pancreatic, liver and oesophageal cancers.
• Gynaecological cancers: Procedures for ovarian, uterine, cervical and vulvar cancers.
• Head and neck cancers: Resection of tumours of the mouth, throat, thyroid and salivary glands.
• Thoracic (lung) cancers: Lobectomies and wedge resections for non-small cell lung cancer.
• Skin cancers: Wide local excisions for melanoma and non-melanoma skin cancers, including sentinel lymph node biopsies.
• Sarcoma (soft tissue and bone): Limb-sparing surgeries to remove these rare tumours.
• Urological cancers: Nephrectomies (kidney), cystectomies (bladder), and prostatectomies.
• Peritoneal surface malignancies: Including advanced procedures like Cytoreductive Surgery (CRS) with Hyperthermic Intraperitoneal Chemotherapy (HIPEC) for selected cases of appendix, colon, or ovarian cancer spread within the abdomen.

Treatment is never a single event but a carefully navigated journey at NMC. Once a patient is referred to the department of surgical oncology, the process begins with a thorough review in a multidisciplinary tumour board. To agree on the best sequence of therapies, the surgical oncologist, medical oncologist, radiation oncologist, radiologist and pathologist jointly review the case.

Surgery alone might be the entire treatment for early-stage cancers. Minimally invasive techniques are always the first option. Surgeons at NMC Hospitals and clinics in Abu Dhabi, Dubai, Sharjah, Ajman, Ras Al Khaimah and Al Ain are skilled in laparoscopic and robotic-assisted surgeries, known for using small incisions. This leads to less pain, shorter hospital stays and faster recovery. Surgery is combined with pre-operative (neoadjuvant) chemotherapy or radiation for more advanced or complex cancers to shrink a tumour before attempting removal. Post-operative (adjuvant) therapy to eliminate any microscopic remaining disease is also used.

To support patients, a dedicated oncology nurse navigator is assigned who helps coordinate appointments, provides education and offers a consistent point of contact. The recovery plan is mapped before the operation begins. This includes pain management, nutrition support and physiotherapy. NMC maintains specialised protocols and intensive care capabilities, ensuring patient safety and the best possible outcomes for complex procedures like CRS and HIPEC.

Consultant surgeons lead our surgical oncology team at NMC, who have completed advanced fellowship training in cancer surgery from leading international institutions. Not just general surgeons, they have dedicated their careers to the nuances of oncologic resection. With this, they have a deep understanding of tumour biology and know the importance of achieving clear margins.

These specialists are supported by a multidisciplinary team including anaesthetists experts in cancer patients, specialised oncology nurses, stoma therapists (for bowel surgery), physiotherapists and clinical psychologists. Clear communication and explaining complex procedures, potential risks and realistic outcomes are what they are known for. This allows patients and their families to make informed decisions.

NMC's network offers coordinated, compassionate and world-class surgical care for anyone searching for an experienced cancer surgeon in Dubai, Abu Dhabi or across the UAE.