The Different Roles of Surgery in Oncology

Oncology and soft tissue surgery are very closely linked and an understanding of one must accompany the other, at least on a basic level. one can think of the cancer patient as inevitable, especially with the current level of veterinary practice: more and more ani- mals are living longer due to the great care that owners and veterinarians can now pro- vide. the goal of surgery is vital to its planning. Most would love to cure cancer, but other goals are just as important, including obtaining a diagnosis, getting disease to a microscopic level to allow adjuvant therapy a greater chance for change, or even pallia- tion. Beyond the understanding between the surgeon and oncologist is the role of oth- ers in diagnosing and treating the cancer patient. radiation may be an important adju- vant therapy, diagnostic imaging may be more advanced, depending on the role of the surgery, the pathologist may have to perform more advanced staining techniques to achieve a diagnosis, and nutritional support can be quite vital and is important to the owner.

The absolute KEy to oncologic treatment (be it surgical, chemotherapeutic, or radiation) is a DiaGnoSiS. Biologic behavior must be known prior to attempting definitive therapy of any tumor. the biologic behavior consists of the behavior that the tumor has locally. is it invasive or not? the second part of biologic behavior is the tendency of the tumor to spread, and if it does – to what site(s) does it spread? other key information includes grading, which can help to tell the rate of spread and if it might spread early vs late. Grading usually consists of the number of mitotic figures per 40 high power fields, not per single high power field. Great examples include a benign sebaceous adenoma – no spread and no local invasion. Epulides can be incredibly locally invasive, but do not metastasize. High-grade mast cell tumors are very locally invasive and likely to metasta- size. Each must be treated quite differently, and the role of surgery can be quite different. [...]