Surgical Oncology

Fred Hutch Surgeons are Leaders in the Field

Fred Hutch surgeons did the first robot-assisted hepatectomy (liver removal) and robot-assisted bile duct operations in the Pacific Northwest. Our surgeons were also the first in Washington state to do the Whipple procedure for pancreatic cancer using a robot-assisted device.

Knowing when to do an open or minimally invasive procedure is important, and this is part of the expertise offered by Fred Hutch surgeons. Our surgeons are among the country’s leading experts in minimally invasive surgery for common cancers, like colon cancer, as well as rare cancers, like intradural spinal cord tumors.

Our surgeons are also experts in open surgical techniques, and many of them specialize in specific cancer operations as well.

At Fred Hutchinson Cancer Center, patients receive surgical oncology care from leading doctors who specialize in surgeries to remove tumors and cancerous tissue.

Our surgeons are nationally and internationally recognized. These doctors not only treat cancer in Fred Hutch patients, they are leaders who are helping to advance cancer care for all.

Your Fred Hutch surgical oncologist knows the most advanced surgical options for treating your disease and will design a personalized treatment plan to fit your needs.

Fred Hutch, in partnership with UW Medicine, is home to one of the most comprehensive and technologically advanced robot-assisted surgery programs in the Puget Sound region. UW Medicine brought robot-assisted surgery to the area, and it is the leading regional center where surgeons come to train and learn from our doctors.

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About Surgical Oncology

Surgical oncology is an area of medicine that focuses on diagnosing and treating cancer using surgery. It can help diagnose cancer and find out how advanced a cancer is (the stage). Surgery can also be used to treat cancer by removing diseased tissue as well as any lymph nodes that may be nearby. Lymph nodes are parts of the immune system that work like filters, and cancer can spread to them.

Sometimes, surgery can be used to prevent cancer — for example, when a doctor removes polyps (growths) from the colon that could become cancerous. Doctors use surgery to restore the form or function of body tissues and parts that were affected by cancer treatment, too.

In addition, surgery can help relieve symptoms associated with cancer and give patients a better quality of life, such as a procedure to help reduce pain. This is called palliative surgery.

Surgery is often used along with other types of cancer treatments, such as chemotherapy, hormone therapy, immunotherapy and radiation treatments.

Learn About Surgical Techniques

Types of Surgery

We offer the full range of surgeries available to treat cancer. These surgeries are done at UW Medical Center – Montlake or Seattle Children’s, using leading-edge techniques and state-of-the-art equipment. Below are descriptions of the most common types of surgery that our surgeons do.

Preventive Surgery

Preventive surgery (also called prophylactic surgery) is used to stop cancer from developing. For example, doctors can remove precancerous polyps during a screening colonoscopy, which can help prevent colorectal cancer.

Another example of preventive surgery is colon removal (prophylactic colectomy) for familial adenomatous polyposis (FAP). FAP is an inherited condition where hundreds or thousands of colon polyps form over time. These polyps will become cancerous if they are not treated.

People with inherited mutations in the BRCA1 or BRCA2 gene (changes in their DNA that run in their family) may decide to have preventive surgery to reduce their risk of developing cancer. One procedure is a double mastectomy (removal of both breasts) and ovary and fallopian-tube removal (salpingo-oophorectomy).

Diagnostic Surgery

biopsy, where a small area of tissue is removed. Another type is called excisional biopsy, when an entire mass is removed.

Incisional and excisional biopsies can be done using minimally invasive surgical techniques or during traditional open surgery. Doctors can also take biopsies during endoscopic procedures or by using a needle to take cells for testing.

Staging Surgery

Staging surgery is used to confirm how much cancer is in the body and where it is, including if the cancer has spread and how far.

Often, staging is done during a surgery to remove a tumor. Other times, a surgeon will do a staging surgery on its own, so they can look inside the body and take samples of tissue for testing before another surgery or treatment begins. For example, if a patient has pancreatic cancer, the surgeon may use laparoscopic staging surgery to look at the tumor, find out its stage and see if a separate surgery is needed to remove it. If possible, the surgeon will remove the tumor. But if the tumor is too widespread to be removed, the surgeon will only take a biopsy (tissue sample).

Treatment of Curative Surgery

More than half of people with cancer have surgery as treatment to remove their cancer. In some cases, it is the only treatment that is needed. However, some cancers, like those that affect the blood or lymph, cannot be treated with surgery because the cancer is widespread in the body.

There are many surgical techniques that can be used as treatment or to help cure cancer. Some patients have a surgical procedure that helps deliver another type of treatment. For example, most patients who have chemotherapy need a central venous access device (port and catheter). A small surgical procedure is used to put this device in their body, and when treatment is over, another minor procedure is used to remove it.

Another example is a surgical technique called an intraperitoneal catheter, which is used to deliver chemotherapy directly into the abdominal cavity of a person with ovarian or uterine cancer. It is placed in the patient’s body during a surgery to remove the cancer.

CRS-HIPEC

Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) surgery is for people who have a type of cancer that has spread to the abdominal lining (peritoneal carcinomatosis). The cancer may have started in the appendix, stomach, colon, rectum, ovaries or fallopian tubes.

There are two stages to this surgery:

Surgically remove all the cancer that can be seen.
Put liquid chemotherapy medicines into the abdomen to destroy any cancer cells that may be left.

CRS-HIPEC is also used for mesothelioma of the abdomen and some rare sarcomas that can spread to the abdominal lining (peritoneum).

Learn more about CRS-HIPEC

Reconstructive Surgery

Reconstructive surgery recreates and restores parts of the body that have been affected by cancer or cancer treatment. One common procedure is breast reconstruction for patients who have had a lumpectomy or mastectomy. Other common procedures are facial reconstruction for people who have had surgery for head or neck cancer.

Sometimes, a person with sarcoma may have reconstructive surgery to put in a metallic implant. Other patients might have a bone transplant after having cancerous bone removed, which is also a type of reconstructive surgery. If a patient has cancer in the pelvic cavity and one or more of their organs need to be removed (like the rectum, bladder or vagina), a plastic surgeon may do surgery to reconstruct the area.

Another type of reconstructive surgery is called microvascular surgery. This is when a surgeon uses a microscope to see and sew together tiny blood vessels.

Learn more about Reconstructive Surgery

Palliative Surgery

Even if surgery cannot cure a cancer, it can sometimes still be helpful for treating the effects of cancer. This is called palliative surgery. Palliative surgery can help improve a patient’s quality of life by helping to reduce their pain and improve other issues caused by advanced cancer. For example, if a tumor is pressing on nerves and causing pain, and other treatments are not available, palliative surgery might be an option.

Supportive Care Services

Along with treating your cancer, Fred Hutch provides a range of services to support you and your caregiver. This is part of how we take care of you — not just your disease.

Along with your radiation oncologist, radiation therapist, and radiation oncology nurse, you’ll have many others to provide support. From registered dietitians to chaplains to social workers, our experts specialize in caring for people with cancer. We understand this may be one of the most intense and challenging experiences you and your family ever go through. We are here to provide the care you need.

Learn about Supportive Care Services