Cancer Surgery: Part of a Plan

What should you consider when you're deciding where to be treated for cancer?

Surgery has been a mainstay of cancer treatment for millennia—in fact, the use of surgery to treat cancer appears in Egyptian papyri dating back as far as 2500 BC. Today, medical breakthroughs have opened exciting new possibilities for the successful surgical treatment of cancer.

As critical as surgical advances are, however, they’re most effective when they’re part of a continuum of cancer care, says H. Richard Alexander Jr., MD, FACS, Chief Surgical Officer and Chief, Surgical Oncology at Rutgers Cancer Institute of New Jersey, the state’s only National Cancer Institute-Designated Comprehensive Cancer Center.

H. Richard Alexander Jr., MD
H. Richard Alexander Jr., MD

“The best outcome for surgery doesn’t just depend on what happens in the operating room,” says Dr. Alexander. “The best outcome happens when surgery is integrated into a comprehensive, individualized plan of care for a patient who has a new diagnosis of cancer.”

Complementary Treatments

As part of the robust partnership between RWJBarnabas Health (RWJBH) and Rutgers Cancer Institute, experts from a wide range of specialties—surgical oncology, radiation oncology, medical oncology, gastroenterology, genetics counseling, and more—have weekly conferences to assess individual patient cases and make recommendations.

“These discussions aren’t about deciding whether to do surgery versus some other treatment,” explains Dr. Alexander. “Instead, because we understand cancer so much better now, these discussions are about finding the best ways to use surgery to complement the latest chemotherapy, immunotherapy, or biologic treatments.”

All treatments offered by Rutgers Cancer Institute and RWJBH are available to any patients being treated within the system, regardless of the facility at which the patient’s treatment originated. Among those treatments are advanced and complex surgeries, some of which are only available at Rutgers Cancer Institute or RWJBH facilities, including:

  • Robotic surgery and laparoscopic surgery. These are minimally invasive and very precise and are performed with the most up-to-date technology on the market.
  • HIPEC (hyperthermic intraperitoneal chemotherapy) surgery, used for cancers that have spread to the abdominal cavity. This treatment strategy involves the surgical removal of metastatic cancer, followed by heated chemotherapy given within the abdominal cavity, which is designed to obliterate the remaining invisible cancer cells that may be present in the tissues.
  • Preventive, or prophylactic, surgery, in which sophisticated testing and analysis is used to identify high-risk patients and remove an organ or gland before cancer can develop. This may be recommended for people at risk of developing breast, colon, endometrial, gastric, ovarian, thyroid, and many other types of cancer.

Experience counts when it comes to cancer surgery. “There’s a large body of literature showing a relationship between the volume of operative procedures done and how successful the outcomes are,” says Dr. Alexander. “The more experienced surgeons and hospitals have, the better patients do in terms of a shorter length of stay, fewer complications, and the return to normal life more quickly.

“That’s something we do especially well at Rutgers Cancer Institute and RWJBarnabas Health,” he says. “We have the experience and technology to recognize potential complications early on and intervene as necessary.”

Next Steps

When a patient is told that cancer surgery is needed, how should he or she decide what to do next?

The first step, says Dr. Alexander, is to do research. “Every doctor wants the best outcome for their patients, and no doctor should object to a patient asking for a referral for another opinion,” he says.

Patients also have the option of calling the RWJBH Oncology Access Center at 844.CANCERNJ (844-226-2376). “The call will be taken by a specialist who is trained to gather information about the patient and identify the appropriate experts to evaluate and potentially provide treatment for them,” explains Dr. Alexander.

Be sure to consider the continuum of care in the place where you will receive treatment.

“Treatment that is fragmented, or administered in different locations without proper coordination, becomes more challenging,” he says. “To me, it’s always best for a patient to get cancer treatment from a multidisciplinary team of specialists who have good communication and coordination, from diagnosis through treatment, discharge, and survivorship.”

To help keep communication flowing smoothly among all experts treating a cancer patient at RWJBH facilities and Rutgers Cancer Institute, an oncology nurse navigator assists each patient throughout the cancer journey.

“When it comes to cancer treatment, patients shouldn’t move forward until they’re absolutely certain the best care plan has been presented to them,” says Dr. Alexander. “We’re uniquely positioned to provide that plan through the partnership between Rutgers Cancer Institute and RWJBarnabas Health.”

Cancer Can’t Wait

Because of the pandemic, cancer patients may have concerns about scheduling surgery. However, cancer care shouldn’t be delayed.

Rutgers Cancer Institute of New Jersey and RWJBarnabas Health facilities have taken every precaution to keep patients, visitors, and care-team members safe, including:

  • COVID-19 screening and testing of all patients and staff prior to working in an operating room or being involved in a surgical procedure
  • Rigorous cleaning and disinfecting practices in recovery room spaces, frequently touched surfaces, exam rooms, and terminals.

RWJBarnabas Health, together with Rutgers Cancer Institute—the state’s only NCI-Designated Comprehensive Cancer Center—provides close-to-home access to the latest treatment options. For more information, visit our Cancer page or call 844.CANCERNJ.