Types of cancer surgery

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Different types of surgery are used to help diagnose and treat cancer.

The type of surgery and the way it is done will depend on:

  • the part of the body that needs surgery
  • the type of cancer
  • the size and location of the tumour
  • the stage of cancer
  • the goals of surgery
  • your general health and preferences
  • the facilities and experts available

Approaches to surgery

Surgeons choose a specific type of surgery to treat a cancer. Then they decide on the best approach to take. The approach describes the way the surgeon reaches the surgical area (site) or organ.

There are 2 main approaches to surgery.

Open surgery uses a large cut (wide incision) to reach and examine, remove or repair tissue. It is often called conventional surgery or traditional surgery because it is a well known way to do surgery.

Minimally invasive surgery causes less injury to the body because the surgeon makes a few small cuts instead of one large cut. The surgeon inserts an endoscope through the cuts to look at an area inside the body. Special tools are also used to remove or treat tissue. For example, laparoscopic surgery is a minimally invasive surgery done on the abdomen or pelvis. Minimally invasive surgery tends to have a shorter hospital stay, faster recovery time and fewer problems (complications). But this approach to surgery cannot be used for everyone or every type of cancer because of the location or stage of the cancer or other factors.

Sometimes minimally invasive surgery can be done through an opening or cavity in the body instead of through small cuts. For example, sometimes bladder and prostate cancers can be treated with a transurethral resection. This means that the cancer or abnormal tissue is removed through the urethra.

Procedures that use surgery

Medical procedures may use very minor surgery or non-invasive tools. Some of these procedures are different than what we commonly think of as surgery because surgical cuts may not happen. Many newer procedures use different types of surgical tools and radiology to remove or destroy tissue.

Cryosurgery uses extreme cold from liquid nitrogen or liquid carbon dioxide to freeze and destroy abnormal cells or tissue. Find out more about cryosurgery.

Electrosurgery uses heat from electricity to destroy abnormal cells or tissue. It can be done by different methods. There are different types of electrosurgery.

High-intensity focused ultrasound (HIFU) uses ultrasound waves to create intense heat, which destroys tissue.

Endoscopic surgery uses an endoscope that the surgeon places in the body through small cuts or a natural opening. The surgeon uses the endoscope to look at structures or organs or remove tissue. Different types of endoscopes are used to examine and treat different parts of the body. For example, a laparoscope is used to examine the abdomen or pelvis. Find out more about endoscopy.

Laser surgery uses a laser beam to destroy abnormal cells. Find out more about laser surgery.

Mohs surgery removes cancer of the skin in layers, little by little, until no cancer remains. After each layer is removed, the doctor examines it under a microscope to look for cancer cells. Mohs surgery is done when doctors want to save as much normal tissue as possible (called tissue sparing) to make sure the skin looks good and to keep the area functioning normally. Find out more about Mohs surgery.

Radiosurgery delivers precisely targeted high doses of radiation (high-energy rays or particles) to destroy cancerous tissue without using a surgical cut or opening. Even though surgery is in the name, it is actually a type of external radiation therapy. It is also called stereotactic radiosurgery.

Radiofrequency ablation (RFA) uses heat from high-frequency electrical currents made by radio waves to kill cancer cells. The electrical currents are passed through a special needle or probe to heat and destroy abnormal cells or tissue. Find out more about radiofrequency ablation.

Robotic surgery is also called robot-assisted laparoscopic surgery or computer-assisted surgery. During robotic surgery, the surgeon sits at a station a short distance away from the person on the operating table. The surgeon uses a computer to move robotic arms that are connected to surgical tools inside the person's body.

Stereotactic surgery uses a CT scan or an MRI to locate a tumour in 3D space. It is used for accurate biopsies, to remove tumours or to precisely deliver radiation.

Percutaneous ethanol injection (PEI) uses a needle to inject concentrated alcohol (ethanol) directly into a tumour. The doctor uses an ultrasound or a CT scan to guide the needle through the skin and into the tumour. Alcohol works by drawing water out of (dehydrating) the cancer cells, which causes them to die.

Questions to ask about surgery

To make the decisions that are right for you, ask your healthcare team questions about surgery.

Expert review and references

  • Gary Groot, MD, PhD, FRCSC
  • American Cancer Society. Less Invasive Cancer Surgery Techniques. 2019: https://www.cancer.org/.
  • American Society of Clinical Oncology (ASCO). What is Cancer Surgery?. 2021: https://www.cancer.net/.
  • Vasudevan SA, Whitlock RS, Weldon CB, Nuchtern JG. General principles of surgery. Blaney SM, Adamson PC, Helman LJ (eds.) . Pizzo and Pollack's Pediatric Oncology. 8th ed. Wolters Kluwer ; 2021 : Kindle version, chapter 15. https://read.amazon.ca/?asin=B08DVWZNVP&language=en-CA .
  • Cancer Care Ontario. Cancer Treatments: Surgery. https://www.cancercareontario.ca/en. Monday, November 14, 2022.
  • National Cancer Institute. Surgery to Treat Cancer. National Institutes of Health; 2015: https://www.cancer.gov/.

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