Oncology Surgery
Cancer Surgery Bahamas is a surgical oncology practice but also provides advance laparoscopic surgery services and General Surgery. We provide careful and empathetic approach to care with a focus on quality.
Good patient outcomes is what drives our practice as we strive for excellence to offer value to our patients.
Surgical oncologists are general surgeons who have completed an additional two to three years of fellowship training ata Cancer Center in order to diagnose, biopsy and surgically treat cancers. Improved surgical outcomes and increased survival has been shown in patients who choose their care by a Surgical Oncologist. (see abstract of article from the US Department of Health and Human Services – National Institutes of Health website Mechanisms of Improved Outcomes for Breast Cancer between Surgical Oncologists and General Surgeons)
DURING IDENTIFICATION AND DIAGNOSES the Surgical Oncologist’s familiarity with cancers and their progressions allows them to better recognize malignancies and manage care for their patients.
DURING SURGERY the Surgical Oncologist has extensive experience with cancer procedures because it is their career focus. The Surgical Oncologist statistically has a lower rate of positive margins (cancerous cells in the edge of the tissue removed), less need for second operations, and a higher long term survival rate in cancer surgeries than those same surgeries performed by a general surgeon.
AFTER SURGERY the Surgical Oncologist uses specialized training & expertise to better manage & coordinate cancer care for their patients to minimize recurrences and improve the overall outcome for their patients. Using a Surgical Oncology Cancer Specialists will improve your outcome and chances of survival. Some cancer surgeries are more technically challenging operations than others. Examples of these procedures include colon resections, liver resections and removal of the pancreas. It has been repeatedly demonstrated that there is an improved outcome for patients who receive care for their malignancies by a Surgical Oncologist rather than a general surgeon. Hospital stay and complications, as well as risk of recurrence and survival, are well documented to be improved when surgery and care is delivered by someone whose entire practice and career focus is the care of people with cancer. Frequently, patients with “common variety” cancers are cared for by general surgeons in most communities because it’s simple, routine, and just needs to be “cut out”. Right? Wrong! What difference does it make? An enormous difference! These cancers are often felt to be “common variety” or “routine” by everyone but the patient and Surgical Oncologists. Consider a study reported in the Annals of Surgical Oncology in 2005 examining the outcome of 29,666 women with breast cancer cared for in Los Angeles County (Annals of Surgical Oncology 10:606-615). This study examined the difference in long term outcome depending only on whether a patient was cared for by a general surgeon or had their entire cancer care coordinated by a Surgical Oncologist.
Treatment by a Surgical Oncologist resulted in an astounding 33% reduction in the risk of death at five years compared to when care was delivered by a general surgeon. In another study at the University of Massachusetts (Annals of Surgical Oncology 5:28-32) the impact of Surgical Oncology was examined by determining the quality of breast cancer surgery at the university in women with cancers that could not be detected by physical exam. Surgical Oncologists achieved a much lower rate of positive margins (cancer cells extending to the edge of the tissue removed) at the time of cancer removal (25% vs.41%), required fewer second operations (18% vs. 48%), and achieved a higher rate of breast conservation (88% vs. 70%) than did general surgeons. Adequate surgical management of breast cancer as well as all other cancers is fundamental to improving outcome. Knowing what to do, when to do it, how to do it, and how what is done impacts subsequent care and outcome is the key. Coordination of care and surgery by a specialist who devotes his career and all his attention to comprehensive cancer care leads to fewer recurrences, a better chance of survival, and less stress on our patients. We want all patients to have the best outcome possible.
Selecting a Surgical Oncologist for your surgery and cancer makes a difference!
The Surgical Oncologist
The surgical oncologist is most often the first specialist to see a patient before other oncologic specialists. The primary physician most commonly pursues a diagnosis, and in circumstances where this requires biopsy, the surgeon is called. For decades, any surgeon was considered competent to exercise all surgical skills, including cancer surgery. Indeed, while most surgeons may be acceptably competent, the specialty of surgical oncology is increasingly becoming recognized.
Surgical oncologists are clinical scientists with knowledge of and experience in cancer surgery that come from additional training, limitation of the scope of general surgical practice, familiarity with the biology and natural history of cancers, and the role of the other oncologic specialties in their diagnosis and management. Membership in the Society of Surgical Oncology, postgraduate training in a cancer institute or university program under a mentor known for cancer surgical expertise, concentration of surgical practice on cancer and related diseases, and publications are some of the appropriate criteria.
Because the implications for a proven neoplasm, potentially resectable, entail many other considerations to optimize curability, the prudent surgical oncologist surveys the potential contributions of medical oncology, radiation oncology, and other specialties before proceeding with the operation. Joint assessment is appropriate to determine whether chemotherapy or radiotherapy prior to surgery may improve outcome. Most often, this entails direct consultation with the medical and/or radiation oncologist. An opportunity for the three specialties to see the patient in the native unaltered state is of great value for subsequent planning.
Confidence building makes for easy consultation over the years with colleagues who share mutual trust. The treatment of breast cancer, rectal cancer and soft tissue sarcoma, for example, are most often best approached by multi-disciplinary components from all three specialties. Whereas specific diseases may be treated well by single-modality approaches, bi-disciplinary or tri-disciplinary opinion is usually advantageous.
Surgical oncologists must also be available for surgical aspects of management later in the course of disease. Venous access devices may be required, depending on the drugs to be used and the status of peripheral veins. Intestinal obstruction in the course of cancer may require operative surgical management. A medical or radiation oncologist may discover a suspicious mass or infiltration that needs biopsy and pathologic assessment. Palliative surgery is an area where medical and radiation oncologists often present problems to the surgeon in hopes of potential operative remedy. Debulking, diverting, and pain-relieving operations are all appropriate procedures in the proper circumstance.
Breast Cancer
Breast and ovary (BRCA I & II), Colon ( APC, MSH, MLH) Multiple Endocrine Neoplasia.Evaluation and management of abnormal mammograms and suspicious masses, breast conservation therapy, skin sparing mastectomy, sentinel lymph node mapping, axillary lymph node dissection, oncoplastic breast surgery.
Colon Cancer
Open and laparosopic resections, Sphincter sparing rectal surgery, Total mesorectal excision
Hepatobiliary (Liver and Pancreas)
Resection of thyroid, parathyroid, adrenal and pancreatic masses, Resection of tumors of the liver, bile ducts and pancreas. Resection of primary liver tumors as well as metastatic disease to the liver, and radiofrequency ablation.
Endocrine
Resection of tumors of the liver, bile ducts and pancreas. Resection of primary liver tumors as well as metastatic disease to the liver, and radiofrequency ablation
Genetic Testing
Breast and ovary (BRCA I & II), Colon ( APC, MSH, MLH) Multiple Endocrine Neoplasia.
Gastrointestinal Cancer
Resection of tumors of the stomach and small bowel
Venous access
Port-a-cath insertions for chemotherapy
Melanoma (Skin Cancer)
Primary excision and sentinel node mapping, lymph node dissection
Hyperthermic Intraperitoneal Chemotherapy (HIPEC)
Anorectal Disease
Appendicitis
Colon Disease – Ulcerative Colitis
Diverticular Disease
Gallbladder Disease
Pancreatitis
Misc Masses, Lipomas