Surgery used to be the first modality in the treatment of cancer. It used to be thought that a radical surgery to remove all the cancer tissue and ALL the surrounding healthy tissue was the only way to cure and prevent a recurrence. This led to disfiguring and disabling surgery, e.g. the Halstead operation for Breast Cancer. Eventually, smaller surgical fields were found to be equally effective, specially when combined with other modalities of treatment. Now surgery is mainly used in combination with other treatments, and sometimes, is not the first modality. 

The role of surgery is

- to provide a diagnosis, with a biopsy of a newly discovered tumor

-to remove the cancer in a properly performed curative Cancer Operation. This should involve cleanly removing the  tumor, and a margin of healthy, cancer free tissue, with lymph nodes that drain the area. If this is not   feasible in the beginning, because of tumor size, or where it is located, pre-operative treatment with  chemotherapy and/ or radiation therapy is used  to shrink it. Then the surgery may be more successful in  its goal of a curative operation.

- to palliate symptoms. Even if the surgery is non-curative, it may be necessary to alleviate obstruction or  remove a bleeding site. 

Some of the procedures performed by Surgeons are being increasingly performed by an Interventional Radiologist, e.g,

      biopsies can be performed under CT scan visualization,

      feeding tubes and ports for accessing veins (Venous Access Device, or VAD), can be placed under              fluoroscopic guidance, and

      stents can be placed for obstructed bile ducts from the surface of the skin.