The treatment for cancer typically includes chemotherapy, radiation therapy, and/or surgery. Surgical management of cancer may be essential to prevent metastasis.

Dr. R. Padmakumar performs different cancer surgeries:

1. Thyroid Cancer, Papillary Thyroid Carcinoma – Thyroidectomy for Thyroid cancer
2. Stomach Cancer Surgery
3. Colorectal Cancer Surgery
4. Colon Cancer / Intestinal Cancer – Colectomy, Laparoscopic Abdominoperineal resection (APR), Anterior Resection without colostomy
5. Breast Cancer – Mastectomy, Lumpectomy, Axillary Dissection, Breast Reconstruction Surgery
6. Chest Cancer – Thoracoscopy
7. Soft Tissue Sarcomas
8. Cervical Cancer Surgery – Radical hysterectomy
9. Ovarian cancer – Hysterectomy, Bilateral salpingo-oophorectomy, omentectomy, Lymph node clearance.
10. Esophageal Cancer Surgery
11. Uterine Cancer – Radical Hysterectomy
12. Anal Cancer
13. Endometrial Cancer – Radical Hysterectomy
14. Gallbladder Cancer

Endoscopies performed to detect Cancer

Thyroidectomy for Thyroid Cancer

Thyroid cancer can be of different types:  Medullary thyroid cancer, anaplastic thyroid cancer, papillary thyroid cancer, follicular thyroid cancer, Hurthle cell cancer.  Surgery to remove the thyroid is the most common treatment for thyroid cancers.  It is also termed thyroidectomy.  Depending on the type and stage of the thyroid cancer, it may be necessary to remove the entire thyroid gland (total thyroidectomy) or part of it (hemithyroidectomy). 

Thyroidectomy can be performed as Open, Endoscopic, or Robotic.  In Endoscopic Thyroidectomy, small incisions are made at the axilla, and the thyroid is removed through these small incisions.  Parathyroid tumors can also be removed by endoscopic method.  Robotic Thyroidectomy involves the aid of robots in carrying out the procedure.  In Open Thyroidectomy, the thyroid is removed by making a large incision at the neck. 

Radical neck dissection is performed for surgical control of metastatic neck disease.  This can also be performed endoscopically. In case of lymph node metastasis from thyroid cancer, cervical lymphadenectomy is the treatment choice.  Endoscopic Cervical lymphadenectomy can be performed without neck cut or neck scar.

Stomach Cancer Surgery

Laparoscopic Gastrectomy is performed to remove part of stomach affected with cancer. Laparoscopic Gastrojejunostomy is performed for stomach cancer if the tumor in the stomach obstructs food from leaving the stomach. This allows the food to leave the stomach through new bypass route.

• Keyhole cancer surgery for cancer stomach
• Stapler anastomosis to promote perfect healing
• Early resumption of activities without prolonged rest

Colon Cancer Surgery

• Colectomy
• Laparoscopic Abdominoperineal resection (APR)
• Anterior Resection without colostomy

– Avoids major trouble for patient for taking care of stoma

– Avoids Ressurgery

Advantages of Laparoscopic Surgery

• Avoids abstinence from work
• Helping early initiation of adjuvent therapy (chemotherapy, radiotherapy)
• Avoids wound related problems like pain, infection and hernia
• Better cancer clearance
• Better lymph node clearance
• Reduced recurrence.
• Significantly improve quality of life

Mastectomy (Breast Cancer Surgery)

Mastectomy is performed to remove the cancer-affected breast. Depending on the size and severity of the Breast Cancer, the surgeon may decide to proceed with any of the following surgical treatment:

• Mastectomy: Surgery to remove the complete breast
• Lumpectomy : Wide excision or removal of breast lump along with surrounding normal tissue.
• Axillary Dissection: Surgery to remove associated lymph nodes
• Reconstruction Surgery: To renovate lost breast with breast implants

There are different types of mastectomy which is performed depending on the severity of the cancer. These include:

• Total Mastectomy / Simple Mastectomy
• Double Mastectomy / Bilasteral Mastectomy
• Skin-Sparing Mastectomy /
• Nipple-Sparing Mastectomy
• Mastectomy with Breast Reconstruction
• Modified Radical mastectomy
• Radical Mastectomy
• Breast Conservation Surgery (BCS)

Thoracoscopy for Chest Cancer

• Significantly reduced pain
• Avoids major thoracotomy
• Maximum preservation of lung tissue.

Hysterectomy and Bilateral Salpingo-oophorectomy for cancers related to uterus and cervix

Radical hysterectomy, Bilateral salpingo-oophorectomy, omentectomy, Lymph node clearance are some of the surgeries performed for Cervical Cancer / Ovarian Cancer / Endometrial Cancer / Uterine Cancer.

Soft Tissue Sarcoma

Soft tissue sarcomas start in body’s soft tissues like fat, muscle, nerves, lymph, fibrous tissues, blood vessels, or deep skin tissues.  There are different types of soft tissue sarcomas like liposarcoma, angiosarcoma, etc.  Surgery is the usual treatment for soft tissue sarcomas and might include radiation therapy and chemotherapy.

Image shows Liposarcoma mass weighing 4.2 kg and 1.2 kg removed from the abdomen. Liposarcoma is a rare type of cancer and starts in the fat cells.  Liposarcoma can affect the fat cells in any body part, but mostly occurs in the limb muscles or in the abdomen. Cancer Surgery may be essential to remove these masses. There are four types of liposarcoma: Well-differentiated liposarcoma, Myxoid liposarcoma, Pleomorphic liposarcoma, Dedifferentiated liposarcoma

Department of Minimally Invasive Surgery, VPS Lakeshore Hospital, headed by Dr. R. Padmakumar, offers Cancer Surgery and comprehensive surgical care of a variety of cancers including, stomach cancer, colon cancer, breast cancer, chest cancer, soft tissue tumors etc.

The Department of Minimally Invasive Surgery (MIS) has an efficient team with vast experience in laparoscopic surgeries. Dr. R. Padmakumar is one of the few surgeons in the world performing keyhole surgery for Thyroid Cancer.

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• Mastectomy: Surgery to remove the complete breast
• Lumpectomy : Wide excision or removal of breast lump along with surrounding normal tissue.
• Axillary Dissection: Surgery to remove associated lymph nodes
• Reconstruction Surgery: To renovate lost breast with breast implants

Breast cancer surgery is recommended to treat various stages of breast cancer and includes:

• Women with High Risk of Breast Cancer: Women with a strong family history of the disease condition are recommended to perform certain tests to understand the chances for the condition and perform mastectomy as an option to prevent breast cancer. They can choose for breast reconstruction surgery to replace the entire breast.
• Noninvasive Breast Cancer: Women diagnosed with non invasive breast cancer can undergo lumpectomy.
• Early-stage Breast Cancer: Breast cancer at early stages can be treated with lumpectomy or mastectomy with or without breast reconstruction.
• Larger Breast Cancers and Locally Advanced Breast Cancers: Advanced stages of breast cancer are treated with mastectomy.
• Recurrent Breast Cancer: Breast cancers that reoccur after preliminary treatments are removed with mastectomy.

Based on the stage of the condition, these procedures can be followed by Chemotherapy, Hormonal therapy, or Radiation to prevent local or distant tumor reoccurrence.

Breast Cancer Screening

Breast cancer is one of the leading causes of cancer deaths in women. The purpose of screening is to look for the presence of cancer before there are any symptoms or signs of the disease. Cancer is most curable at an early stage, and the goal of screening is to detect the presence of cancer at a very early stage itself. Screening helps in lowering the chances of death or eliminating deaths from cancer altogether.

There are different ways of screening for breast cancer:

• Self Breast Examination
• Clinical Breast Examination
• Mammogram
• Sonomammography
• Thermal Scan of Breast

Types of Mastectomy

Total Mastectomy  / Simple Mastectomy

Removes all breast tissue but leaves the pectoral muscles beneath.  Total mastectomy can be performed on one breast (unilateral) or both breasts (bilateral).

Double Mastectomy (Bilateral Mastectomy)

Total mastectomy of both breasts.  Bilateral mastectomy is performed if there is cancer in both breasts.

Skin-Sparing Mastectomy or Nipple-Sparing Mastectomy

Removes the breast tissue but spares the skin or nipple.

Mastectomy with Breast Reconstruction

Depending on the condition of the patient and based on the treatment plan, breast reconstruction surgery can be performed at the same time after mastectomy or later in a separate surgery.

Modified Radical Mastectomy

Removes all the breast tissue and the underarm lymph nodes on the same side.

Radical mastectomy

Removes all the breast tissue, the pectoral muscles underneath, and underarm lymph nodes.  This may become necessary if the cancer has spread to your muscles.

Breast Conservation Surgery (BCS)

• Removes Tumor and surrounding margin.
• Possible when tumor is not very large
• Only single focus of tumor
• Breast shape reasonably —- axillary clearance
• Removal of Lymph nodes from axilla
• Good for tumor clearance

Mastectomy for Gynecomastia

Gynecomastia is the term for enlarged breast tissue in males. For Gynecomastia subcutaneous mastectomy or circumareolar mastectomy is performed. Liposuction is also performed for gynecomastia.

Procedure

The Breast cancer surgery is initiated by the surgeon by administering a dose of anesthesia to relax the patient and to be in a sleep-like state. The surgeon makes an incision in the breast and removes the cancerous tissues and surrounding tissues from the area. The length and location of the incision depends on the site of the cancer within the breast. The lymph nodes in the armpit are also examined. A few lymph nodes in which the tumor has reached are also removed. After removing the entire or part of the cancer affected breast the surgeon closes the incision using dissolvable stitches to reduce scarring.

Reconstruction surgery can be performed immediately or later, after the breast cancer surgery. During a breast reconstruction surgery, the breast can be reconstructed in two methods: using an implant or by tissues obtained from other parts of the body. Breast implants are used for immediate reconstruction of the breast and the implants are filled with silicone gel or saline solution.  Breast reconstruction using body tissue involves relocation or body tissues using a pedicle flap or free flap surgery.

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