LO 5 Therapy of cancer using surgery

• One of many ways to treats cancer either curative or palliative

• Surgery is a theraphy to eliminate tumor, to handle the complication dan to reconstruc by way of surgical

Indication of surgery

• There are two, they are diagnostic and therapeutic;

• A.diagnostic– Biopsy ; to determine diagnosis of pathology.• To prepare the preparation for pathology examination,

we can use biopsy or operation speciment• There are a several kinds of biopsy, it’s insisi biopsy,

eksisi biopsy, puch biopsy, truncut biopsy etc.– Exploration surgery; to determaine clinic diagnosis

• B. therapeutic; to treat – Curative– Palliative

• Curative surgey– Broad excision or radical excision ; is to pick up the

tumor along with its local extension. The surgery not only involve the tumor but also the tissue around it. The broad of tissue involved depends on the progressive of the tumor

– En block excision ; it’s to do radical excision and also dissection of regional lymphe without cutting the channel between it.• Ex, commando operation ( combine mandibular and

neck dissection operation)– Lymphadenectomy ; means we eliminate the

lymph that has metastasis– Supra radical operation; it’s en block operation

along with a broad tissue and organ excision around the tumor

– Residif and metastasis excision• Pallative operation– Simple excision– De bulking operation ; partial excision to reduce

the mass of tumor, to support chemotheraphy and radiotheraphy.

– By pass operation, to recover the passage inside the lumen.it’s for inoperable cancer inside channel body that cause obstruction.

– Dearterialisation, to stop the blood flow to tumor by way of surgery

– Regional perfution, to make different sirculation for the part of body that has tumor. It’s used to give chemotheraphy which has high dose

– Infution intraarterial, give chemotheraphy by way of catheter trough artery that supply tumor

– Nerve manipulation, to handle the unbearable high intense of pain (intrachle pain) and medically can’t hande it.

Anamnesis• For determine clinic diagnostic, we must find about;• Tumor state

– Main complaint and other complaint along with it and also the onset

– riwayat penyakit– pengobatan yg telah diberikan– faktor risiko– lokasi topografi tumor dan metastasisnya– sifat tumor– operabilitas tumor– luas ekstensi

• komplikasi penyakit• penyakit sekunder