Oncologic Surgery

Oncologic surgery is a group of surgical procedures used to treat a variety of cancers.

Most solid cancers or tumors need to be removed to improve a child’s health and ease symptoms such as fever and pain.

Oncologic surgery is commonly used to treat cancers such as:

Neuroblastomas. These tumors are the most common type of solid tumor in children. These neuroendocrine tumors develop from the sympathetic nervous system.
Wilms tumors. Wilms tumor is a cancer of the kidneys in children.
Germ cell tumors. These cancers originate in the cells that form the ovaries and testicles but can appear anywhere in the body.

Pediatric surgeons at Riley at IU Health consult with a multidisciplinary team of specialists including oncologists, gastroenterologists, nephrologists, pulmonologists, endocrinologists, neonatologists and others to determine the right time for surgery. Depending on the specific type of cancer, surgery may be the first step in a treatment plan, or it may come after other treatments, such as chemotherapy, which is used to shrink the tumor.

Doctors use different tests to obtain as much information as they can about the tumor and to determine how surgery will impact other organs near the tumor. These tests include:

Blood tests. A sample of blood is studied to figure out what kinds of cells and antibodies are growing in a tumor.
Biopsy. A biopsy lets doctors study tumor cells under a microscope.
Computed tomography (CT). CT scans use X-rays to make a cross sectional image of tumors.
Magnetic resonance imaging (MRI). MRI makes a picture of the tumor and nearby organs and tissues using a magnetic field and radio waves.
Ultrasound. This imaging test creates images of the tumor and surrounding blood vessels and tissues using sound waves.

Pediatric surgeons at Riley at IU Health are active in the Children’s Oncology Group. This means children receive access to the most advanced cancer treatment protocols.

When children have cancerous tumors, each case is presented before a tumor board of pediatric specialists, including surgeons, oncologists, radiation oncologists and pathologists. This group discusses each case and determines the best course of action for each child. Doctors talk with family members about the procedure and show them pictures of the tumor so they understand what is involved in the surgery.

What to Expect

Your child should not eat or drink anything after midnight on the day before the oncologic surgery procedure.

On the day of the oncologic surgery:

Your child should not eat anything the morning of the surgery.
When you arrive at the hospital, a nurse will meet you and your child.
Your child will change into a hospital gown.
An anesthesiologist will meet with you to discuss the use of general anesthesia, which will keep your child asleep during the surgery.
The pediatric surgeon will meet with you to discuss the surgery and answer any questions.
A Child Life specialist will be with you and your child to help keep him or her calm by playing games on an iPad, showing a favorite movie or playing music.
If your child is very nervous, a sedative can be given to help him or her calm down.
Your child will be taken to the operating room.
The anesthesiologist will begin to administer general anesthesia.
Once your child is asleep, the pediatric surgeon will begin the surgery.
The time it takes to perform oncologic surgery varies based on each specific case.
Your child’s heart rate, blood pressure, respiratory rate and oxygen level will be monitored during the procedure.

Immediately after oncologic surgery:

Your child will be moved to a recovery room to wake up. You can be with your child as soon as he or she awakes.
A nurse will monitor your child’s vital signs.
When your child wakes up, nurses will continue to check blood pressure, pulse and breathing rates until they return to normal.
The pediatric surgeon will meet with you to discuss the surgery’s outcomes.
The surgeon will discuss any instructions you need to follow for the next few days as your child recovers.

Key Points to Remember

Oncologic surgery is a group of surgical procedures used to treat a variety of cancers.
Oncologic surgery is commonly used to treat germ cell tumors, neuroblastoma and Wilms tumor.
The time it takes to perform oncologic surgery varies based on each specific case.
Oncologic surgery may be the first step in cancer treatment or a later step (after chemotherapy).
Pediatric surgeons work with pediatric oncologists to plan the most effective oncologic surgery.