What is cytoreduction?

Cytoreduction, also known as tumor debulking or cytoreductive surgery, is the surgery used by a specialized surgeon to remove as much of the tumor as possible to increase the chances of success in radiotherapy and chemotherapy treatments. This removal also makes it possible to eliminate surrounding tissue that may contain cancerous cells.

Why is it performed?

Cytoreduction is performed with the intention of alleviating the patient’s symptoms or to prolong the patient’s life.

What does it consist of?

Surgical cytoreduction allows patients who only have a mild response to conventional chemotherapy to have more active carcinoma removed. In addition, it allows faster detection of patients who require rescue therapy, i.e. those who do not respond well to treatment and need other treatments.

During the operation anesthesia is used so that the patient loses sensitivity or is not conscious during the operation. Anesthesia can be of different types:

  • Local: numbness of a small part of the body.
  • Regional: numbness of a part of the body (a leg or an arm).
  • General: total numbness and loss of consciousness.

Additionally, nowadays, it is possible to remove residual teratoma refractory to chemotherapy, which can cause mortality and morbidity, due to local growth.

Preparation for cytoreduction

Before undergoing cytoreductive surgery, several tests will be performed so that the physician can assess the patient’s surgical needs. The usual tests include:

  • Blood test
  • Electrocardiogram (ECG)
  • Chest x-ray
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It is often required not to drink or eat before surgery for a period of time determined by the surgeon.

Aftercare after surgery

Postoperative care will vary depending on the type of tumor to be removed and the surgery used. You will probably need to stay in the hospital for some time after the operation. You will also need to see a specialist periodically to assess progress or remove stitches. After the surgery, the doctor may give a series of indications to follow, which may include guidelines on:

  • Food
  • Wound care
  • Drugs
  • Pain management
  • Activities you can do
  • Return to work

Alternatives to this procedure

The appropriate treatment to remove the cancer will vary depending on the type of cancer itself, its stage or location, among other factors. Surgery is effective especially when the tumor has not spread to other parts of the body. In these cases, it offers a better chance of cure. Surgery can also be used to treat problems caused by the cancer, such as the removal of a tumor blocking the bowel.

There are other treatments that may be used before, after or along with surgery:

  • Radiation therapy
  • Chemotherapy
  • Immunotherapy
  • Direct therapy
  • Hormone therapy
  • Stem cell or bone marrow transplantation