Surgery

What is surgery?

Generally speaking, surgery is indicated in the treatment of most tumours. It is usually the first phase of treatment, but is sometimes preceded and/or followed by chemotherapy and/or radiotherapy.

Cancer surgery naturally involves removing the tumour as precisely as possible. But it is also usually complemented by a lymph-node dissection: the surgeon removes as much as possible of the lymph nodes which drain the tumour and are therefore liable to be affected in their turn. For breast cancer, the sentinel lymph node technique allows a single lymph node to be removed. If it appears healthy, the others will be preserved, whereas if it is affected, the lymph node chain will be removed. These operations are usually practised under the same anaesthetic. The analysis of these lymph nodes will also help decide upon the follow-up to the surgical intervention (chemotherapy, radiotherapy etc.).

Surgery treatment at Institut Curie

• Institut Curie has specialist surgeons for various types of cancers: ENT, digestive, sarcoma, gynaecological, breast and ophthalmologic. Institut Curie is the national centre for retinoblastoma treatment and the leading healthcare centre for choroidal melanoma. More than 4,000 patients with breast cancer were treated at Institut Curie in 2014. Some cancers cannot be operated on in situ. This applies in particular to thoracic and brain cancers. The treatment can however be carried out at Institut Curie: the patient will be operated on in one of our partner establishments and will then return to continue their treatment.
• Outpatient surgery (the patient enters the hospital to be operated on in the morning and leaves the same day) is developing, and is one of the priorities for the coming years. For the time being, it is mainly carried out for ophthalmology, senology and small digestive surgery procedures. The idea is for the patient to return to their usual environment more rapidly, which is more reassuring for them.
• Institut Curie forms part of RENAPE, a network of experts in peritoneal carcinomatosis care, i.e. the treatment of some abdominal cancers which have spread to surrounding tissues. This type of cancer requires very special care, which few centres are able to offer. The treatment consists in particular of performing intra-peritoneal hyperthermal chemotherapy (IPHC). This innovative technique significantly improves life expectancy for this type of cancer, which until recently had a very poor prognosis. The existence of a department of supportive care is particularly important in helping patients in their convalescence after this type of intervention: physiotherapists and dieticians in particular will be of great help to the patient.
• Institut Curie also has an innovative wounds and healing department, a real boon for patients who have undergone major surgery, as well as for the surgeons. The dressings consultation is very reassuring to patients, who no longer need to look for a surgery in town to carry out this special service.

The anaesthetics team is trained in the most innovative techniques. General and locoregional anaesthetics are regularly used. But less common approaches, such as hypnotherapy, are also being developed for the patients’ comfort.