Surgery For Childhood Cancer

Key points about surgery for childhood cancer

• many tamariki with cancer will have surgery during their treatment
• most surgeries happen in the operating room while your child is asleep under general anaesthesia
• your child will need to have an empty stomach if they have an operation under a general anaesthetic

Why might my child need surgery for childhood cancer?

Many tamariki with cancer will have surgery during their treatment.

Surgeons may operate on your child to:

• remove a part or all of a suspicious mass or lump (biopsy) to diagnose or find the stage of a cancer
• put in a central line
• completely remove or reduce the size of a tumour

In some cases, removing the tumour may be the only treatment your child needs but usually, they will also have chemotherapy or radiation to kill any remaining cancer cells.

Surgery is an important part of the treatment for tamariki with solid tumours or brain tumours.

Most surgeries happen in the operating room while your child is asleep under general anaesthesia. The general surgeon, orthopaedic surgeon or neurosurgeon will be part of a team of people caring for your child.

Are there different kinds of surgical removal of tumours?

Resection

This is surgery that removes all or most of the tumour either when your child receives their diagnosis or at a later planned date. Sometimes, surgeons cannot remove a tumour because it is in a difficult place in the body or because the tumour is too large. In this situation, your child may have chemotherapy or radiation before surgery to help shrink the tumour and make it easier for the surgeon to remove.

Debulking

Sometimes a tumour may be too large for the surgeon to remove safely. If this is the case, the surgeon may remove as much as possible without removing it all together (debulking). This can help your child feel more comfortable. Chemotherapy and radiotherapy may then be more effective on the smaller tumour.

'Second look' procedures

Some children with solid tumours and brain tumours may have a 'second look' procedure, 3-6 months after the first debulking. If radiotherapy and/or chemotherapy have shrunk the tumour, it may then be easier for the surgeon to remove it. Or, the surgeon may check the area to see if the cancer has returned and may remove a piece of the surrounding tissue (biopsy) for testing.

Is surgery necessary as part of supportive care?

Supportive care surgery can help your child through their cancer treatment. If treatment makes it difficult for your child to eat, a doctor or nurse may place a feeding tube into your child's stomach or digestive tract. This will stay in place until your child is well enough to eat normally again.

Find out more about tube feeding

Your child will probably need a central venous line (catheter). This line will make it easier to give intravenous (IV) fluid and medicine. It will also make it easier to take blood.

Find out more about having intravenous (IV) fluid and medicine

Does surgery for childhood cancer hurt?

Your child will not feel or be aware of anything during the surgery because they will have a general anaesthetic and will be asleep.

After the surgery, an anaesthetist or another doctor will arrange medicines to help with any pain. The anaesthetist is the doctor who gives the anaesthetic. Their role is to keep your child safe and comfortable before, during and after surgery.

Find out more about having a general anaesthetic

What happens before surgery for childhood cancer?

The anaesthetist will meet with your child and family before the surgery, to discuss the anaesthetic, including risks and benefits. They will explain how they will give the anaesthetic and answer any questions you may have. They will also ask for written consent to give the anaesthetic to your child.

It may be possible for you to go with your child into the operating room and stay until your child is asleep. This can help put your child at ease in a strange environment. It's a good idea to do some preparation before your child has a procedure. This will help give you confidence.

See some suggestions for helping your child before, during and after cancer treatment

Your child will need to have an empty stomach if they are having an operation under a general anaesthetic. This is to reduce the risk of stomach contents getting into your child's lungs while they are unconscious. The anaesthetist and your child's nurse will give you instructions about fasting from food and drink. For your child's safety, it is important to follow the instructions exactly.

What can you do to help your child before their surgery?

Read about fasting and consent for procedures for childhood cancer.

Ask your child's nurse to help you prepare for the procedure if you would like to go with your child into the operating room

Read about coping with cancer treatment and hospital

Read more about childhood cancer